What Causes Clear or Bloody Nipple Discharge? Your Symptoms Explained
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Breast discharge can be caused by normal and abnormal hormonal changes. Pregnancy and breastfeeding are normal hormonal changes that can cause milky nipple discharge. Cancerous and non cancerous breast conditions can also cause discharge from the nipples. Read now for more information on causes and treatment options.
Nipple discharge symptoms
Discharge from one or both nipples, called galactorrhea, can be alarming, but it is usually not a sign of a serious medical condition. The characteristics of discharge will vary based on the underlying cause. A detailed description of the color, when the discharge occurs, and accompanying symptoms will allow your physician to determine whether tests and imaging are needed.
Common characteristics of nipple discharge
If you're experiencing nipple discharge, it can likely be described by:
- Color: It may be bloody, clear, milky, yellow, or black.
- Onset: Discharge may occur spontaneously or only when pinching the nipple.
- Unilateral or bilateral: Discharge may come from just one or both nipples.
- Location: Discharge may come from a single location on the nipple or from multiple spots.
Common accompanying symptoms
If you're experiencing nipple discharge, it's likely to also experience:
Nipple discharge causes
The following details may help you better understand your symptoms. If your nipple discharge persists or becomes worrisome due to other symptoms, see a physician.
Normal hormonal changes
An elevated level of prolactin, the hormone that stimulates lactation, can cause the production of breast milk.
- Pregnancy: Increased levels of estrogen in pregnancy can cause milky nipple discharge.
- Breastfeeding: After delivering a baby, milk is produced and released from the nipples to allow breastfeeding.
Abnormal hormonal changes
Certain medical conditions and medications can cause elevated prolactin in the absence of pregnancy or breastfeeding. In addition to causing nipple discharge, high prolactin commonly causes menstruation to stop.
- Thyroid disorders: An abnormally low level of thyroid hormone can indirectly lead to high prolactin levels. Other possible symptoms of low thyroid hormone include constipation, fatigue and constantly feeling cold.
- Pituitary tumor: A tumor in the pituitary gland in the brain can cause increased prolactin levels. This condition can be associated with headaches and decreased peripheral vision.
- Medication side effect: Certain medications cause a decrease in dopamine, which normally inhibits prolactin. As a result, prolactin increases and stimulates milky nipple discharge. Antipsychotic medications commonly have this side effect. In addition, some antidepressants and antihypertensives can also cause galactorrhea.
- Chronic medical conditions: Liver or kidney disease can cause elevated prolactin, leading to milky nipple discharge.
- Chest wall abnormalities: Injury, infection, or surgery of the chest wall can cause abnormal signaling that results in high prolactin and nipple discharge.
The following breast conditions may result in nipple discharge.
- Benign breast problems: Abnormalities, such as growths or blockages, of one or more of the ducts that transport milk to the surface of the nipple can cause discharge. Changes in the breasts around the time of menstruation can also cause nipple discharge.
- Breast infection: An infection can cause nipple discharge filled with pus. The breasts are particularly vulnerable to infection during breastfeeding. Typically, there will also be redness and pain.
- Breast cancer: Rarely, nipple discharge can be a sign of cancer in the breast. In this case, the discharge will be present on just one side with other symptoms such as a mass or a rash on the nipple.
5 nipple discharge conditions
The list below shows results from the use of our quiz by Buoy users who experienced nipple discharge. This list does not constitute medical advice and may not accurately represent what you have.
High prolactin hormone level
Hyperprolactinemia is a common hormonal disorder in which there are higher than normal levels of prolactin in the blood.
Top Symptoms: headache, vaginal bleeding, irregular period, decreased sex drive, enlargement of breasts
Urgency: Primary care doctor
Physiologic breast discharge
Physiologic breast discharge is any fluid that comes out of the nipple area in your breast.
Top Symptoms: nipple discharge, randomly leaking fluid from the breast
Symptoms that never occur with physiologic breast discharge: breast lump
Urgency: Primary care docto
There are several types of breast cancer, depending on the part of the breast where it starts. The most common types are ductal carcinoma in situ (DCIS), invasive ductal carcinoma and invasive lobular carcinoma.
Women over age 50 with a family history of the disease, and/or certain genetic factors, are most at risk, but anyone can get breast cancer at any age. It is rare in men but does occur.
Symptoms include a lump, thickening, or pain anywhere in the breast or armpit; red, flaky, or irritated breast or nipple skin; nipple discharge; and any area of irregular skin or misshapenness.
Many harmless conditions can cause similar signs, so it is important to see a medical provider about any of these symptoms.
Diagnosis is made through physical examination; imaging such as ultrasound, mammogram, or MRI; and sometimes biopsy.
Treatment involves a combination of surgery, radiation therapy, and chemotherapy.
The best prevention is a combination of screening mammograms as recommended by the medical provider, and monthly self-examination.
Top Symptoms: breast pain, armpit lump, breast mass or retraction, breast lump, nipple discharge
Urgency: Primary care doctor
Breast problems such as lumps are very common and often not caused by breast cancer. An intraductal papilloma is such a benign breast lump situated in the milk ducts.
Top Symptoms: breast lump, painful breast lump, painless breast lump, white or clear fluid leaking from the breast, nipple lump
Symptoms that never occur with intraductal papilloma: armpit lump
Urgency: Primary care doctor
A prolactinoma is abnormal growth of the cells that produce the hormone prolactin in the pituitary gland, a small endocrine gland at the base of the brain. Prolactinoma leads to hyperprolactinemia or excess levels of prolactin in the bloodstream. Prolactinomas can occur in men or women but are more c..
Nipple discharge treatments and relief
Most cases of nipple discharge do not require urgent evaluation. A breast infection is one exception, however, since the infection can spread to the rest of the body.
Home treatments may help with nipple discharge, such as the following.
- Wear loose clothing and avoid stimulating the nipples
- Cover the nipples with pads: This can prevent clothes from getting stained or wet.
- If you are breastfeeding: You should continue to breastfeed and make sure your breasts drain completely.
- Warm compresses
When to see a doctor
Persistent nipple discharge, especially among other symptoms, may require tests and imaging. Make an appointment with your physician if:
- You recently started a new medication
- Your nipple discharge is present only on one side
- You notice a mass in the breast
- Your discharge appears spontaneously, without squeezing the nipples
- You have bloody or clear discharge
Your physician may prescribe one or more of the following treatments, depending on the cause of your nipple discharge:
- Stopping a medication that may be responsible
- Decrease prolactin levels: Likely with a new medication.
- Address a thyroid disorder: Likely with a new medication.
- Antibiotics and/or drainage to treat a breast infection
- Referral to a surgeon: This is if a tumor in the breast or pituitary gland has been discovered on imaging.
When it is an emergency
Seek emergency nipple discharge treatment if:
FAQs about nipple discharge
Can hormones cause nipple discharge?
Elevated prolactin levels cause milk production in the breasts, leading to nipple discharge. This occurs as a normal part of pregnancy and breastfeeding. Medical conditions that cause a high level of the prolactin can lead to milky nipple discharge. In some cases, the high prolactin is caused by changes in other hormones, such as estrogen and thyroid hormone.
Several medical conditions can cause milk production when you are not pregnant or breastfeeding. These include hypothyroidism (low levels of thyroid hormone), pituitary tumors, and liver or kidney disease. Some medications can also cause milk production as a side effect.
Why is there a clear discharge from my breast when squeezed?
Nipple discharge that only occurs with squeezing is usually normal. However, you should see a physician if the discharge comes from only one breast, if it continues without stimulation, if you notice a mass, or if the discharge becomes bloody or straw-colored.
Why do I have nipple discharge before my period?
Nipple discharge can occur as part of the fibrocystic breast changes that happen before menstruation in some people. In this case, the discharge will likely be bilateral and dark in color, and the breasts will become tender and lumpy.
Why do I discharge from one nipple?
Discharge from only one nipple is likely caused by a process occurring only in that breast. Possible causes include a breast infection, blockage of a duct, or a type of benign growth called intraductal papilloma. Rarely, discharge from just one nipple can be a sign of breast cancer. Unilateral nipple discharge should be evaluated by a medical provider.
Questions your doctor may ask about nipple discharge
- Has anyone in your family had cancer?
- Do you currently smoke?
- When was your last menstrual period?
- What color is your discharge?
Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.
Lauren is a resident physician in family medicine at the University of Illinois at Chicago. She earned her medical degree at the University of Pennsylvania and her undergraduate degree at Oberlin College. Lauren also has an interest in teaching as well as experience with college tutoring and writing MCAT preparatory materials. She believes family medicine challenges her to maintain a broad field of medical knowledge and she hopes to work in an academic setting in the future. In her free time, Lauren enjoys running, reading, and visiting historic sites.
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