Nipple discharge in males can be a concerning symptom, though it is not always a sign of a severe underlying condition. While less common in men than in women, this phenomenon warrants attention and understanding.
Characteristics of Nipple Discharge
Male nipple discharge can manifest in various ways, providing clues about its origin. The fluid’s color can range from clear, milky white, yellow, or green to brown or bloody. Its consistency might be watery, thick, or sticky.
Discharge can occur from one nipple (unilateral) or both (bilateral). It may also happen spontaneously or only when the nipple is squeezed. While clear or milky discharge from both nipples, occurring only with squeezing, may be less alarming, any spontaneous or bloody discharge, especially from a single nipple, is more concerning.
Underlying Reasons for Discharge
Nipple discharge in men stems from various medical and non-medical factors, from benign conditions to, in rare instances, more serious diseases. Hormonal imbalances frequently contribute, such as in gynecomastia, a condition involving enlarged male breast tissue caused by relatively high estrogen levels compared to testosterone.
Certain medications can also induce nipple discharge as a side effect by affecting hormone levels, particularly prolactin. Examples include some sedatives, antidepressants, blood pressure medications, and opioids. Benign growths within the milk ducts, such as intraductal papillomas, are another cause. These small, non-cancerous tumors can lead to clear or bloody discharge, often from a single duct, due to fragile blood vessels. Chronic irritation or trauma to the nipple area can also result in discharge.
More serious conditions can also cause nipple discharge. Pituitary tumors, specifically prolactinomas, can cause the pituitary gland to produce excessive prolactin, leading to milky discharge from one or both nipples, often with symptoms like decreased libido or headaches. Thyroid issues, particularly an underactive thyroid (hypothyroidism), can disrupt hormone regulation and cause discharge. While rare, male breast cancer can present with nipple discharge, which may be clear or bloody and originates from a single nipple, sometimes alongside a palpable lump. Duct ectasia, where milk ducts beneath the nipple become blocked and inflamed, can also lead to thick, sticky, greenish, or multicolored discharge.
Indicators for Medical Consultation
Given that nipple discharge in men is not typical, specific signs and symptoms should prompt a consultation with a healthcare professional. Any instance of nipple discharge in a male should be evaluated by a doctor, especially if it occurs spontaneously without squeezing.
Discharge originating from only one nipple (unilateral) is a red flag that warrants prompt medical attention. Bloody or clear discharge is particularly concerning and should be investigated immediately. The presence of a new lump or thickening in the breast or armpit, along with nipple discharge, significantly increases the need for medical evaluation. Other concerning symptoms include changes in the skin around the nipple or breast, such as dimpling, redness, scaling, or ulceration. A change in the nipple’s shape, like it turning inward (nipple retraction), also necessitates a medical visit.
Medical Evaluation and Care
When seeking medical attention for male nipple discharge, the diagnostic process begins with a thorough review of your medical history and a physical examination of the breast and nipple area. The doctor will assess the discharge characteristics, including its color, consistency, and whether it comes from one or both nipples. This initial assessment helps guide further diagnostic steps.
Blood tests are often performed to check hormone levels, particularly prolactin and thyroid hormones, as imbalances can cause discharge. Imaging studies such as mammography and breast ultrasound are used to visualize breast tissue and identify abnormalities, such as masses or dilated ducts. In some cases, a ductography, which involves injecting a contrast dye into the milk ducts before an X-ray, may be performed to highlight their internal structure. Should an abnormality be detected, a biopsy, where a small tissue sample is taken for microscopic examination, may be necessary to determine the exact cause. Treatment for nipple discharge depends on the underlying cause identified through this comprehensive evaluation.