Discharge from the nipple

The mammary gland is an organ that initially presupposes the natural secretion of colostrum and milk. Nevertheless, sometimes the discharge from the nipples is not associated with lactation, but means the development of a disease.

Are such discharges always a sign of pathology, and when is it necessary to sound an alarm?

[1], [2], [3]

Causes of the discharge from the nipples

Physiological (normal) discharge from the nipple is known to all - this is lactation, that is, the allocation of breast milk in pregnant and lactating women. However, sometimes this phenomenon can mean the development of some pathology.

• Ectasia of the gland ducts is an expansion of the subalveolar canals, which is most often associated with age-related changes in the glands. Ectasia is thick, greenish-yellow or brown.
• Papilloma is a benign tumor inside the duct, in which small bloody discharge appears.
• Galactorrhea is the secretion of milk from the nipple, which is not associated with pregnancy and the birth of a child. As a rule, this condition is due to increased production of prolactin - a special hormone that stimulates the release of milk. In turn, the cause of galactorrhea can be treatment with contraceptives, hormonal imbalance, hypothyroidism, pituitary dysfunction.
• Trauma to the chest can also provoke bleeding nipple.
• Inflammatory processes in the mammary gland with signs of suppuration may cause the discharge of pus from the nipple.
• The change in the hormonal level and, as a consequence, mastopathy - a frequent cause of the appearance of secretions.
• Oncological diseases of the glands is an intra-cellular carcinoma or an invasive tumor. One of the signs of malignant pathology is precisely the isolation of the liquid substance from the nipple.

Pathogenesis

The mammary glands are paired organs that perform the function of glands - that is, their purpose is secretion. But not everyone and not always. Everyone knows that the breast is the source of milk during lactation in women. Each gland consists of lobes and lobules, divided by specific septa. Each part is connected to the nipple by a milk channel, through which milk flows.

During the period of gestation the fetal tissues swell, which means the moment of readiness for the process of breastfeeding.

In addition to lactation, excreta can be considered the norm in such cases:

• immediately before the start of the menstrual cycle and menstrual bleeding;
• with sexual arousal, stimulation of the chest and orgasm.

In the excited state, a hormone oxytocin is produced in man, which leads to a reduction in the milk channels. As a result, a few drops of clear (!) Liquid can stand out. If the color of the liquid is red, black or green, this should alert the woman: perhaps the integrity of the tissues or duct is broken, which contributes to getting into the duct and exiting the blood or pus.

[4], [5]

Symptoms of the discharge from the nipples

There may be discharge from the nipples with pressure on the areola, but more often the secret follows on its own.

The consistency of the substance being separated can be liquid or viscous.

The color can also vary from transparent, translucent, yellowish-greenish and milky discharge to bloody, brown and even black.

The most common secretion occurs in patients after 50 years, and at a young age - much less often. The risk of developing mammary pathologies increases with age, as well as with the number of pregnancies, abortions, and periods of breastfeeding.

When the appearance of excretions, it is necessary to carefully determine the amount, color and odor of the secret that appears. These signs may indicate the development of a particular pathology, which must be treated without waiting for the occurrence of negative consequences.

• White discharge from the nipples normally appear in the lactation period and represent breast milk. In other situations, this may be a sign of galactorrhea - the excess production of the hormone prolactin, which provides milk production.
• Yellow discharge from the nipple is also observed with galactorrhea, especially if the pathology is caused by insufficient liver or kidney function, thyroid disease, impaired pituitary function, or prolonged intake of hormonal drugs.
• Brown discharge from the nipple can occur after a recent chest injury, or with other injuries of the milky canals or vessels. Such damage usually provokes tumors, for example, cysts - in this case the secret is often brown with a greenish or grayish tinge.
• Bloody discharge from the juice often indicates the presence of formidable diseases, more often of a malignant nature. However, in some cases, the blood from the nipple is secreted with the intraprostatic papilloma, which, however, also with time can degenerate into an oncological disease.
• Green discharge from the nipple suggests that a secret contains more or less pus. In this case, the liquid to be separated may have a grayish or yellowish hue. This condition is inherent in mastopathy - dyshormonal disorder, which is characterized by the appearance of seals and soreness in the glands.
• Transparent discharge from the nipples can be caused by physiological causes - stress, a monthly cycle, stimulation. Normally, such transparent secretions are insignificant (only a few drops) and are not accompanied by odor and discomfort.
• Purulent discharge from the nipple is a common problem in the development of inflammatory diseases of the breast. For example, purulent abscessing can occur in the process of breastfeeding, with infection in the milk ducts. This disease is often accompanied by soreness of the gland, reddening of the areola and increasing swelling.
• Sticky discharge from the nipple, with a different color range - a typical symptom of deformations of subalveolar ducts, or their blockage. An additional sign of this condition can be a tightening of the tissues around the nipple, as well as a retracted nipple.
• Gray discharge from the nipple is sometimes the cause of increased levels of prolactin in the body. This symptom can be observed during pregnancy, or with long-term use of contraceptives and other hormone-containing drugs.
• The discharge from the nipples with odor is usually accompanied by inflammatory diseases of the mammary glands, namely, the purulent stage of the process. The fact is that bacteria and the products of their vital activity can exude a specific odor, which is especially pronounced in purulent discharge. Inflammatory diseases always occur with significant painful sensations, redness and swelling of the glands. Temperatures can be increased, both local and general body temperature.
• Black discharge from the nipples in the overwhelming majority of cases indicate the presence of blood in a secret that is inherent in many tumor processes. In this case, the blood is black due to the fact that the pathological focus is most likely located deep in the gland tissues, and not directly near the surface.
• Dry discharge from the nipples - a frequent sign of ectasia of the breast. A dry or dense secret is formed from thick and viscous secretions that accumulate in the lumen of the milky duct. Such secret can have a different color and smell.
• Curdous discharge from the nipples is a rare phenomenon, but sometimes this happens if, during breastfeeding, a fungal infection enters the milk ducts. Especially susceptible to the disease are those women who have cracks, wounds on the nipples. Curd secret can have a sour smell. The breast thus hurts and itches, the volume of allocated milk can decrease.

Each disease of the mammary glands is determined by its symptoms. It is almost impossible to recognize the disease by yourself, therefore, seeking medical help should be immediate.

[6],

Allocations from the nipple before monthly

If the discharge from the nipple appears before menstruation, or during it, then such a sign may indicate a strong change in the hormonal level. This is primarily a hormone prolactin, responsible for lactation. Changes in the hormonal background may be disrupted for several reasons, but most often this is the result of prolonged use of contraceptive drugs.

Allocations before menstruation are usually minor, and the secret is a kind of colostrum: it can be clear, light, yellowish. In order to determine the cause of this phenomenon, it is recommended to pass a blood test for the content of prolactin.

Sometimes it happens that a woman for a few years after childbirth before the monthly continues to be allocated a small amount of milk. The reason for this can be all the same prolactin, the level of which decreases more slowly than other women.

[7], [8], [9], [10]

Discharge from the nipples during pregnancy

Secretion from the mammary glands can begin not only immediately after childbirth, but also during pregnancy. Of course, this is not the case with everyone, but it is often enough.

Discharge from the nipples during pregnancy have a slightly yellowish or light hue - this is nothing like colostrum, which is the liquid that precedes breast milk. Why does it stand out?

In a pregnant woman, the mammary glands intensively increase in size throughout the gestation period: glandular tissue structures expand, and this proliferation of prolactin hormone stimulates.

Discharges from the nipples before birth occur most often. In some, colostrum begins to be produced only on the third day after childbirth. However, in some cases, with the active production of prolactin, milk can appear much earlier, from about the 20th week of pregnancy. Very rarely a small amount of colostrum can be seen in the first trimester - this is also considered one of the variants of the norm.

[11], [12], [13]

Complications and consequences

The scale of the consequences of pathological discharge from the nipples depends on what disease they are caused.

If the secretion is not related to physiological causes (lactation period, pregnancy, stimulation of the nipples), then it is necessary to contact a mammalogist or gynecologist. Not having done this on time, you can expose yourself to the risk of serious diseases:

• Telit - an inflammatory process in the nipple (often the infection gets through the cracks in the area of the nipple);
• mastitis is an inflammatory process in the tissues of the mammary gland (can develop with milk stagnation during breastfeeding, or for other reasons);
• malignant tumors of the breast;
• diffuse and nodal mastopathy is a proliferative process in the mammary gland.

To avoid the development of the aforementioned diseases, it is very important to visit a doctor on a timely basis for preventive examination. Especially it is necessary to be alarmed at detection of any allocation from the nipples, which have appeared for not clear reason.

[14], [15], [16]

Diagnostics of the discharge from the nipples

During the consultation about the discharge from the nipple, the doctor may prescribe some types of examination, including tests. Which diagnostic methods will be used depends on which disease is suspected.

• The medical examination includes a visual assessment and palpation of the mammary glands.
• X-ray method, or mammography, involves examining patients after 50 years. The doctor receives an image from two angles, which allows us to examine in detail the structure of the mammary glands.

• The ultrasound method can be used to examine patients of any age. The ultrasound procedure visualizes both the gland tissue and the nearest lymph nodes.
• Ductography is used for examination of milk ducts;
• The cytological analysis is based on the study of the material taken from the tissues of the gland. Such a study is performed most often with suspicion of a tumor process.
• Immunohistochemical analysis reveals the nature of the tumor, if any.

In addition, instrumental diagnostics can be prescribed in the form of methods such as computed tomography, chest radiography, radioisotope visualization of the bone system, ultrasound examination of the liver (to search for possible metastases).

Of the tests, it is often suggested to donate blood for hormones, a general blood test for the presence of an inflammatory process, and also conduct a study on oncomarkers (this analysis determines the probability of a cancer).

[17], [18], [19], [20], [21]

Differential diagnosis

Differential diagnosis, as a rule, is conducted between the following diseases:

• nodal mastopathy;
• fibroadenoma;
• lymphogranuloma;
• mastitis;
• intraprostatic papilloma;
• malignant tumor;
• galactocele.

Treatment of the discharge from the nipples

Spontaneous secretion from the nipples can not be cured without knowing the true reason for its appearance. For this purpose, the diagnosis is carried out, the purpose of which is to determine the factor that causes the discharge from the mammary glands.

Therefore, the question - what to do with the allocation of nipples? - You can answer unequivocally: consult with a doctor and conduct a thorough diagnosis.

It may be necessary to adjust the hormonal background. For this, there are special drugs - agonists YES, which include Bromkriptin and Parlodel. These drugs inhibit the synthesis of prolactin. The standard dosage of drugs is 2.5 to 3.75 mg per day. At the discretion of the doctor, the amount of the drug can be doubled. The duration of the course of treatment is to stabilize the hormonal level.

Alternative treatment of discharge from the nipple can be done only after consultation with the doctor, after the delivery of all necessary tests and the final diagnosis.

You can not treat a symptom without knowing the cause of the pathology. Therefore, do not rush to begin treatment with herbs - first find out which disease caused the appearance of excreta.

The same can be said about such a method of treatment as homeopathy. Any therapy begins only after the diagnosis becomes known. If the patient starts to treat the inflammatory process on her own, but in practice it turns out that she has malignant formation, the consequences can be unpredictable. Often in such cases, it is necessary to prescribe surgical treatment.

Do not rush with nontraditional methods of treating discharge from the nipples. Not knowing the reasons for the appearance of excreta, this can significantly damage your health.

Prevention

Prevention of discharge from the nipples is to comply with recommendations for the preservation of mammary gland health. These recommendations are fairly simple, but very important for the normal functioning of the body.

• It is necessary to avoid stressful situations, nervous shocks, and psycho-emotional stresses in every possible way. Stresses extremely negatively affect the hormonal background, which contributes to the development of breast diseases.
• It is recommended to adhere to a healthy lifestyle: do not smoke, do not abuse alcohol, go to bed on time, eat fully, be physically active. A healthy lifestyle allows you to keep your immune system strong.
• It's important to keep track of your weight. The fact is that extra pounds can lead to undesirable changes in the mammary glands, which over the years can develop into a disease with the appearance of discharge from the nipples.
• Reception of contraceptive means should be not long. You can not select contraceptive preparations yourself - this choice should be agreed with the doctor.
• Monthly self-examination of the breast should be carried out - this is a necessary stage of prevention and early detection of dangerous diseases.
• All women are recommended to undergo an examination every two years at a mammal, and after 50 years - every year.

You can not ignore the suspicious symptoms, you need to seek help from a specialist in time.

[22], [23]

Forecast

The prognosis of such a symptom as a discharge from the nipples, directly depends on the underlying cause: the more complex and dangerous the diagnosis, the worse the prognosis. Physiological excretions are considered normal and eventually disappear on their own.

[24], [25]