What Is Nipple Discharge? Types

Breast health can be an important aspect of female fertility. These glandular organs are highly sensitive to hormone levels and undergo changes themselves in sync with a woman's menstrual cycle. Seeing a discharge from the nipples can make people question, 'is nipple discharge a sign of female infertility?'

Although nipple discharge may be completely harmless, you must get it checked. Here is a basic guide on understanding nipple discharge.

What Is Breast Nipple Discharge?

Nipple discharge simply means any liquid that comes out of the nipples on its own or when they are squeezed. The fluid can appear clear, milky, yellow, grey, brown, or bloody and be sticky or watery in texture. Both, males, and females can experience nipple discharge.

Nipple discharge is common in people who are pregnant or breast feeding, but anyone can get nipple discharge. Nipple discharge may not mean anything in some cases, but it can be an indicator of a serous underlying condition, such as breast cancer or breast cyst. Thus, it must never be ignored.

What Kind of Nipple Discharge Is Normal?

Let’s evaluate normal vs abnormal nipple discharge. Nipple discharge may be normal if it is clear, yellow, green, white, or brown in colour. Other not harmful nipple discharge characteristics usually include the following:

• Discharge is coming from both breasts
• Discharge only occurs when pressure is applied on the breast
• Discharge is coming from several milk ducts

The following are some of the usual characteristics of abnormal nipple discharge:

• Discharge is bloody
• Discharge occurs on its own
• Discharge happens from only 1 breast
• Discharge accompanies pain, redness, or swelling in and around the nipples or changes in the shape of the nipples

Normal nipple discharge can be caused due to the following:

Pregnancy

Women may notice clear discharge from their nipples in the early stages of their pregnancy and a milky discharge in the late stages of their pregnancy.

Stopping Breastfeeding 

If you plan on stopping breastfeeding your little one, you are advised to expect milk-like discharge from your nipples. This type of nipple discharge can continue up till 1 year.

Stimulation 

Nipples may secrete discharge upon being stimulated or squeezed in some cases. This may also occur, if your nipples are chaffing against your bra or other piece of clothing.     
Although not common, but sexual arousal can also be the cause of nipple discharge.

Medication 

Certain medicine, including birth control pills, can cause nipple discharge.

Stress

Stress can be the culprit behind nipple discharge as it urges the body to release prolactin.

What Are the Types of Nipple Discharge?

The most common types of nipple discharges are listed below:

• Bloody discharge, which is usually caused by papilloma
• Milky discharge, which is the most common type of nipple discharge
• Clear discharge, which can be caused by cancer if it’s coming from only 1 breast
• Greenish nipple discharge, which can be cause by a draining cyst underneath the areola or nipple

Nipple Discharge in Men 

It may seem unusual, but men can also have nipple discharge or develop breast cancer in some cases. In men, nipple discharge is more likely to be caused by medication or an infection, but it is important to get it checked to rule out cancer.

What Are the Most Common Causes of Nipple Discharge?

Gynecomastia 

Breast enlargement or tenderness

Testosterone deficiency 

Also called male hypogonadism, this can be associated with galactorrhoea, which is nipple discharge. Other symptoms include erectile dysfunction and lack of sexual desire

Breast infection 

Cracks or openings in the skin from injuries, skin conditions, or nipple piercings can allow bacteria to enter and increase the risk of infection. Symptoms include redness, swelling, warmth, fever, and pain in the breast area.

Mechanical irritation 

Runner's nipple can be caused by a shirt rubbing against the chest, especially in hot or humid weather. You can try applying petroleum jelly to your nipples before running, using plastic band-aids, or running without a shirt.

Your doctor will likely order some diagnostic tests, including a mammogram, to check for the cause of the bloody discharge even if the bloody discharge has cleared on its own. Additionally, you will also be required to have a biopsy of the affected area to rule out cancer and confirm the diagnosis.

Other possible nipple discharge reasons include the following:

• Abscess
• Breast cancer
• Infection in the breast
• Endocrine diseases
• Galactorrhoea
• Birth control medication
• Injury or trauma to the breast
• Paget’s disease
• Mammary duct ectasia
• Intraductal papilloma
• Fibrocystic breasts
• Hormonal changes

How Does Hyperprolactinemia Cause Infertility?

Hyperprolactinemia can contribute towards infertility in many ways. Firstly, it may disrupt ovulation. If the woman's body does not release an egg in time, the menstrual cycles will be affected. Depending on the severity of the case, menstrual cycles may be irregular or may stop completely.

In cases of mild hyperprolactinemia, the ovaries may release an egg in time, but the body may not produce adequate amounts of progesterone. This shortens the luteal phase that follows ovulation. As a result, even if the egg is fertilised, it may not be able to attach itself to the uterus. Thus, the woman may miscarry even before she realises that she is pregnant.

What Does Breast Cancer Nipple Discharge Look Like?

Generally, breast cancer nipple discharge appears to be clear or bloody; however, this may not be the same for every case.

Nipple discharge is a potential symptom of breast cancer. About 7-15% of the women who complain about nipple discharge will likely have breast cancer. This also means that nipple discharge may not be due to cancer in the majority of cases.

Majority of the women who notice nipple discharge and are diagnosed with cancer are likely to have papillary carcinoma or ductal carcinoma in situ.

An imaging scan may be recommended by your doctor to rule out the possibility of cancer or to confirm the diagnosis if they are unable to establish a clear benign cause for the nipple discharge. If you have a family history of breast cancer, you must consult your healthcare provider immediately, even if you are a male.

When Should I Be Concerned About Nipple Discharge?

Oftentimes, nipple discharge is caused by a harmless condition and usually not cancer, but you should never ignore it, especially if you notice the following:

• Lump in the breast
• Discharge from only 1 breast
• Bloody or clear discharge
• Discharge is involuntary and doesn’t stop
• Change in the size or the shape of the breast
• Swelling around the collarbone and the armpit

In most scenarios, nipple discharge is a sign of an underlying condition that needs medical attention.

Women who are post-menopausal and experience nipple discharge should consult their healthcare provider immediately. Such women are advised to avoid handling their breasts or massaging their nipples even to examine the discharge.

Nipple Discharge Treatment

The treatment plan for nipple discharge largely depends on the cause of the discharge, as nipple discharge is only a symptom of an underlying condition. If you are concerned about your nipple discharge or if you notice any of the warning sings mentioned above, you are advised to see a doctor.

Summing Up

Nipple discharge can be a reason to worry, but it is often caused by conditions that are not life-threatening. However, if you have persistent discharge from the nipples that is not associated with any of the above-mentioned causes, it may be a sign of hormonal imbalance or a tumour. In such cases, the nipple discharge may be clear, milky or have a greenish tinge.   
In some cases, nipple discharge could impact a woman's fertility. Bloody discharge could be a sign of cancer and should not be ignored. If you are concerned about nipple discharge and infertility, you can book an appointment with our fertility experts.