Patient's question:
My wife is 46 years old this year. Six months ago, there was nipple discharge in her right breast.Doctor's answer:
Hello, nipple discharge can be divided into physiological and pathological types. Generally, bilateral discharge may be physiological, such as when most women still have a small amount of milk secretion within one year of stopping breastfeeding; during the second and third trimesters of pregnancy, some pregnant women's breasts may secrete a small amount of pale colostrum; in a few women, intense sexual climax can cause highly congested breast blood vessels, breast enlargement, nipple erection, and temporary nipple discharge; and during menopause, endocrine disorders can cause some women to secrete a small amount of milk. Additionally, conditions such as breast hyperplasia, duct ectasia, breast trauma, inflammation, various benign and malignant breast tumors, hyperprolactinemia, hypothyroidism, and pituitary tumors, as well as endocrine disorders caused by these conditions, can lead to pathological nipple discharge.The reason for nipple discharge is the excessive secretion of prolactin in the body. The causes of hyperprolactinemia are complex and can be divided into physiological and pathological categories. They can be systemic or local. First, multiple induced abortions after childbirth can cause elevated prolactin levels in the body; poor sleep and long-term use of sedatives or sleeping pills; long-term use of antitubercular drugs for pulmonary or intestinal tuberculosis; post-marital women who need long-term oral contraceptives due to discomfort with an intrauterine device; and additionally, hyperpituitarism, pituitary microadenomas, hypothalamic disorders, and antihypertensive medications.
Physiological discharge is often caused by intense sexual stimulation, leading to a temporary increase in prolactin, which quickly returns to normal. In non-pregnant women, if lactation occurs accompanied by amenorrhea, it is called hyperprolactinemic amenorrhea, which can lead to infertility. Duct ectasia may also cause a small amount of milky-like discharge. Some women with breast hyperplasia may experience nipple discharge accompanied by breast tenderness, likely due to endocrine disorders. If the discharge is bloody or entirely bloody, it should be a warning sign of breast cancer.
In summary, women with nipple discharge should not take it lightly but should also avoid panic. They should seek timely medical examination, such as smear tests of the discharge, fasting blood tests for prolactin, or even mammography, to identify the cause and receive appropriate treatment.