Nipple Discharge in Women and Men: Types and Causes

Nipple discharge refers to any fluid that dribbles out of the breast. Any unexpected discharge in women who are not pregnant or breast-feeding, needs to be evaluated by a doctor. Nipple discharge in men could hint at a problem and needs further assessment.

One or both breasts may produce a nipple discharge, either suddenly or when you squeeze your nipples or breasts. A nipple discharge may look milky, yellow, green, brown or bloody. Nonmilk discharge comes out of your nipple through the same nipple openings that carry milk. The consistency of nipple discharge may vary from thick and sticky or thin and watery.

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Types of Discharge

Doctors will often ask questions about the discharge to help find the cause. Examples of some of the most common types of nipple discharge include:

  • Milky discharge:This is the most common type of nipple discharge. In women, this can be because the woman has recently stopped breast-feeding or due to hormonal swings in a premenopausal woman.
  • Bloody discharge: This can be caused by a non-cancerous tumor called a papilloma, which can irritate the tissue inside a breast duct. Bloody discharge can be due to cancer in rare cases.
  • Clear discharge: Clear discharge from both breasts is usually less disturbing. However, discharge from one breast can be a symptom of breast cancer.
  • Green-tinged nipple discharge:Discharge of this color can be a symptom of a cyst underneath the nipple that is draining.

Causes of Nipple Discharge

Nipple discharge is a normal part of breast function during pregnancy or breast-feeding. It also may be associated with menstrual hormone changes and fibrocystic changes. The milky discharge after breast-feeding will normally affect both breasts and can endure for up to two or three years after a woman stops breast-feeding.

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A papilloma is a benign or noncancerous tumor that can be associated with bloody discharge. It appears spontaneously and involves a single duct. The bloody discharge may resolve on its own and requires evaluation with an ultrasound of the area behind the nipple and areola. If the ultrasound shows a lesion within a milk duct, you may need a biopsy to confirm. Often, nipple discharge comes from a benign condition. However, breast cancer is a possibility, especially if:

  • Only one breast is affected
  • You have a lump in your breast
  • The discharge is spontaneous and persistent
  • The discharge contains blood
  • The discharge affects only a single duct

Possible causes of nipple discharge in women include:

  • Breast cancer
  • Excessive breast stimulation
  • Abscess
  • Birth control pills
  • Pregnancy and breast-feeding
  • Menstrual cycle hormone changes
  • Ductal carcinoma in situ (DCIS)
  • Endocrine disorders
  • Fibrocystic breasts(lumpy or rope-like breast tissue)
  • Galactorrhea
  • Prolactinoma
  • Injury or trauma to the breast
  • Intraductal papilloma (a benign, wartlike growth in a milk duct)
  • Mammary duct ectasia
  • Mastitis(an infection in breast tissue that most commonly affects women who are breast-feeding)
  • Medication use
  • Paget’s disease of the breast
  • Periductal mastitis

When to see a doctor

Nipple discharge is rarely a sign of breast cancer, but might be a sign of an underlying condition that requires treatment. If you’re still having menstrual periods and your nipple discharge persists after your next menstrual cycle, see your doctor. Also, if you’ve completed menopause and you’re experiencing a spontaneous nipple discharge that involves one breast, see your doctor immediately for further evaluation.

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Nipple Discharge in Men

Nipple discharge in men may be caused by:

  • testosteronedeficiency
  • cancer of the breast
  • gynecomastia, a condition that causes breast enlargement or tenderness
  • pituitary tumor, this is because the pituitary gland is responsible for releasing hormones that cause milk production in the nipples

Nipple discharge is very rare in men, so any man experiencing this should see his doctor immediately.

Babies can also experience nipple discharge soon after birth due to the presence of their mother’s hormones that are still circulating in their bodies. This side effect usually subsides a few days after birth.

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