In all genders, nipple discharge is a fairly common concern, although it is seen more often in women. It can be any fluid that oozes out of the nipple and can range in colour from clear or milky to green or bloody. Although it’s often harmless—particularly when it’s linked to hormonal changes or breastfeeding—it can sometimes alert patients and medical professionals to more significant underlying conditions.
In most cases, discharge or leaking from the nipple is not a cause for concern, but it can also be concerning; it is worth understanding the causes behind the symptom, associated symptoms, and when to seek professional guidance for early detection and peace of mind. Educating patients with the right and caring information is key to the betterment of their health and wellbeing at Chase Lodge Hospital. In this article, we will explain what nipple discharge is, some potential causes, the symptoms, how it can be diagnosed, and what treatments are available, all in terms you can readily understand, as someone in the UK.
What Is Nipple Discharge?
Nipple discharge is any fluid that leaks from a breast nipple. The discharge may be white, yellow, green, brown, clear or bloody. The discharge may be thin, thin and watery, thick or sticky. It can occur from one or both nipples and may be spontaneous or only when the nipple is squeezed.
Nipple discharge is more commonly seen in women, but, when present in men, it must always be considered worthy of evaluation. In females, it could present as an element of normal hormonal fluctuations or in a background of troublesome breast pathologies. The nature of the discharge, when it occurs and whether it is associated with other symptoms can guide the physician toward its cause and whether it needs further evaluation.
Common Causes of Nipple Discharge
There are several possible conditions that can cause nipple discharge—some benign, others needing treatment by a doctor.
Benign Causes:
- Fibrocystic breast changes are a common cause, most often caused by hormonal shifts that occur during the menstrual cycle. This can lead to sore breasts, lumps and, rarely, discharge from the nipples.
- Lactation is the most common and completely normal reason for discharge for women who are nursing or have recently given birth.
- Some medications, like oral contraceptives and some antidepressants (notably SSRIs), can also cause stimulation by affecting hormones.
Infections and Injuries:
- Mastitis, or breast infections, particularly during breastfeeding, can prompt yellow or greenish discharge, sometimes with fever or swelling.
- Injury or trauma to the breast tissue can also cause temporary discharge due to damaged ducts.
Duct Ectasia:
- Duct ectasia, which is a common condition in older women, occurs when milk ducts under the nipple widen. This can lead to thick, sticky discharge that can be green or black and is generally harmless.
Prolactinoma:
- A prolactinoma—a non-cancerous tumour of the pituitary gland that results in increased levels of prolactin—can lead to a milk-like discharge even in people not pregnant or nursing.
Breast Cancer:
- While uncommon, nipple discharge can indicate breast cancer, especially if the fluid is bloody, spontaneous and one-sided.
Blood in the Discharge:
- The most common cause of bloody nipple discharge is intraductal papilloma (a benign growth arising in the milk ducts). However, in a small percentage of cases, blood-tinged discharge may also be associated with malignancies, such as ductal carcinoma, and may warrant further medical attention.
Nipple Discharge During Pregnancy
Hormonal changes associated with pregnancy—most notably the increase in prolactin—can cause nipple discharge in the first trimester. It can look clear, yellow or slightly bloody and is generally harmless.
Some pregnant people experience bloody discharge from an increase in blood flow and the formation of milk ducts. Although this can be a common element of pregnancy, it’s always a good idea to let your midwife or GP know so they can rule out other conditions. At Chase Lodge Hospital, we frequently see expectant mothers and tell them that such symptoms are usually harmless, as part of the body’s normal preparations for breastfeeding.
Symptoms Associated with Nipple Discharge
These symptoms include:
- Pain or tenderness in the breast (probably the most common symptom associated with nipple discharge)
- Redness or other changes to the skin surrounding the nipple (but not in the nipple itself)
- More than one lump (although the lump can be benign)
To Prevent Nipple Discharge
Nipple discharge during pregnancy or after childbirth is normal as it will happen when the breast starts producing milk in preparation for breastfeeding.
Some symptoms, when observed alongside nipple discharge, can be indicative of a more serious problem. It is crucial to monitor and report one or more of the following:
- Bloody, clear, yellow or green discharge
- Nipple leakage without nipple compression
- Non-resolving, persistent discharge
- Pain, tenderness, swelling or a lump
- Discharge from just one nipple, particularly in individuals who are not breastfeeding
If any of these are present, especially if in combination, it is worth seeing a GP or breast specialist.
Diagnosis of Nipple Discharge
A detailed clinical breast examination by a GP or specialist is often the first step in diagnosing the cause of nipple discharge. Further diagnostic measures, based on the findings, can include:
- Mammogram: A specialised X-ray that detects conditions in breast tissue, particularly in people over the age of 40.
- Ultrasound: Useful for visualising cysts, masses or ductal changes.
- Blood tests: To check hormone levels, especially prolactin.
- Biopsy: If a lump or suspicious area is discovered, a small sample of tissue may be removed to rule out cancer.
Nipple Discharge Treatment Options
Managing nipple discharge is generally based on the cause of the discharge. In many cases, particularly if the discharge is linked to hormonal fluctuations or other benign conditions, no treatment is needed other than observation.
When intervention is required, these may include:
- Antibiotics for treating infections like mastitis.
- Hormone therapy or adjustment for medical treatment if discharge is associated with medications or hormonal disorders.
- Surgical resection of intraductal papillomas or excision of involved ducts for persistent, unexplained or bloody discharge.
- Avoid unnecessary nipple stimulation or check current medications with your GP.
We have flexible offers available at Chase Lodge Hospital to offer a patient-centred approach to different illnesses.
When to See a Doctor
You need to seek medical advice if:
- There is bloody or clear discharge without an explanation.
- The discharge is constant or from only one breast.
- It comes with lumps, pain, swelling or skin changes near the nipple or breast.
When assessed quickly, early treatment can be offered and outcomes improved.
Conclusion
Nipple discharge is often harmless, but it should never be brushed off—particularly if it happens unexpectedly or comes with other concerning symptoms. Understanding the potential causes and when to pursue them further can help people catch issues early and find peace of mind.
At Chase Lodge Hospital, we seek to empower patients to make informed decisions about their breast health. If you are worried about your nipple discharge or related symptoms, feel free to book a consultation to see one of our specialists. That’s why early detection and expert care are so critical.
