Nipple Discharge | Causes | Diagnosis | Treatment
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Nipple Discharge - Causes, Diagnosis and Treatment

Published on May 26, 2022 and last reviewed on Apr 11, 2023   -  5 min read


Nipple discharge is a normal condition during hormonal variations. This article explains the causes of normal, abnormal nipple discharge and its treatment.

What Is Nipple Discharge?

When any fluid leaks out of the nipple of the breast, it is referred to as nipple discharge.

Nipple discharge during pregnancy and breastfeeding is normal. It can also occur during stimulation of the nipple, such as suckling, irritation from clothing, or sexual arousal. It is wise to consult a doctor if the nipple discharge is spontaneous. There usually are 15 to 20 milk ducts opening onto each nipple. Nipple discharge can come from one or several ducts. The consistency of nipple discharge can vary; it may be thick and sticky or thin and watery.

What Are the Causes of Normal Nipple Discharge?

Nipple discharge is considered normal. The fluid can be extracted from the nipples with the help of breast pumps and other special techniques. The fluid that can be extracted varies from 50 % to 70 % of average women. This discharge from a normal breast is referred to as physiological discharge. This discharge is milky, yellow, or green in appearance, and it does not happen spontaneously. Therefore, physiological nipple discharge is not a cause for concern.

A normal nipple discharge may be due to the following:

  • Pregnancy - In the early and late stages of pregnancy, there will be watery and milky discharge from the nipple.

  • Discontinuation of Breastfeeding - After nursing the baby, some women may experience milk-like breast discharge that persists for a while.

  • Stimulation - During stimulation or when squeezed, the nipples may secrete fluid.

What Are the Causes of Abnormal Nipple Discharge?

There are many causes of nipple discharge. These include:

Duct Ectasia:

This is a noncancerous (benign) condition in which the ducts under the nipple enlarge due to inflammation and become clogged with thick discharge. It usually occurs in women after menopause. The discharge can be green, brown, black, or very thick and have a cheese-like consistency. It usually affects both the breasts. In most cases, no treatment is required; hot packs can relieve any discomfort. However, the ducts can be removed surgically if the discharge is annoying.

Duct Papilloma:

A duct papilloma is a noncancerous growth within a milk duct in the breast, usually near the nipple. It may remain primarily asymptomatic or cause discharge from the nipples that are clear or blood-stained. It usually involves a single milk duct and is from one breast. They are the most common reason women experience abnormal nipple discharge. Rarely, duct papillomas can be associated with breast cancer called ductal papilloma in situ.

Nipple Eczema:

Eczema or dermatitis can cause a weeping, crusty nipple discharge when the skin of the nipple becomes infected. Cortisone-based creams are the first-line treatment, which is similar to eczema treatment.

Breast Cancer:

Breast cancer is a rare cause of nipple discharge. Nipple discharge can be an early sign of breast cancer. Less than 5 percent of women with breast cancer have nipple discharge.

Paget's Disease of the Nipple :

Paget's disease is an uncommon type of breast cancer that involves the nipple. Paget's disease typically causes ulceration, scaling, or flaking of the nipple skin, with a blood-stained nipple discharge.


Galactorrhoea can occur in anyone, regardless of sex or age. It causes milky nipple discharge, not related to pregnancy or breastfeeding. Instead, it is caused by the increased production of a hormone called prolactin. This is a hormone involved with breast growth and breastfeeding. Galactorrhea is not a disease and has many possible causes.

These include:

  • Pituitary gland tumors.

  • Hypothyroidism.

  • Herbs such as fennel and anise.

  • Hormones and psychotropic drugs.

  • Illegal drugs such as marijuana.

Fibrocystic Breast Changes:

The presence or development of fibrous tissue and cysts is called fibrocystic breast. It may cause lumps or thickenings in the breast tissue. The fibrocystic breast can cause pain, itching, and rarely clear, white, green, or yellow nipple discharge.

What Is the Connection Between Cancer and Nipple Discharge?

Most nipple discharges are either normal or are caused by a noncancerous medical condition. In the case of breast cancer, the discharge will probably come from one breast (unilateral) and mostly accompanied by a lump. Discharge from the breast may be a symptom of some forms of cancer like ductal carcinoma in situ (DCIS), an early form of breast cancer that develops within the ducts of the breast located beneath the nipple, or with Paget's disease, a rare type of breast cancer involving the nipple. It can cause the nipple and the surrounding areola to bleed. Therefore, it is advisable to get checked for breast discharge, especially if it is a new symptom.

How Is Nipple Discharge Diagnosed?

The diagnosis of nipple discharge is based on the medical history and physical examination. The tests used to identify the cause of the discharge includes:

  • Imaging: Tests including mammography (breast X-ray used to identify any abnormal growth or changes), MRI (magnetic resonance imaging), and ultrasound can help identify any abnormal changes, thus helping in identifying the cause.

  • Biopsy: If the imaging tests or physical examination show any abnormalities, the doctor advises a biopsy, in which a sample of breast tissue is examined.

  • Blood tests: A blood test is recommended to measure hormone levels.

What Is the Treatment for Nipple Discharge?

The treatment options for nipple discharge depend on the cause of the discharge. Some cases, such as discharge in later pregnancy or physiological discharge, do not require treatment. Nipple discharge that is spontaneous, blood-stained, persistent, and unrelated to pregnancy or breastfeeding must be investigated further. Nipple discharge from breast cancer often occurs when the tumor is in the initial stage; understanding it and providing prompt treatment helps to reduce the consequences.

The treatment depends on the cause of nipple discharge and may include:

  • In case of infections, antibiotics are recommended. If an abscess is present, it needs to be drained.

  • In the case of fibrocystic disease, aspiration (withdrawing fluid through a needle) of the breast cyst or cysts can solve the problem.

  • Intraductal papillomas are symptomatic and can be removed surgically.

  • Mammary duct ectasia does not require any specific treatment; warm packs ease the discomfort until the condition fades away on its own.

  • Breast cancer requires surgery, radiation, chemotherapy, and hormone therapy.

Conclusion :

Nipple discharge cannot always be a cause of concern; it can occur in anyone during pregnancy and menopause. The nature of the discharge and associated symptoms can help determine the cause of nipple discharge. If the discharge is spontaneous and persistent, do consult the physician. Treatment depends on the cause of the discharge.

Frequently Asked Questions


Is It Normal to Have Nipple Discharge?

Nipple discharge commonly occurs in both nipples, and it is often released when the nipples are squeezed or compressed. Nipple discharges are common during the following situations:
Pregnancy - During the early stage of pregnancy, some women get clear nipple discharge coming from their nipples. But during the later period of pregnancy, this discharge will be a watery, milky appearance.
After Breastfeeding - Even after stopping breastfeeding the baby, many women notice a milk-like breast discharge for a while.
Stimulation - Upon stimulation or squeezing, nipples might secrete fluid. Nipple discharge is normal when the nipples are repeatedly chafed by the bra or during vigorous exercise.


When Should I Be Considered About Nipple Discharge?

Immediate attention is required when the following symptoms are experienced:
- Spontaneous and regular nipple discharge.
- When discharge happens only from one breast.
- If the discharge is bloodstained or smelly.
- If you are not a breastfeeding mother and discharge happens without any pressure on the breast.
- Over 50 years of age.
- Discharge along with lump, redness, pain, or swelling in the breast.


Why Does Fluid Comes Out of the Nipple While Squeezing?

Nipple discharge is common during pregnancy or breastfeeding. It is also seen during menstrual hormone and fibrocystic changes during stimulations. These discharges are caused by abnormal levels of prolactin hormone production.


When Is the Nipple Discharge Common?

Nipple discharge is common during pregnancy, during and after breastfeeding, upon stimulation, and during hormonal changes.


Does Stress Cause Nipple Discharge?

Stress can also cause nipples to discharge. When a person is stressed, the body releases prolactin which causes milky white nipple discharge. If the discharge happens during stressful incidents, try to reduce the stress.


Will Nipple Discharge Be Caused Due to Hormonal Changes?

During menstruation, the hormones act as a rollercoaster. Due to these changes, many side effects develop, and nipple discharge is one such. To control this, the gynecologist may suggest hormonal birth control pills.


What Is the Treatment for Nipple Discharge?

The treatment depends on the cause of the nipple discharge. Physiological discharge and discharge during later pregnancy do not require any treatment. Other treatment options are:
Infections - Antibiotics are recommended for discharge caused due to infections. If there is an abscess, then draining of the abscess is needed.
Fibrocystic Disease - Withdrawing fluid through a needle from the breast cyst or cysts is needed.
Intraductal Papillomas - Surgical removal is required.
Mammary Duct Ectasia - It does not require any specific treatment. Using warm packs helps in reducing the discomfort.
Breast Cancer - It requires surgery, radiation, hormonal therapy, and chemotherapy.


Which Infection Causes Nipple Discharge?

Mastitis is the infection of the breast causing nipple discharge that contains pus. Mastitis is normally seen in breastfeeding women. But it can also develop in women who are not breastfeeding. The infection or abscess of the breast can cause soreness, redness, or feel warm to the touch.


Does the Thyroid Cause Nipple Discharge?

Women with an underactive thyroid can have nipple discharge from both the breasts as a side effect of some medications or due to a growth in the pituitary, resulting in an increase in a hormone called prolactin.


What Color of Nipple Discharge Is Normal?

The normal nipple discharge color is typically milky, yellow, or green in appearance. The nipple discharge does not happen spontaneously, and it is often seen coming from more than one duct. Milky nipple discharge is also normal during pregnancy and breastfeeding.


Does Drugs Cause Nipple Discharge?

Certain drugs causing nipple discharge as a side effect include:
- Antihypertensive Drugs - Methyldopa, Reserpine, Verapamil.
- Gastrointestinal Agents - Cimetidine, Metoclopramide.
- Hormones - Estrogen, oral contraceptives.
- Opiates - Codeine, Heroin, Methadone, Morphine.
- Psychotropic Agents - Antipsychotics, Monoamine oxidase inhibitors,
- Neuroleptics, Selective serotonin reuptake inhibitors, Tricyclic antidepressants.


Is Nipple Discharge Common During Puberty?

Women are at a high chance of nipple discharge during puberty and just before menopause. When the nipple is squeezed, the hormone prolactin is activated, and the nipple discharge is initiated. The discharge will be a clear, white, or cloudy discharge that appears when the nipple is pressed and is usually normal.


What Are the Symptoms of Nipple Infection?

In case of nipple infection, the nipple will be itchy, swollen, and warm. The nipple discharge will contain pus, and the skin will appear red.

Last reviewed at:
11 Apr 2023  -  5 min read




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