What could cause breast pain and nipple discharge?

Question

Hello doctor,

I had an I-pill out of panic, even though there was no intercourse and just dry sex, and after four days, I started having severe pain in my breasts. I had it examined by a gynecologist, who said no lumps were found. She prescribed Primocare-1000 (a multivitamin supplement) and vitamin B tablets. A few days later, I noticed a very small white discharge from my left nipple, and on that day, I had my period, too.

Within two to three days after my period, the breast pain vanished. But now, again, it has been around five days, and I am having a throbbing, burning kind of pain in my left breast, and the nipple opening is also visible, although I did not find any discharge. What could be the cause of this pain and discomfort?

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I can understand your concern.

Thanks for the detailed timeline; it helps in narrowing down the likely causes. Here is a breakdown of what is happening and what might be behind your symptoms: You took an I-pill (Levonorgestrel, an emergency contraceptive) even though there was no actual intercourse, just dry sex. Around four days later, you developed severe breast pain. A gynecologist examined you, found no lumps, and prescribed Primocare-1000 (a multivitamin supplement) and vitamin B tablets, which are often used for mastalgia (breast pain).

A few days later, you noticed very mild white nipple discharge and started your period on the same day. After your period ended, the pain resolved. However, after a few days, you experienced a return of throbbing/burning pain in your left breast, with the nipple opening visible, though no discharge was found.

Based on your symptoms and the emergency contraceptive use, here are the most likely explanations:

Hormonal fluctuations (most likely) - The I-pill (Levonorgestrel) contains a high dose of synthetic progesterone, which alters your hormone balance abruptly. This can cause breast pain or burning (mastalgia), nipple sensitivity, clear or milky discharge, and cycle disruption or PMS-like symptoms without pregnancy. Since your period came about a few days later, your body likely went through a mini hormonal rollercoaster, which is common after emergency contraception.
Benign breast condition (like ductal ectasia or fibrocystic changes) - The visible nipple opening and temporary discharge could point to minor ductal changes, which are not dangerous but can cause localized pain. These conditions can flare up around hormonal shifts, such as just before or after periods.
Prolactin elevation: Nipple discharge and pain without pregnancy can sometimes be due to raised prolactin levels (a hormone that affects breast tissue). This might happen transiently after stress or hormonal changes, but if it persists, it could need checking.
Local irritation or nerve pain - Burning or throbbing pain can also be caused by nerve-related discomfort in the chest wall or breast (like intercostal neuralgia), which may feel worse near ovulation or the period.

Monitor and track symptoms, note when the pain worsens (cycle-related), any discharge, or changes in shape or skin. If it has been a few weeks since the last check, and symptoms persist or worsen, it is worth repeating a clinical breast exam and possibly getting a breast ultrasound.

I suggest you do the following -

Blood tests (if symptoms continue): Prolactin, thyroid function (TSH). These hormones affect breast tissue and may be involved.
Consider continuing Vitamin B complex and Primocare. These are often effective for cyclical mastalgia and might take a few cycles to show full benefit.
Avoid caffeine and salt (optional but helpful in some women): This can reduce breast pain if related to fluid retention or fibrocystic changes.

Red flags (see a doctor as soon as possible if you notice): Bloody or persistent milky discharge from one nipple, skin changes (dimpling, puckering), a lump that feels fixed or growing, pain that worsens despite treatment. This is very likely hormonal and benign, especially given the timing of the I-Pill and your cycle, but it is smart to stay alert and proactive.

I hope this helps.

Thank you.