Colostrum-like discharge from the nipples is the appearance of white or yellowish discharge from the mammary glands. The symptom may be accompanied by pain and severe swelling of the breast, menstrual irregularities. The expiration of a fluid resembling colostrum from the nipples is observed with physiological hormonal changes, hypothalamic-pituitary pathologies, diseases of the genital area. To identify the causes of colostrum-like discharge, ultrasound of the mammary glands, mammography, CT of the breast and reproductive organs, gynecological examination, and hormone levels are used. To eliminate the symptom, the underlying disease is treated.
Liquid white discharge from the nipples normally appears in pregnant women, which is due to the production of prolactin, the hormone responsible for the formation of breast milk. Several colostrum-like drops flow from one or both mammary glands, the amount of secretion increases as childbirth approaches. The discharge occurs spontaneously, without pressure on the chest. At the same time, the mammary glands swell. Colostrum-like discharge from the nipples is observed in newborns during the first days of life, which is associated with the action of maternal prolactin, which has penetrated the placenta (the so-called physiological mastitis).
A thick secret from the nipples of a white or slightly yellowish color, which appears when the breast is squeezed, can be a sign of mastopathy. Women report that the appearance of colostrum-like secretions is accompanied by discomfort and a feeling of fullness in the mammary gland. The connection of the symptom with menstruation is characteristic: a plentiful secret is observed a couple of days before the onset of menstruation. Allocations are typical for fibrocystic mastopathy, but sometimes appear in the nodular form. In addition to white discharge, patients are concerned about swelling of the skin of the breast, periodic pain.
Gynecomastia is characterized by a combination of colostrum-like discharge with an increase in the male mammary glands in size and compaction of their tissue. A scanty discharge (a few drops) protrudes on the nipples when the areolar region is squeezed. The discharge is watery, white or light yellow in color. Patients notice discomfort and fullness in the chest, often the man himself discovers a bilateral seal of elastic consistency, slightly painful on palpation. With a significant increase in the breast, patients complain of a cosmetic defect that interferes with everyday life.
Benign prolactin-secreting tumors are the most common cause of abnormal colostrum-like discharge. The symptom is bilateral, white liquid colostrum flows from the nipples. When pressing on the mammary gland, pain is felt, and the amount of discharge increases, due to which it begins to drain in a thin stream. Women notice yellowish spots on the bra, dried white crusts on the nipples and areola. Allocations with pituitary adenoma occur against the background of a lengthening of the menstrual cycle, some patients complain of pain during intercourse (dyspareunia).
Whitish discharge from the nipples may be a sign of adrenal insufficiency, hypothyroidism. The symptom is caused by violations of the connections between the peripheral endocrine organs and the pituitary gland, a change in the hormonal background. A few drops of discharge flow from both mammary glands, which is accompanied by swelling, a feeling of heaviness and discomfort in the chest. It is also characterized by a decrease in sexual desire, the menstrual cycle becomes irregular, and dysfunctional uterine bleeding is possible.
Isolation of a colostrum-like secret from the nipples is due to an inflammatory lesion of the reproductive system. These pathological conditions are often accompanied by a change in the concentration of hormones and an increase in their effect on the glandular tissue of the breast. Characteristically scanty, rather thick discharge from one or both nipples, which has a yellowish tint. Patients are concerned about pain in the lower abdomen, irregular periods, vaginal discharge. Colostrum-like discharge from the breast is provoked by:
Colostrum-like discharge from both nipples is a common side effect in the treatment of depression and anxiety disorders. Their appearance is associated with a decrease in the level of certain neurotransmitters in the brain that inhibit the production of prolactin, as a result of which the concentration of this hormone in the blood increases significantly. The symptom is periodically observed in patients taking contraceptive medications for a long time. White discharge from the mammary glands develop after the use of drugs of the following groups:
The primary examination of patients with discharge from the mammary gland is carried out by a mammologist. Diagnostic search involves the implementation of instrumental and laboratory methods aimed at finding out the root cause of the appearance of colostrum-like discharge from the nipples. At the same time, the structural and functional features of the mammary glands are evaluated, the general condition of the genital area and the hormonal background are studied. The following have the greatest diagnostic value:
Mammography allows to exclude breast pathology as the cause of colostrum-like discharge.
The periodic occurrence of colostrum-like discharge from the nipples in pregnant women is a variant of the norm and does not require specific therapy. Women need to visit the gynecologist regularly and tell the doctor in a timely manner if the amount or color of the discharge has changed. White discharge from the chest in non-pregnant patients indicates the presence of the disease, so they need to seek medical help. Until the cause of the symptom is established, it is not advisable to take medications.
Medical tactics depend on the underlying disease that caused colostrum-like discharge. If the symptom is caused by taking certain medications, the treatment regimen is corrected and, if possible, these drugs are replaced with drugs with a similar pharmacological effect. It is necessary to stop taking plants that stimulate lactation. Drug therapy includes several groups of drugs:
Surgery after initial therapy aimed at reducing the size of the tumor is indicated for all hypothalamic-pituitary neoplasias that stimulate the appearance of colostrum-like secretions. Surgical removal of the adenoma is combined with targeted radiation therapy. Operations are recommended for extensive lesions of the ovaries (polycystosis, large dermoid cysts) and uterus (diffuse endometriosis). Depending on the age of the patient and her reproductive plans, organ-preserving or radical interventions (ovariectomy, hysterectomy) are performed.