Persistent Breast Discharge: Causes, Fertility & Testing

Question
Dear Doctor,
My wife has been experiencing heavy breast discharge roughly for the past 7years.both the breasts have discharge, which is clear but sometimes milky.
she has had her prolactin levels rechecked time and again but the reports are always normal.What other causes can there be for this problem. can this effect her fertility. what other tests can clear this problem if its not high prolactin.
thank you.
Regards
Khan

Answer
Usually, if the prolactin level is normal, there is no problem. However, I have had a patient who had milky discharge from her breasts and a normal prolactin level. The discharge did not stop and I sent her for imaging studies of her pituitary gland, anyhow. It showed a microadenoma of the pituitary gland, which was treated with Parlodel, and completely resolved. If,in spite of normal prolactin levels, your wife still has a milky discharge from her nipples, I would suggest imaging studies (either CT scan or MRI) of her pituitary gland, just to make sure t here is no abnormality that can be treated.