Causes of Breast Secretion, Nipple Discharge

Nipple discharge affects many women who are not pregnant or breastfeeding and the presence of breast secretions do not always indicate any serious problem. While breast milk is expected in pregnancy and after child birth, other secretions from the breast may also occur in women of any age. Young women may experience nipple discharge without any cause for concern but persistent discharge in older women may be a sign of an underlying condition.

Secretions from the breast usually occur from the nipple and nipple discharge should be differentiated from fluids secreted through a breast fistula. A breast or mammary duct fistula is an abnormal passage that forms between a mammary duct in the breast to the surface of the skin, usually near the areola. While a mammary fistula is not very common, it may occur after a prolonged infection and the presence of a fistula should not be considered as nipple discharge. A breast fistula requires further investigation and appropriate treatment.

Types of Nipple Discharge

There are different types of nipple discharge and the type of breast secretion may be an indication of the cause of the discharge.

  • Milky discharge may be breast milk production even in women who are not pregnant or breast feeding and is often due to elevated hormonal levels, specifically prolactin.
  • Clear discharge and sticky discharge may be a sign of inflammation or infection.
  • Bloody discharge may be a sign of severe trauma, infection or cancer.
  • Mucus that is yellow or brown and may be mixed with blood could be due to severe infection, especially if accompanied by breast pain.

Evaluating the type of nipple discharge is not usually sufficient to make a conclusive diagnosis. The presence of other signs and symptoms as well as thorough diagnostic investigation by a medical practitioner should determine the underlying cause of the breast discharge.

Signs and Symptoms of Nipple Discharge

Nipple discharge may occur on its own with no other sign or symptoms or may be accompanied by other symptoms which is indicative of certain conditions.

  • Nipple discharge may occur from both breasts (bilateral) or one breast (unilateral)
  • Breast tenderness or breast pain
  • Swollen breasts or breast lumps
  • Fever
  • Irregular menstrual cycle

Causes of Nipple Discharge

In most cases, breast discharge is not a cause for concern but any persistent discharge associated with other changes requires investigation. Any nipple discharge in males needs to be investigated as it is usually an indication of more serious pathology.

  • Galactorrhea is breast milk production in women who are not pregnant or nursing and is often due to elevated prolactin levels (hyperprolactinemia). Hyperprolactinemia may occur as a result of many conditions including :
  1. Stimulation of the breasts
  2. Pregnancy
  3. Stress
  4. Injury to the breast
  5. Sexual intercourse.
  6. Pituitary disorders
  7. Thyroid disorders particularly hypothyroidism
  8. Kidney or liver failure
  9. Certain drugs like oral contraceptives, antidepressants or antihypertensive drugs.
  • Breast abscess or breast infection due to bacterial, viral or fungal causes is usually accompanied by breast pain, tenderness, redness of the skin with a white to yellow discharge. A painful breast lump may be felt in the case of an abscess. Infections of the breast are usually one sided and may also cause breast swelling.
  • Benign breast disorders :
  1. Intraductal papilloma is a small benign tumor of the milk ducts in the breast. It is the most common cause of nipple discharge and usually affects only one breast. The secretion may be bloody or a clear discharge may be noted.
  2. Fibrocystic breast disease (FBD) is the most common cause of breast lumps in women, particularly older women. It may affect one or both breasts and the presence of multiple small lumps may be noticed along with breast tenderness.
  3. Mammary duct ectasia is the blockage of the milk duct and may affect one breast or both sides. Blockage of the duct often occurs as a result of inflammation due to hormonal changes and may be prone to bacterial infections. Smoking is a predisposing cause for mammary duct ectasia. The nipple discharge in mammary ectasia may vary in color and consistency.
  • Breast cancer, usually intraductal carcinoma, may cause a bloody breast discharge. A breast lump is usually present and swollen lymph nodes (lymphadenopathy) may be noticed.
  • Hormonal disorders affecting the female sex hormones which may occur in perimenopause, premature ovarian failure and polycystic ovarian syndrome. Changes in the menstrual cycle are usually evident, with irregular menses, sudden cessation of periods or changes in menstrual flow. Infertility may also accompany these hormonal disorders.
  • Gynecomastia is the enlargement of the male breast which may be normal during puberty. Persistent enlargement with breast tenderness and/or nipple discharge should be investigated although breast secretions in gynecomastia is not common.

Diagnosis of Breast Discharge

While nipple discharge may occur frequently in women who are not pregnant or breastfeeding, persistent breast secretions should be investigated. Persistent breast discharge is of particular concern in women over 40 years of age, where the discharge is from only one breast, bloody discharge with the presence of breast lumps.

After physical examination and a case history, your medical doctor may consider a mammogram, fine needle aspiration and cytology. If the prolactin levels are elevated, further blood tests may be conducted to evaluate the functioning of the thyroid gland, particularly by testing the thyroid stimulating hormone (TSH).

If you are using any hormone replacement therapy or related drugs for menopause, as contraception or for infertility, your medical doctor may discontinue or change the drugs if the breast discharge is severe and accompanied by other symptoms like breast swelling, tenderness or pain.

Women experiencing nipple discharge with a personal or family history of recurrent breast lumps, even benign lumps. should undergo extensive investigation to exclude breast cancer.


References

  1. Intraductal Papilloma. Medline Plus
  2. Intraductal Carcinoma. National Cancer Institute

Please note that any information or feedback on this website is not intended to replace a consultation with a health care professional and will not constitute a medical diagnosis. By using this website and the comment service you agree to abide by the comment terms and conditions as outlined on this page

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  • Capssie

    Hey, i am 22 years and I didn’t get fully physically intimation with my Bf a 3 months back but now I didn’t do anything physically but from last month my right nipple is discharging a white watery partical with no sticky partical. I am worried is it a serious problem and even I didn’t share this with anyone I am adding an image of that partical. Please tell me what to do.

  • Capssie

    Hey, i am 22 years and I didn’t get fully physically intimation with my Bf a 3 months back but now I didn’t do anything physically but from last month my right nipple is discharging a white watery partical with no sticky partical. I am worried is it a serious problem and even I didn’t share this with anyone

  • Hi Capssie. This is usually not a cause for concern. A white watery discharge like you described can occur but it is usually in small quantities. Physical stimulation can increase the secretion. However, you should still watch it carefully to ensure that it is not something more serious. Also consider pregnancy and exclude it by conducting a pregnancy test. Although you say you have not been fully intimate, if you have otherwise and may not be saying so then pregnancy is one of the considerations.

  • Capssie

    No doc. I didn’t fully intimate ever till now and now its been 3 4 months. I am suffering from this problem from last month. What other considerations can be keep in mind please tell me as I do not fully intimate ever and whatever I had done is with full protection.

  • Hi Capssie. Even if pregnancy is not the cause here, it can still occur and not be anything serious. Of course, there can be other causes even breast cancer may be a possibility. It’s difficult to say for sure through an online platform. Rather speak to your doctor and undergo further investigations if you are concerned. It is better to be safe than sorry.

  • Lahela

    Hey doc, tonight when I was getting ready to lay down in bed, I notice a clear stinky liquid comjng out of my left nipple. My boyfriend and I haven’t had full intercourse, he did enter my slightly but went soft. That has been about 3 weeks ago. Should I get hold of a doctor or not worry?

  • Hi Lahela. It’s always advisable to seek medical advice. Even if the act was not completed, there is nevertheless a possibility of pregnancy since there was penetration. But pregnancy may not be the only cause of this. As you can see from other comments, a breast discharge can occur without pregnancy or any disease especially if there has been physical stimulation of the breast. Speak to your doctor.

  • Elsie

    Hey Doc! I’m 15 years old and one morning my right boob was very sore under the nipple. There is lump and I was worried it was breast cancer. I tried squeezing the lump and white / yellow discharge came out of my nipple. My boob is still very sore and am unsure whether it will disappear on its own or if I have to do something about it.

  • Elsie

    Hey Doc! I’m 15 years old and one morning my right boob was very sore under the nipple. There is lump and I was worried it was breast cancer. I tried squeezing the lump and white / yellow discharge came out of my nipple. My boob is still very sore and am unsure whether it will disappear on its own or if I have to do something about it.

  • Lahela

    Thank you doc, very recently they became very tender to the touch. My boyfriend couldn’t touch them without causing extreme plesure or pain. I’m going to see if I make a appointment with someoen next week.

  • Hi Elsie. There is no reason to focus on breast cancer immediately. Yes, it is a possibility and always a concern for girls and women. However, there could other less serious causes that are often more common in your age group. Breast discharge is possible even if you are not pregnant or have no other medical problem. It is more likely to occur with physical stimulation. Small lumps in the breast may come and go often in response to changes in the menstrual cycle. However, it is always advisable to have it checked up by a doctor as soon as possible.

  • You’re welcome Lahela. Good to hear that you are seeking medical help. This may not be anything serious but rather see a doctor. It is better to be safe than sorry.

  • Aarti

    HI doct I am 40 yrs but last one week when press milk is come out of my breast what is the reason plz help

  • Hi Aarti. There are many possibilities and we cannot say with certainty as to what may be causing this. Only your doctor can advise your further. Small amounts of milk can be secreted years after your breastfed. However, there are times when the breast starts producing milk for other reasons like with a rise in the hormone prolactin that could be linked to a tumor. Furthermore it is also possible that this secretion is not milk. It could be some other breast discharge and in your age conditions like breast cancer also need to be considered. See your gynecologist as soon as possible.

  • Haleem

    Hi dr…I m 23 yrs old,sexually inactive.. I m having a discharge from right breast from last 5 years… Its clear.. Comes without squeezing or touching… And also stain my undergarments… For about 2 or 3 times ,there was blood also. Before menustration i also feel pain otherwise there is no pain.my prolactin level is normal i.e 5.6IU.. Kindly suggest me something

  • Hi Haleem. You should have a mammogram if you have not done so already. The clear discharge on it’s own would not be too much of a concern. But the sign of blood is worrying.Breast tenderness just before you period is also not a cause for concern usually. You need to consult with a gynecologist as soon as possible and do not forget to mention that there was blood on these few occasions.

  • Leandra Clarke

    Hey doc i am 35 weeks pregnant and i squeezed my breast to see if i started to produce milk the left one clear fluid coming out but the right one clear fluid along with a dark brown fluid also comes out. Should this be cause for alarm?

  • Maya

    I am 41 years old. But from the last 4-5 months my right breast is leaking or rather when i press it some milky or milk comes out. Although i am not experiencing any tenderness or pain in my breasts. Please suggest me what to do…

  • Hi Leandra. It’s not usually a cause for concern but it’s difficult for us to say for sure through an online platform. It is advisable that you consult with your OBGYN just to be certain. Rather be safe than sorry.

  • Hi Maya. It is not uncommon for a discharge to leak out with physical stimulation of the breast. However, it is worth having checked up. Breast cancer risk in your age group means that every symptom should be evaluated by a gynecologist, even if there is no pain, tenderness or lumps. Rather speak to your gynecologist and possibly go for a mammogram. It may not be anything to be worried about but rather be safe than sorry and seek medical attention as soon as possible.

  • Stacey

    I’m a 24 year old female virgin.I have white non liquid discharge that
    never goes away in all my nipple pores.I believe it started when I was
    16.Maybe it was wet when I was 16 and it dried up?I don’t remember.I
    cleaned my nipple and stuck a clean needle and gentle dug the discharge
    out my pores but hours later the discharge came back.I always stay
    clogged.I always wear a bra.My chest hurts without a bra because theirs
    so heavey so I even sleep with one on.I’m a D 32 cup and 96 pounds.When I
    was a teenager I used to tie down my breast.It hurt my breast when I
    tied it down and messed up my tissues in my breast,shrinking it and
    making it less perky.I’ve been stopped doing that.I don’t remember if
    that’s when my nipple started getting discharge?I will also add that in
    3rd grade my body got very fertile at the bottom(discharge).I used to
    leek so much and a lot at one time but as I got older it got less and
    less.Thank Jesus Christ for that.If I eat lots yogurt,drink milk or eat
    cream etc.I will leek more and it would be kinda thick.The liquid is
    clear and when it turns kinda thick it has a white tent to it.The
    thickiness is like the raw clear part of a egg and it’s looks like it
    too.None of my discharges smell but it’s annoying.I think that maybe my
    nipple discharge disappear when I’m on my period?I remember one day not
    seeing it but I’m not sure.I’m so used of it being present for many
    years none stop.I don’t even bother with it since it will be right back
    within hours.I don’t know what to do.

  • Hi Guest. Your condition seems to be quite complex and this is not the ideal platform to resolve these health issues. You never mention prior medical care. It is highly advisable that you consult with a gynecologist, which you should have done a long time ago. Please do keep to one gynecologist so that he/she can assess your condition and run all the necessary tests to confirm or exclude possible conditions. With that said, a breast discharge is not uncommon in women of your age and it does not necessarily have to be linked to pregnancy or sexual activity. DO NOT insert needles into your breast. You could cause a serious infection which may do extensive damage to your breast tissue and possibly lead to permanent complications. There is not much that we can advise here and you need medical attention on a face-to-face basis.

  • Lina Purple

    i am 20 years, i am curious that my nipple not come out and i know that the nipple must come out, right? this is abnormal?

  • Hi Lina. We’re not exactly sure what you mean by your nipple not coming out. Do you refer to the nipple not protruding or are you talking about some discharge as the article discussed above?

  • Lina Purple

    sorry, i dont understand the term. i mean that i not have nipple. or the nipple will come out later

  • Hi Linda. You may want to read this article http://www.healthhype.com/abnormal-nipples-in-women-types-causes-of-deformed-nipples.html about abnormal/deformed nipples. We really cannot comment on your problem. It needs to be examined by a medical professional. You should consult with your gynecologist who may then refer you to another specialist like a plastic surgeon.

  • Katherine

    Hello Im Kath. Im 18 years of age. Im very curious about my right breast. There is a small tiny droplet of clear discharge on one pore. The one that surrounds my nipple. Not the actual nipple. It comes out only when you squeeze it. I have breast pain when doing deep palpation on my right breast and I feel a lump but I have checked it through ultrasound and the doctor said it was all normal. But it was a couple weeks ago. I also have experienced some pressure on both breasts and sometimes tolerable pain in one breast. I do take off my bra every night. Till now its still comin out when squeezing. My period is regular. My boyfie had stimulated but it was a couple days ago. In addition, my family has a gene of cancer. Is this pretty much a concer or not? I need help!

  • Lina Purple

    its made me curious with my condition. i really didn’t understood the article well but i read one article said that i must pull myself the nipple or widen the hole to allow nipple out.

  • roxane becker

    Hey doc i have history of bladder cancer but it was removed i am 25 yr old women i been feeling sick weakish and sometimes i feel my body go cold an start sweating n vision blurry literaly feels like im diein but i go lay dwn infront of fan and after a cpl mins i feel lil better and i was haveing the same symptons as befre i found out i had bladder cancer befre i knew i had cancer i was going under kidney staghorn stone surgery and my feet n handa and breast milk was apperaimg so i went to my doctor and told ny doc about my symptons and i told him tgat i googled them and it was sayin it can be signs of cancer well i told him and he was like no its not good to believe in that so i said ok cause he told me the swelling probaly causr by eatimg alot of salt and of course in my head i was like ok cause i do love salt and the breast leaking is normal so i just thru it oit that was nothing serious so the next vist i went to see him and he was removing the stent he placed im me well as of removing he found a tumor and then went back to surgery and results came back as a low grade canceriaum tumor so i had to be checked for the next two yrs if it grows back i still have till jan 2016 to say i officaly bet bladder cancrr so far it has not growed back but now these past 3 weeks i having the same symptons so now i am worried maybe i have cancer some were else in my body

  • Hi Lina. We would not recommend you doing anything of the sort. Please consult with a doctor who may then refer to you to a specialist like a gynecologist or plastic surgeon if need be.

  • Hi Katherine. It is not uncommon for a discharge to appear especially with manipulation like squeezing. It doesn’t mean that you are pregnant like is sometimes thought. Breast pain can occur in relation to your menstrual cycle and it may have absolutely nothing to do with breast cancer. Right now it may be nothing to worry about if your doctor says it is normal but you can consider seeking a second opinion from another doctor. Keep having it checked up with your doctor even if there are no problems for now.

  • Cyndee

    Hi doc, I just turned 40, and decided to do more frequent breast exams, especially when three of my aunts had breast cancer. I did the usual examination but when I squeezed my right nipple, a clear yellow liquid came out. I squeezed it again several times and the same liquid came out. I also have hypothyroidism, what should I do, should I be concerned?

  • Katherine

    Oh thanks Doc. It really helped!

  • Hi Cyndee. Physical stimulation of the breasts can lead to the discharge of fluid. Often it is not a problem but there are some conditions where a nipple discharge may arise. It really is difficult to say for sure but hopefully you are seeing a gynecologist on a frequent basis. Regular mammograms are advisable in your age group. Even though it may not be serious it is a good idea to see your family doctor or gynecologist and discuss it with them.

  • chason

    Hi, I am a 32 yr old mom of 4and I’ve noticed for about 3days now clear sticky fluid from both breasts(it solidifies in my bra during my work hours) and thick creamy white vaginal discharge(no odor)..my first thought was pregnancy, however I had a tubal in 2005..What could this be?

  • Jenny

    Hey doctor, I’m a 19 year old female & I have clear discharge from both my nipples if I squeeze it. I’m on the patch birth control & my period is regular but I’m still worried & there’s absolutely no pain if I touch my breast

  • Amanda

    To who this may concern, I need some advice as I am scared out of my mind. I had a baby 9 months ago and stopped breastfeeding when he was 5 months old. My periods are irregular and I still have milky clear sticky discharge from my nipples. Although at this point it wouldn’t really concern me but after having my first son almost 5 years ago my periods have been irregular SINCE THEN(I remember I went like 3 months at one point without a period) and I remember seeing the milky clear sticky discharge in one nipple way after his birth too!! When my first son was 2 I had my thyroid checked out because the doctor wanted to see if it was causing my depression. That test came back normal. I looked it up online and everything is saying PITUITARY TUMOR!!!!!!! I cried my eyes out last night after reading it all. Please please PLEASE help me!? I’m 24 years old and a single parent to my two little boys and very much a frightened mess!! D’:

  • Joanne Haggerty

    hey i had a baby 18 months ago i never produced enough milk to breast feed but i have started losing the white sticky fluid now?? my periods are irregular and last 2 days max i am 3o. please what does this mean?

  • Aditi

    Hello,
    I am aditi. I am 17 years old with an average height and on the overweight side. For the first time, from my right nipple there was a white semi solid discharge. It was kind of similar to a pimple discharge. My mother and aunt were cancer patients and although I did not feel any lumps, should I be concerned about it?
    I have regular periods which are always 2-3 days late. I started with my periods when I was in 4th grade.
    Please help me.

  • praise

    Hie doctor I have a nipple discharge from both of my nipples since 2010 & I went to see the doctor and she its not very serious and she didn’t give me any medication but my problem is that I am trying to conceive since last year but I am not get pregnant. My periods are normal

  • Hi Jenny. A clear discharge from the nipples is not uncommon or unusual even if you are not pregnant. However, considering you age and that you may be active, you should do a pregnancy test even though you are on contraception. It is always advisable to regularly consult with gynecologist.

  • Hi Praise. Nipple discharge is not entirely abnormal even if you are not pregnant or breastfeeding. There is usually no need for medical treatment. However, it is advisable that in your case a hormone screen (blood test) be done to verify whether your hormone levels are normal because of the discharge from both nipples plus your difficulty conceiving. Your doctor may have already run this test. You need to speak to her to get specific answers.

  • klets

    Hello all.. My wife also had a similar problem we went to a doc and some drugs were proscribed.. She is getting over it..

  • Heidi

    Two days ago both nipples started hurting badly and I noticed a small amount of yellow liquid come from my right breast. I am 38, I had cervical cancer when I was 25 and a hysterectomy at that time. I still have my ovaries but nothing else. I also had a mammogram last year because I felt lumps but it was nothing to worry about. Should I be worried about this considering I have felt this type of pain in 14 years?

  • questionary

    Hi doc! I am 18-years old girl and my left breast is leaking some fluid. This started when I was 15- years old when I was scared of diseases so I kept touching my breasts. It only comes from one spot and it’s white. This has been my biggest source of stress since then. This breast has always been bigger than another one. It only comes by squeezing. If i stop squeezing it like for a week there will be much less fluid coming out. Sometimes it has even stopped when i have stopped squeezing but because it’s my greatest concern I cant leave my breast alone. There are some lumps in both of my breasts and my breats tissue is very hard. I have been touching these lumps for about half year and they haven’t grew. My left breast is lumpier than right one. I can’t leave my breast alone I squeeze it all the time it causes me so much stress. There are no breast cancer in family but my lungs were x-rayed when I was little. Please answer this is causing me way too much stress.

  • Jane

    Hi, I am 33 years old and suffered a miscarriage at 21 weeks 8 months ago. During intimacy with my partner (not intercourse) my left breast leaked a milky slightly yellow liquid. Is this normal? I would have thought my milk had gone by now?

  • Hi Questionary. It is advisable that you have a breast exam by a medical professional, like a gynecologist, as soon as possible. A discharge is not always abnormal, even when you are not pregnant. Repeated stimulation may just aggravate it further. Even the lumps may not be anything serious, especially since they have stayed the same size in all this time and no other symptoms have arise. But there is no way of knowing for certain without a medical assessment. Speak to your doctor.

  • Afrin

    Hey,I am 23 years old.My both nipples are discharging an off white & sticky liquid.This liquid discharges when I squeeze the nipples.But if I don’t squeeze it my breast becomes hard & that is really painful.I did consult a doctor.She told me that was because of sucking!I am not pregnant!I am really very scared!Is it something serious like breast cancer?Please let me know.

  • Cindy Jo Kennedy-Didget

    I’m almost 45 next month, had partial histo 2009 then 2014 had left ovary removed due to mass. I have my right & that is all I have. My breast will leak white & sometimes brown or clear liquid when I squeeze them. My mom had breast cancer & had chemo & radiation, she is gone now & wad still in remission at passing. My sibling has lymphoma cancer was in remission 2yr but it’s back. IDK if I’m having menopause or what cause I’m having insomnia, hot cold & other issues. But the breast Ive kept to myself?

  • Hi Cindy. Given your personal and family history, it i advisable that you consult with a gynecologist as soon as possible. Hopefully you have been having regular mammograms over the years. The breast secretion may not be due to cancer. It could very well be a hormonal disturbance. However, it is important to undergo routine screening given the past history and now with symptoms this screening needs to be done immediately. Yes, the insomnia and temperature symptoms could be menopause but it is best to exclude more serious causes. A gynecologist will advise you accordingly.