Any woman who notices nipple discharge from her breast and is not breastfeeding may immediately go into panic mode.  However before immediately fearing the worst, the sight of discharge from a nipple can be alarming but in the vast majority of cases, it most likely is either normal or a minor issue.

But it is recommended unless a woman is pregnant or breastfeeding, to contact her healthcare provider whenever a discharge from the nipple is noticed.  Keep in mind if a doctor determines the discharge to be abnormal most of the conditions causing it are not serious and are easily treated.

What is considered abnormal discharge?

When there is a discharge from the nipple, the nonmilk discharge comes out of the nipple through the same nipple openings that carry milk.  The consistency can vary from being thick and sticky or thin and watery.

Here are signs of discharge from a nipple that would not be normal:

·Bloody discharge

·Discharge coming from only one breast

·Discharge occurring spontaneously without anything touching, stimulating or irritating the breast

·The color of discharge from a nipple is irrelevant as it could be clear, yellow, white, or green in color

What is considered normal nipple discharge is when a discharge occurs in both nipples and typically comes out if the nipples are compressed or squeezed such as during a mammogram. 

Causes of nipple discharge

There can be several reasons for discharge from a nipple to occur:

Pregnancy and breastfeeding - When a woman is pregnant or breastfeeding, discharge from the nipples is a normal part of breast function during this time.  In the early stages of pregnancy, there can be a clear breast discharge coming from the nipples.  In the later stages right before the baby is born, the discharge may have a more watery or milky appearance in preparation for the baby to nurse.  Even after a woman has stopped breastfeeding, there can still be a milk-like discharge from the nipple that can be present for a while.

Hormonal or fibrocystic changes - For women who are not pregnant or breastfeeding, the discharge could be associated with changes in hormones involved in a woman’s menstrual cycle or it could be from fibrocystic changes in the breast. 

Galactorrhea – This can cause a woman to secrete a milky discharge even though she is not pregnant or breastfeeding.  It could be caused by a pituitary gland tumor, certain medications, some herbs such as anise and fennel, hypothyroidism or smoking marijuana.

Infection – If the discharge contains pus, this usually indicates there is an infection going on.  Typically this is mastitis which usually occurs in women who are breastfeeding.  However, it can occur in women who are not lactating. Other symptoms of mastitis are if the breast is sore, red, or warm to the touch.

Mammary duct ectasia – This is seen in women who are approaching menopause and is inflammation and possible blockage of ducts located underneath the nipple.  The discharge from this would appear thick and greenish.

Stimulation - Stimulation of the nipples can cause them to secrete a fluid.

Intraductal papilloma - A noncancerous tumor called a papilloma can be the source of a bloody discharge from a nipple.  The discharge can resolve on its own but it may require an evaluation with an ultrasound of the area behind the nipple and areola.  The papilloma can be caused by a noncancerous growth within a milk duct which would require a biopsy to get an accurate diagnosis and to rule out cancer.

Other causes of nipple discharge can be the following:

·Abscess

·Birth control pills

·Endocrine disorders

·Medicationuse

·Paget’s disease of the breast

·Prolactinoma

·Injury or trauma to the breast

What about nipple discharge and breast cancer?

This is probably the most concerning and forefront assumption many women may jump to if they discover nipple discharge.  Generally, most women can be rest assured as most nipple discharge is caused by a benign medical condition.

There is though, a greater likelihood of breast cancer if the nipple discharge is accompanied by a lump or mass within the breast or if a woman has an abnormal mammogram. 

Treatment

The treatment of nipple discharge will depend on the cause of it. Once this is determined, a doctor will recommend ways to treat it which could be changing a medication or recommending a medication to treat an underlying health condition, creams to treat skin changes around the nipple, or they may be no need for any treatment.