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meghan427 posted:
For four months my periods have been so light its barely a color change which is very different from my normal heavy flow. I have taking about 7 pregnancy test all negative. Recently I have seen in my right breast a muddy red discharge and in my left a greenish to clear discharge. I have no insurance. I am waiting to get an appt. at a clinic. I am terrified something is wrong. I have a maternal aunt that had breast cancer and many relavites on my biological fathers side with vareous cancers. what could this be? any suggestions?[br>
Jane Harrison Hohner, RN, RNP responded:
Dear meghan: You did the right thing in ruling out pregnancy first. In terms of the too-light flow the following is my best GUESS.

The most common reason for a menstrual pattern like you have described is not having an ovulation every month. In a normal cycle, estrogen is produced all month. Estrogen is responsible for building up the lining of your uterus so you have something to shed each month. The good news is that you have enough estrogen to make a lining that does shed most times.

In a normal cycle, progesterone production increases following ovulation and release of an egg.. Progesterone "stabilizes" the uterine lining in preparation for a possible implantation of a new pregnancy. If you are not pregnant that month the levels of estrogen and progesterone fall, triggering the release of the uterine lining—your period.

So, if you do not ovulate, the estrogen build up of the lining continues, but without the usual ovulation associated progesterone. Thus, the hormone levels don't decline, and the lining stays up inside the uterus—your missed period. Alternatively, the built up lining can begin to shed on its own creating erratic bleeding patterns which are usually "too-light" or super heavy and prolonged.

Causes for not ovulating are multifold: thyroid problems, pituitary problems, ovarian cysts, physical stressors (eg sudden increases in exercise, crash dieting), emotional stressors (problems with boyfriends/girlfriends, money), increased body weight, anorexia, rotating shifts at work, etc. In your specific case the nipple discharge can be a sign of a benign pituitary adenoma. Pituitary problems can both interfere with ovulations AND eventually make estrogen levels so low that there is no lining to be shed.

Generally we tell women that bilateral, white or clear discharge , which is only present with nipple stimulation, is likely to be "normal." Being on birth control pills can sometimes enhance breast discharge. Certain psychiatric medications—especially the antipsychotics —can initiate nipple discharge. Bilateral, spontaneous secretions can be prompted by a pituitary problem, or hypothyroidism. Both low thyroid and elevated prolactin (from the pituitary gland) can be checked for using simple blood tests. Some less common medical conditions causing nipple discharge can include: herpes zoster, lung/kidney tumors, opiates/amphetamines.

The most concerning nipple discharges are those which are red/bloody, unilateral, and coming from just one or two ducts. At your clinic exam they an easily test for the presence of blood from the right nipple using a fecal occult blood test card. They will also look for evidence of an infection or any mass. Depending upon your age a breast ultrasound (younger women) or mammogram (older woman) may be ordered.

Hopefully both the nipple discharge and too-light flows can be attributed to an easily found cause.

meghan427 replied to Jane Harrison Hohner, RN, RNP's response:
Thanks for the info. I am waiting until wed to get my blood work back the ob think it might be prolactinoma. I have read up on it and it makes since. I have headaches 2 to 4 times a day so pretty much all day everyday. My missed periods, weight gain, nipple discharge, tiredness, and some vision problems, and hardly any sex drive. What else would you look for with these problem if it is not prolactinoma?

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