Doc, why do my breasts still produce milk?

Dr Flo, is it normal for milk to come out of my breasts when stimulated? I have never been pregnant. Jackie

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Dr Flo, I am 23 and my right breast produces milk when pressed. I gave birth in 2014 and stopped breastfeeding in 2016. Both breasts were producing milk when pressed long after I stopped breastfeeding; now it is just the right one. Is this normal? Fortunate

Dear Jackie and Fortunate,

It is possible to induce production of milk through repeated stimulation, either with the hands, by sucking or by using a breast pump, even without pregnancy or normal lactation and even in someone who has never been pregnant.

For someone who has been pregnant, as long as you keep stimulating the breasts, by pressing or sucking, milk will be produced.

About six weeks after breastfeeding stops, most people stop producing milk. In a few people this does not happen, but as long as there are no additional issues like pain or breast lump, there is no need to worry.

To avoid milk production, avoid breast stimulation (pulling, pinching, and sucking) and do not wear clothes that have a lot of friction between your nipples and the fabric.

Visit a doctor for a physical breast exam. You may have tests done to find out if you have high prolactin levels (the hormone that causes milk production), and if you have other disorders. If no underlying problem is found, there are medications to reduce prolactin levels if necessary, which will stop the milk production.

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Dr Flo, what causes of loss of libido or lack of sexual pleasure? AW

Dear AW

The normal male sexual response cycle involves desire, arousal, plateau, orgasm and ejaculation, and resolution.

 Low libido means a decrease in desire. It is normal for interest in sex to change based on life circumstances.

For some people, this reduced or lack of interest may be due to underlying issues like low testosterone, chronic illnesses (like liver disease, heart disease, cancer), sleep problems, ageing, depression, stress, relationship issues, alcoholism and drug abuse, too little or too much exercise and some medications like antidepressants, especially SSRIs.

To manage it, eat a regular, balanced diet, exercise, get enough sleep and manage stress. Be evaluated by a doctor, and if there is an underlying illness, it should be managed. Medications that may be causing the problem can be changed.

Low testosterone levels can be managed with testosterone replacement therapy. Counselling and psychotherapy can also help.

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Dr Flo, my feet itch and sometimes I feel a lot of pain when I wear open shoes or when my feet are exposed to air. What’s the problem? Dorcas

Dear Dorcas,

The itching and pain could be due to a nerve problem. Other causes are fungal infection, sweating, impaired blood flow and inflammatory skin conditions like skin allergy, eczema or psoriasis. On rare occasions, itchy feet can be caused by liver or kidney disease.

To manage it, do not stand for long; move around every few minutes, to help with blood flow and relieve pressure from your nerves and muscles. You can also sit down after standing for a while, and raise the legs with a pillow or foot rest.

Use cold packs to cool your feet or soak your feet in warm water and then massage them to improve blood supply. Wear clean socks and aerated shoes with good insoles, and don’t wear the same shoes on consecutive days. Avoid walking on wet surfaces to avoid getting a fungal infection.

Have a doctor review and examine you and do tests like blood sugar test, vitamin deficiency test, nerve conduction study, etc., and if a particular illness is suspected, tests targeting that specific illness.

If an underlying cause can be identified, treating it will stop any further nerve damage. For example, if the problem is diabetes, the best way to control the symptoms is by controlling blood sugar levels.

Unfortunately, nerves do not heal easily and any damage may not be reversible.

Medication can be given for the pain including painkillers, pregabalin, amitriptyline, gabapentin and other medications that help relieve nerve pain. Vitamin B supplements may also be given.

If you have a fungal infection, it can be easily treated with antifungal medication. Inflammatory skin conditions can be managed with creams and oral medications.

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