Is It Normal to Have Blood-Like Fluid from Nipples During Menstruation?

During menstruation, it is possible to express blood-tinged fluid from the breasts?

Hello Dr.
Wang,
I have a question on behalf of a friend, and I would appreciate your prompt response.
My friend is 30 years old and unmarried.
She recently discovered that her nipples can express a bloody fluid, particularly during her menstrual period.
The fluid is red when her period starts and appears darker as her period comes to an end.
She heard from her colleagues that this phenomenon is normal, so she has not considered seeing a doctor.
Dr.
Wang, is there really no issue with my friend's symptoms?
P.S.
To add, this situation only occurs during her menstrual cycle when she sometimes expresses the bloody fluid.
Thank you for your response.

Zhenzhen, 30~39 year old female. Ask Date: 2000/10/30

Dr. Wang Hanzhou reply Obstetrics and Gynecology

If there is such a close relationship between blood and M.C., it may seem insignificant, but I still recommend having a doctor examine it.

Reply Date: 2000/10/30

More Info

It is understandable for your friend to be concerned about the presence of blood-like fluid from her nipples, especially during menstruation. While some breast discharge can be normal, the specifics of her situation warrant careful consideration.

Firstly, it is important to note that nipple discharge can occur for various reasons, and it is not uncommon for women to experience some form of discharge during their menstrual cycle due to hormonal fluctuations. The hormones estrogen and progesterone, which fluctuate throughout the menstrual cycle, can affect breast tissue and lead to changes in the ducts, potentially causing discharge. However, the presence of blood or blood-tinged fluid is something that should not be taken lightly.

In your friend's case, the fact that the discharge is red at the beginning of her menstrual cycle and turns darker as it progresses could suggest that it is related to the menstrual flow itself. Menstrual blood can sometimes be expelled from the body in various ways, including through the nipple, particularly if there is a significant amount of hormonal activity occurring. However, this is not a typical presentation and should be evaluated further.

There are several potential causes for bloody nipple discharge, including:
1. Hormonal Changes: As mentioned, hormonal fluctuations during the menstrual cycle can lead to changes in breast tissue, which may result in discharge.
2. Duct Ectasia: This condition occurs when a milk duct beneath the nipple dilates, fills with fluid, and thickens, which can lead to discharge that may be brown, green, or black, but in some cases, it can also be bloody.

3. Infection or Inflammation: Conditions such as mastitis or abscesses can cause discharge that may be bloody, especially if there is an underlying infection.

4. Fibrocystic Changes: Many women experience fibrocystic breast changes, which can lead to lumps and discharge, sometimes including blood.

5. Intrductal Papilloma: This is a benign tumor that can develop in the ducts of the breast and may cause bloody discharge.

6. Malignancy: Although less common, bloody discharge can sometimes be a sign of breast cancer, particularly if it is unilateral (affecting one breast) and persistent.

Given that your friend is experiencing this symptom only during her menstrual cycle, it may not be an immediate cause for alarm, but it is crucial that she consults with a healthcare professional for a thorough evaluation. A doctor can perform a physical examination, take a detailed medical history, and may recommend imaging studies such as a mammogram or ultrasound, as well as possible laboratory tests to rule out any serious conditions.

In summary, while some nipple discharge can be normal, the presence of blood, especially if it is a new symptom, should not be ignored. It is advisable for your friend to seek medical advice to ensure that there are no underlying health issues that need to be addressed. Early evaluation and intervention can provide peace of mind and ensure appropriate management if necessary.

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