The arrival of menstruation may be accompanied by various manifestations, including insignificant in volume, discharge from the chest. If you find such symptoms for the timely treatment of possible pathologies, it is recommended to consult a doctor.
What is considered normal
For premenstrual syndrome characterized by the presence of certain changes associated with the state of the mammary glands:
- darkening of the nipple area
- the release of colostrum (white or yellow translucent liquid) with a slight pressure on the nipple.
Such discharge may occur in the later stages of pregnancy or in the first time after the birth of a child. But outwardly the chest will look different:
- enlarged nipples
- the appearance of the Montgomery hillocks,
- total breast engorgement.
Discharge from the chest, appearing before menstruation, indicate violations in the process of development prolactin (breast milk hormone). They may have qualitative differences and be:
- similar to colostrum,
- unpleasantly smelling.
In the presence of a disease, fluid is excreted even in cases where there is no pressure on the breast and the nipple area. In addition, the following symptoms may indicate the development of inflammation or oncology:
- general malaise,
- feeling that the chest is bursting from the inside (sometimes it is accompanied by strong spasms),
- violation of the menstrual cycle,
- the appearance of tumors in the breast,
- increase in body temperature.
The cause of these manifestations may be one of the following diseases.
When galactorrhea women appear discharge, resembling milk or colostrum. Their occurrence provoked by hormonal imbalancewhich is considered a consequence of:
- inclusion in the diet of products that contribute to the production of milk,
- prolonged hormone treatment
- development of benign tumors in the pituitary gland,
- impaired functioning of the central nervous system, hypothalamus, thyroid gland,
- diseases of the adrenal glands and liver,
- surgeries affecting the spinal cord,
- severe irritation in the nipple area,
- using unsuitable underwear.
Benign neoplasm, called mastopathy, is detected in approximately 30% of women in reproductive age. Its main cause is the presence of hormonal disorders in the form of progesterone deficiency or excess estrogen or prolactin.
Among the primary factors that favor the development of mastopathy are:
- frequent childbirth and abortion,
- menstrual disorders,
- long-term use of hormonal contraceptives,
- lack of childbirth to 30 years,
- refusal of breastfeeding,
- anomalies in the structure of the reproductive system.
There are also a number of secondary reasons:
- thyroid gland,
- pituitary gland,
- adrenal glands.
- Genetic predisposition.
- Non-compliance with the rules of healthy eating.
- The presence of bad habits.
Milky duct ectasia
Under the ectasia of the ducts of the milk, understand their expansion, which is considered a natural phenomenon, but only as long as it does not become permanent. Normally, ectasia occurs during pregnancy or in the second part of the menstrual cycle, and ends at the end of the lactation period or at the onset of menstruation.
The main reason for the constant expansion of the ducts - inflammation in the chest, age-related changes or diseases of the mammary glands:
Another name for the disease is cystadenopapilloma. It is a type of mastopathy that manifested by growths in the milky duct. Most often, the intraductal papilloma develops during menopause, but its appearance is quite possible at the reproductive age.
The neoplasm is formed during the growth of epithelial cells on a fibrovascular base that does not have clear boundaries. It is localized in the milk ducts (occupies the space between the lobular and the nipple part).
By the nature of the papilloma can be benign, malignant (intraductal cancer) or atypical. Perhaps multi-focal neoplasm development - papillomatosis. Selections can have various colors - from transparent to dark brown. Also there is pain when touching the mammary glands and the presence of seals.
Inflammatory milk-induced pathology inside the ducts. Occurs immediately after the start of breastfeeding. Main symptoms:
- breast pain
- reddening of the breast, its swelling and hardening,
- high temperature
- the appearance of pain and burning sensation when touched.
Breast injuries are injuries:
- actually chest area.
Mechanical impact on the listed departments introduces a person into a state of shock, leading to a lack of air. Inhalation of toxic substances gives no less negative result.
In the worst case, it can cause death, but more often it leads to diseases of organs located in the chest, including the mammary glands.
Malignant tumors that trigger the appearance of discharge from the chest during menstruation include nipple or breast cancer. Most often we are talking about tumors of the ducts or lobular parts. They are formed as a result of the proliferation of glandular tissues.
The development of pathology can be triggered by:
- age changes
- hereditary predisposition
- injuries to the chest,
- constant stress
- unhealthy food
- chronic disease related to genital
- inactive way of life
- frequent completion of the abortion procedure,
- infertility or rejection of sexual intercourse,
- dysfunctions of the kidneys and adrenal glands,
- endocrine system diseases
- exposure to radiation.
When to see a doctor
The first symptom, indicating the need to consult a specialist in the presence of discharge from the mammary glands, are increasing chest pain. Also, the reason for the examination should be the appearance in the nipple area:
Finally, seals formed inside the mammary glands, which are easily detected by palpation, can be dangerous.
Diagnosis and treatment
If there are any suspicions about the pathology, the woman should immediately visit the breast specialist, consultations of the therapist or oncologist will also be necessary, and undergo a number of diagnostic examinations:
- Breast ultrasound (applied before menopause)
- mammography (the method is the most informative)
- contrast mammography (if there is suspicion of papilloma).
You will also need to donate blood for analysis on the level of the hormone prolactin, as well as samples of secretions for the implementation of cytological examination.
Treatment of discharge from the chest before menstruation, caused by various pathologies, is usually aimed at restoring the functions of the thyroid gland, liver and ovaries. The patient is prescribed hormones containing estrogen or progesterone. In addition, the following drugs are used in therapy:
- means of inhibiting milk production,
- reductants of water and electrolyte balance.
If the medications fail to eliminate the neoplasm, surgery may be required (up to breast amputation), as well as hormone, radiation or chemical therapy.
Although some diseases can be recognized independently, their cure should take place only with the participation of a specialist. For this reason, it is not recommended to hesitate to contact a doctor, as well as to regularly examine and palpate the mammary glands in order to identify potential diseases as early as possible.
Discharge from the chest shortly before menstruation can be caused by increased activity of the hormonal system. They look like clear, yellowish or whitish drops and come out in small quantities. Their appearance can be triggered by the use of hormonal drugs, such as contraceptives.
Sometimes excessive hormonal activity is a temporary phenomenon that stops on its own, but such violations do not go without a trace for women's health. In addition, a hormonal imbalance may be the result of a serious disease affecting the organs of the endocrine or reproductive system.
Other causes of secretion from the mammary glands are dishormonal and inflammatory diseases, benign and malignant tumor pathologies. Common disorders are mastitis, galactorrhea, fibroadenoma, ectasia of the milk ducts, intraductal papilloma. Also unnatural discharge causes trauma to the chest.
Inflammatory diseases and injuries can provoke an infectious process in the tissues of the mammary glands. As a result, pathological fluid accumulates from the nipples in the ducts.
Breast fibroadenoma is a benign tumor that develops due to the increased activity of sex hormones. The fluid in this pathology is released before menstruation or in the middle of the cycle.
In galactorrhea in women, there is an excessive synthesis of the hormone prolactin, which is responsible for the production of breast milk. The causes of this disorder may be thyroid disease, pathology of the pituitary, hormonal drugs.
The release of fluid occurs and the development of dangerous cancer. In such cases, the fluid often has blood impurities, and the woman has additional symptoms, such as nipple deformity, itching and peeling of the skin in the areola area.
Noticing the discharge from the breast, it is necessary to pay attention to their nature - color, texture, amount of fluid, exactly how it comes out (spontaneously or only when you press the chest), whether drops are often released from one breast or both. It is also important to note whether there are any additional symptoms - pains or lumps in the chest, fever, headaches or general weakness. All this information will need to be voiced at the doctor's office.
If you find a discharge from the mammary glands that are not related to pregnancy, be sure to get tested by a breast doctor. It is especially important to do this as soon as possible, if the secreted secret has an unusual color, smell or texture. Perhaps the reason for this incomprehensible manifestation is associated with the natural processes occurring in the body or with its reaction to the medications taken. In any case, the exact answer will be given only by the doctor, therefore, the incomprehensible symptom should not be ignored.
Physiological causes of discharge from the mammary glands before menstruation
Gynecologists note that the release of colostrum from the breast is normal only during pregnancy. Colostrum or discharge can be noticed from early in pregnancy.
In most cases, the appearance of colostrum can not be attributed to the physiological norm. It is allowed to separate a small amount of liquid of a light shade in the process of pressing on the nipple area before menstruation. In some women, colostrum or discharge can be seen with pronounced sexual arousal (orgasm), as well as directly at the time of stimulation of the areola.
Colostrum before the delay of menstruation sometimes appears in connection with conception. Transparent highlights are whitish. The result of the pregnancy test may be negative.
Colostrum or discharge notice after termination of pregnancy or its fading. If the development of pregnancy has stopped during the third trimester, milk usually appears after 2-3 days. A woman should take medications to suppress lactation.
Before menstruation, colostrum is released within 2 years after stopping breastfeeding. This period is necessary for the hormonal system of a woman to restore its functions.
When to see a doctor
Many patients ask the doctor whether the colostrum observed during menstruation can be a normal variant. According to statistics, every tenth woman with colostrum of nipples is diagnosed with oncology. The hue of a secret is not the basis for a diagnosis. If colostrum is detected on the eve of menstruation, not associated with lactation and pregnancy, you should contact a specialist for further examination:
- ultrasound examination (before menopause)
- contrast mammography (in menopause),
- determining the level of the main sex steroids,
- cytological examination of the secret.
Allowed at all
Normally, milk or clear droplets may appear from the nipple in women in the following cases:
- After conception, the entire period of gestation. Even before the delay, many people feel an increase in the size of the mammary glands, and from 20-22 weeks (sometimes even earlier) they begin to notice the appearance of droplets of liquid. At first, this is not a large number at all; as it approaches the time of birth, the amount of discharge can increase. No need to worry about this.
Discharge may appear, including after abortion, even in the early stages (after abortion, miscarriage, frozen).
- During lactation. Immediately after birth, the mammary glands already secrete a special secret - colostrum. It is thick, maybe with a yellowish tinge, extremely rich in vitamins, trace elements, protein immune complexes
In an extra-pregnant state, small discharges from the mammary glands are also allowed in women:
- with regular nipple stimulation,
- a few days before menstruation,
- during sex.
And here more about the causes and treatment of acute endometritis.
Milk production is under the control of the pituitary gland, which secretes a special hormone - prolactin, as well as the level of estrogen and gestagen affects the process. Pituitary microadenoma - a tumor the size of just a few millimeters. Almost always, it is asymptomatic, rarely gives symptoms such as headache, migraine, etc. Found in most cases with a random survey, as well as when searching for the causes of infertility, galactorrhea.
The milk production mechanism is normal
Pituitary microadenoma leads to increased production of prolactin, which in turn affects the mammary glands, which begin to produce something like milk. The intensity of the discharge can be from a few drops to a jet discharge of a secret, which brings the girl a lot of inconvenience.
Treatment of the pituitary microadenoma is extremely rarely operative - with large sizes and compression of the surrounding tissues, with intensive growth. More often, therapy ends with the taking of drugs - dopamine receptor antagonists, which leads to a significant decrease in the level of prolactin in the blood, the secretion of the milk secretion also stops there. Examples of drugs - Cabergoline, Dostinex, Bromocriptine.
See this video on the symptoms and treatment of hyperprolactinemia:
Not only pituitary tumors can lead to an increase in the level of prolactin in the blood. Some other diseases and conditions that at first glance are not related to the work of the pituitary gland can also lead to transient such conditions (temporary). For example, the following:
- genital inflammation - the uterus, appendages are in constant relationship with the work of the mammary glands, changes in some boomerang leads to dysfunction of others,
- medication - antidepressants (for example, amitriptyline and others), affecting the work of the brain, lead to an increase in prolactin levels at the time of taking the drug, but it is not always recommended that the drug be canceled when galactorrhea occurs - consultation with a doctor is necessary,
- hypothyroidism - the thyroid gland is "closely" tied to the work of the pituitary gland, hormones that control its function are produced here, therefore a decrease in its work steadily leads to an excess production of all the pituitary active substances, including prolactin.
Algorithm for the diagnosis of hyperprolactinemia
Enlarged lobular ducts
Pathology is more common in women of pre-menopausal age. Its essence lies in the ectasia (expansion) of the ducts, which were previously necessary for the movement of milk. The secret can stagnate in them, sometimes it can inflame. As a result, women note the following symptoms:
- discharge of yellowish or greenish secretions of sticky texture from the nipples,
- duct dilation is painful on palpation, the skin above it may redden.
The diagnosis is confirmed by mammography, breast ultrasound, and if necessary, ductography (duct examination).Treatment depends on the clinical picture and complaints - from symptomatic (compresses, antibacterial therapy) to operative with suppuration and abscess formation.
Occur inside the milky passages. More often papillomas are formed in areas of the ducts located close to the areola. They are easily injured even with the slightest click on this area. As a result, the girl notes:
- the appearance of bleeding of varying intensity,
- no pain and no previous symptoms.
Treatment can be operative or observant tactics are chosen. The diagnosis is established on the basis of ductography - studies of the ducts of the mammary glands.
Acute or chronic inflammation in the mammary glands
Mastitis is more common during breastfeeding. But inflammation of the mammary glands outside lactation is possible. Usually in this case, the woman notes the presence of chronic sources of infection in the chest - fungal or bacterial in nature.
The woman notes the following symptoms:
- tenderness in the mammary gland at the site of localization of the lesion,
- hyperemia of the skin over the area,
- the appearance of purulent discharge from the nipples, possibly mixed with blood,
Treatment may be conservative if an abscess has not yet formed. If suppuration has reached this stage, treatment is only operative.
Even minor blows with blunt objects, a fall can lead to the formation of a hematoma. Emptying it can cause brown and bloody discharge from the chest. And when you join the inflammation, they can become purulent, with an unpleasant smell, the condition is accompanied by pain and fever. To even minor damage to the mammary glands should be taken seriously.
When you need to see a doctor
Given the growth of malignant tumors of the mammary glands, even among young women, one should always be wary of any discharge from the nipple, if they are not associated with pregnancy or lactation. You must visit the doctor and undergo a minimum examination:
- blood test for tumor marker - CA-15.3 - its increase indicates a high risk of a malignant process,
- Breast ultrasound - shown to women under 45 years old, when fatty breast involution has not yet come,
- mammography - performed for women after 45 years, ultrasound at this age is no longer significant,
- ductography - contrasting ducts of the mammary glands, is performed to detect intraductal cancer or papilloma.
In addition, each woman should conduct self-examination of the mammary glands at 6-12 day of the menstrual cycle.
The mammary glands reflect the function of the coordinated work of the whole body of a woman. Pain, discharge from the nipples and other symptoms or discomfort can be the first signs of serious diseases, so it is important to timely consult a doctor and an examination, after which you can make a treatment plan.
What is colostrum?
As soon as the woman managed to get pregnant, her body begins to rebuild, to make and give birth to a healthy baby. From the second to the third trimester, the majority is marked by the release of colostrum (colostrum), although some have it in earlier periods.
The peculiarity of colostrum, which is a viscous, sticky liquid whitish or yellowish, is its calorific value (150 kcal per 100 ml) and complex composition. It should be noted the presence of a large number of proteins, much of which are proteins of immune cells.
In colostrum, unlike mature milk, there is less water, so that the kidneys of the crumbs are protected from excessive load. In addition, the baby after birth is not yet able to take a lot of food, and since the colostrum is very energy intensive, the child gets enough calories with a small amount of food.
- Albumin and globulins. They have the same amino acid composition as proteins of baby tissues. They are characterized by easy digestibility and do not provoke undesirable tension of the digestive tract organs.
- Sodium and potassium salts. Similar explains the salty taste of the secret.
- Immune defense factors (macrophages, neutrophils, leukocytes, T-lymphocytes, interferon and other substances). Their task is to provide passive immunity, anti-infective and antiallergic protection in case of rapid colonization of microflora. For example, interferon has antiviral properties. Doctors do not for nothing consider colostrum a real medicine for a newborn. Enough 2 ml. the secret is that the body starts the process of immunization.
- Lactoferrin. The substance contributes to the normal absorption of iron.
- Immunoglobulin A. Once in the child, it covers the surface of the intestine and other weak points, which prevents various infections from having a harmful effect.
- Substances that form the so-called HAMLET complex. They are able to eliminate malignant cells. However, the properties of this complex are fully disclosed only if the mother is breastfeeding.
- Antioxidants (vitamins A, E, beta-carotene, selenium, zinc). Protect from the negative effects of free radicals.
- Hormones and hormone-like factors. With their help, the development of the digestive tract and the organism as a whole is stimulated.
- Prebiotics. In their colostrum there are more than 130 species. Their presence causes the nutrition of intestinal microflora and protection against infections. They prevent pathogenic bacteria from attaching to the intestinal mucosa.
Among the significant advantages of colostrum should be noted a small content of lactose and fat. Also, the colostrum has a laxative effect, thereby accelerating the elimination of meconium (primary calories).
Colostrum, released from the breast, with full confidence can be called an indispensable product for an infant, since its composition is ideal for normal maturation of the body.
Causes of secretion of nipple secretion in non-pregnant women
Can there be colostrum without pregnancy? The secret of the mammary gland is able to stand out for various reasons. Colostrum is usually considered to be released during pregnancy or immediately after delivery, and some women note the appearance of a yellowish liquid, like colostrum, before menstruation.
To find out the real cause of what is happening, you should sign up for a consultation with a doctor.
The secretion of milk is greatly influenced by the hormone prolactin. Its synthesis is carried out in the pituitary gland, while the hormone content increases many times during pregnancy, breastfeeding and before menstruation.
Galactorrhea is a condition in which colostrum is released in non-pregnant and non-breastfeeding women. However, in some cases it may be natural.
Why, in the absence of pregnancy and lactation, colostrum production occurs and when such a phenomenon is considered normal? Colostrum secretion is allowed when:
- After the end of the lactation period, no more than 5 months have passed.
- The last pregnancy was a maximum of 2-3 years ago, while breastfeeding was absent, and the monthly cycle returned to normal.
- Conception occurred, although the test so far shows the opposite.
It happens that the fetus can stand still or the pregnancy is interrupted for one reason or another (for example, after an abortion), but the production of colostrum occurs. In such situations, physicians should prescribe drugs that inhibit the production of prolactin.
Why is colostrum coming from the breast if the girl is not pregnant? The secret can be distinguished not only in the cases mentioned above. His appearance is quite acceptable:
- Before you start your period.
- When wearing tight underwear.
- When having sex while pressing on the nipple and the nipple field.
- With frequent massaging of the chest area.
Often after menstruation or the end of lactation, this problem disappears on its own. If it lasts too long and has unpleasant symptoms, you should seek medical attention.
Diseases and pathological processes
The production of colostrum outside of pregnancy is mainly due to an increase in prolactin concentration. Its number can grow due to many violations. In other words, the discharge provoked:
- Medication. Colostrum secretion occurs in women taking hormonal drugs (oral contraceptives, steroid hormones), tranquilizers, sedatives, analgesics, drugs that allow you to control blood pressure.
- Herbs with lactogonic action. The use of many plants (dill, cumin, anise, grapes, fenugreek) is often practiced to increase milk production. However, herbs can work even in the absence of lactation.
- Prolactinoma - a tumor of the pituitary gland, in which the production of hormones, including prolactin.
- Pathological formations in the hypothalamus.
- Hypothyroidism, in which the functions of the thyroid gland are reduced, hormones are produced in insufficient quantities, but prolactin, on the contrary, becomes larger.
- Diseases of the adrenal glands, accompanied by an increase in the concentration of cortisol and its derivatives.
- Polycystic ovary, the development of which is complemented by increased secretion of prolactin.
- Renal or hepatic failure. Disposal of the hormone is carried out in the kidneys. If they are affected, prolactin accumulates in significant doses.
- Injuries, burns and surgery in the area of the mammary glands, the consequence of which is damage to the nerve fibers.
When colostrum comes from the breast, its amount can vary. For most women who are interested in why colostrum is excreted under pressure, the situation is bilateral in nature. The appearance of a secret from one nipple may indicate both a pathological and a natural process.
Negative symptoms of a secret
In order not to miss the initial stage of a serious illness, you should be attentive to your own health. The following signs should alert:
- If six months after the baby was weaned, yellowish drops spontaneously stand out from the chest, although the woman is sure that there is no pregnancy.
- If a girl has never become pregnant, and she has a foul-smelling colostrum or a discharge of a greenish, brownish tinge, with an admixture of blood or pus.
Any pain or discomfort should alert the woman. This condition may develop due to the occurrence of the inflammatory process in the tissues and ducts of the breast.
Fluid can be released spontaneously or only when pressed. In the presence of abundant spontaneous secretions, it is possible to detect a benign tumor of the pituitary gland. In papilloma of the milk duct, discharge by appearance sometimes resembles colostrum.
Selection of therapeutic therapy
Universal ways to eliminate galactorrhea does not exist. Treatment directly depends on the factors that provoked a similar condition:
- It will be possible to cope with prolactinoma with the help of drugs, surgical intervention or radiotherapy. Often the tumor is benign in nature and does not cause serious disruptions in the patient's health.
- If colostrum has occurred due to the intake of certain drugs, their use should be discontinued. If necessary, the doctor will select more suitable medicines.
- When the cause of the condition cannot be determined, therapy is prescribed, the action of which is aimed at reducing the production of prolactin.
If the methods used were ineffective, surgical removal of the ducts is not excluded. However, in most cases, the colostrum secretion stops on its own as soon as the root cause has been eliminated.
In order not to provoke an increase in colostrum secretion, it is recommended that several rules be followed:
- Wearing spacious clothes and using absorbent pads that fit into a bra.
- It is necessary to refrain from touching the nipples during sexual intercourse.
- Self-examination of the breast in order to identify the seals is desirable to carry out no more than once a month.
- Stop any breast massage treatments.
- In case of injuries, treat the affected area with healing agents.
- Record any deviations in the menstrual cycle.
Isolation of colostrum without pregnancy is normal, although for some it becomes a symptom of abnormalities in the function of internal organs. Since it is difficult to determine the root cause of the pathological process without medical assistance, it is necessary to consult a qualified specialist.