What is nipple discharge?
Breasts are modified sweat glands that are created to make fluid. There are numerous little openings in your nipples through which the fluid can come out.
Nipple discharge (ND) refers to any liquid, other than breast milk, that leaks from your nipple(s). It usually happens during pregnancy and breastfeeding. Some women continue to have a milky white discharge from their nipples for up to three years after they stop breastfeeding.
ND can also be caused by hormonal fluctuations and breast changes due to fibrocystic breast disease.
ND affects one in five women and it can occur from one or both nipples. Although it might be clear or milky looking, the discharge is typically greenish. Its consistency might range from thin and watery to thick and sticky.
It is particularly concerning if ND suddenly develops (you might notice it on your clothes), only emanates from one breast, or is blood-stained. Additionally, it is more concerning when women experience ND after menopause.
What causes nipple discharge?
In addition to pregnancy and breastfeeding, there are numerous other causes of nipple discharge which may include:
- Squeezing or stimulating your nipples can send chemical signals to the pituitary gland in your brain (which prepares your body for breastfeeding), which results in drainage
- A pituitary gland issue or a hormonal issue, such as hypothyroidism
- Medications, such as some antidepressants and birth control pills
- Breast duct inflammation and blockage
- Noncancerous tumors of the pituitary
- Enlargement of the milk ducts
- Use of certain herbs, such as fennel and anise
- Fibrocystic breasts (normal lumpiness in the breast)
- Long-term kidney disease
- Using illegal drugs, such as cocaine, opioids, and marijuana
- Breast infection
- Injury to the breast
- Mastitis and periductal mastitis
What are the symptoms of nipple discharge?
An abnormal nipple discharge (ND) includes:
- Bloody discharge
- Discharge from only one nipple
- Emerges on its own, without you pressing or touching your nipple
It's more likely that an ND is normal if it:
- Emerges from both nipples.
- Results from squeezing your nipples.
How is nipple discharge treated?
The treatment of nipple discharge (ND) is determined by the underlying cause. Treatment can range from a consultation with a doctor to medication and surgical procedures. The course of action depends on the cause. Sometimes, there is no need for treatment. If you are pregnant, the discharge should stop shortly after delivery unless you are nursing.
The following are potential treatments for additional causes:
- Any medication that produced the discharge must be changed
- Eliminate lumps
- Remove some or all the breast ducts
- Get creams to cure the skin alterations around your nipple
- Obtain medication to treat a health issue
How to diagnose nipple discharge
Your doctor will inquire about your signs and symptoms, as well as your past health conditions, and perform a breast exam. Your healthcare professional can identify the cause of the discharge by looking at the color and consistency of the discharge, as well as whether it originates from one or both breasts.
The following tests may be performed:
- Testing hormone levels in the blood (thyroid and prolactin levels)
- Selective breast ultrasound
- MRI of the breast
- Blood test to measure hormone levels (thyroid and prolactin levels)
- Mammary ductoscopy (inserting a thin tube connected to a video camera into the duct)
- Ductogram, also known as a galactogram (filling the problematic duct with a dye and then obtaining a mammogram)
- Biopsy or surgery
When to see a doctor
Nipple discharge (ND) does not always signify breast cancer, but it might point to a problem that requires root-cause intervention.
- If you're still menstruating and your ND doesn't go away after your next menstrual cycle, schedule an appointment with your doctor to get it examined.
- If you're past menopause and you experience a spontaneous ND from just one duct in one breast, get checked out by your doctor immediately.
- If you experience ND that doesn't occur during pregnancy or nursing, it lasts longer than four weeks or you experience any of the symptoms listed above, you should visit your doctor within a week.
- If you experience symptoms of infection in addition to ND, such as redness, swelling, pus-like discharge, or a fever, you should be evaluated in a day or two at most.
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