Nipple Discharge: Causes and Concerns for Men - Breast and Thyroid

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Nipple discharge in men can be a concerning symptom, and it’s understandable that you are seeking clarity on this issue. The presence of white discharge from the nipples, especially if it is not accompanied by other symptoms such as pain, swelling, or changes in breast tissue, can have various causes.
One of the potential causes of nipple discharge in men is hyperprolactinemia, which is an elevated level of prolactin, a hormone that stimulates milk production. Prolactinomas, which are benign tumors of the pituitary gland, can lead to increased prolactin levels and may cause nipple discharge. However, this condition is relatively rare in men. Other causes of elevated prolactin levels can include certain medications, such as antipsychotics, antidepressants, and even some medications for hair loss like finasteride (Proscar), which you mentioned you have been taking for four years. While finasteride is not commonly associated with nipple discharge, it can affect hormone levels and might contribute to changes in breast tissue.

Another possibility is that the discharge could be related to a condition called gynecomastia, which is the enlargement of breast tissue in men. While you indicated that you do not have gynecomastia, it is worth noting that hormonal imbalances can sometimes lead to transient changes in breast tissue and discharge, even in the absence of noticeable enlargement.

Infections or inflammation of the breast tissue, such as mastitis, can also cause discharge, but this is less common in men and usually presents with additional symptoms like pain, redness, or swelling.
Given your history of testicular injuries, it’s also important to consider that trauma can sometimes lead to hormonal changes, although this is less likely to be the direct cause of nipple discharge.
Since you mentioned that the discharge was only present when you squeezed the nipple and not spontaneously, this could indicate a benign condition. However, it is essential to monitor the situation closely. If the discharge recurs, becomes more pronounced, or is accompanied by other symptoms such as breast tenderness, swelling, or changes in sexual function, it would be prudent to consult a healthcare provider for further evaluation.
A healthcare provider may recommend blood tests to check hormone levels, including prolactin, and possibly imaging studies like an MRI of the pituitary gland if hyperprolactinemia is suspected.
In summary, while the presence of white nipple discharge in men can be concerning, it is not always indicative of a serious condition. Factors such as medication use, hormonal imbalances, and benign breast conditions can all play a role. It is advisable to keep track of any changes and consult with a healthcare professional if you have further concerns or if symptoms persist. Your health and peace of mind are important, and a thorough evaluation can help clarify the situation.