This may be a bit obscure: I stopped breastfeeding about

Patient

Q: This may be a bit obscure: I stopped breastfeeding about six months ago and ever since have had that tiny breast secretion of a drop of cloudy fluid, moreso from the left breast, which was more productive when breastfeeding. I've been taking the combined pill (30) since stopping breastfeeding. I take it at the same time of day every day. I missed a pill last week and took it about 6 or 7 hours late. Even though all info including WHO guidelines says no further action need be taken, as it was close-ish to the placebo pills, I decided to skip them. That's the second time in a row I skipped them(can't exactly remember why I skipped them last time). Then I thought no more about it til tonight when the breast secretion changed; instead of nothing on one side and a drop of cloudy fluid on the other, it was now a drop or two of white fluid from each side. Could this mean I am pregnant? I'm really worried.

Doctor

A:   Hello,
Thanks for the query to ATD for an opinion,

The fact that you have been on regular combined oc pills since last 6 months and you took the pill 6-7 hrs after having missed the pill last week, ( the day closer to your placebo pills), it still keeps you protected and ovulation is not expected. Infact you should be experiencing your withdrawal bleed in next few days.

The presence of secretions in both breasts and in minimal levels can be possibly due to still increased levels of prolactin in your body which are naturally increased during breast feeding but takes generally months to revert back to normal unless you have been taking dopamine agonists like CABERGOLINE tabs. So keeping that in picture your concern about pregnancy is understandable but rest assured that you are still protected. Just incase you need a confirmation, you may get a serum beta hcg test done which if negative shall rule out pregnancy conclusively.

I hope i have answered your query in detail,
Wishing you good health
Regards

Comments / Follow Ups

Patient: Thank you for your answer and it is helpful . I did realise that, based on the specifics of when I took the missed pill etc, I should still be protected and that breast secretions are normal for a long time after finishing breastfeeding. I wasn't worried until I noticed the secretion changed suddenly from being a barely-there trace of clear or cloudy fluid on one nipple, to being a couple of drops of white fluid from both nipples. Could you address this change specifically, with regard to my worry it could mean I'm pregnant? Many thanks.
Doctor: It still doesn't mean that you are pregnant , the lactiferous ducts and myoepithelial cells get influenced by the combined oc pills as well and the myoepithelial cells under progesterone withdrawal after stoppage of pills can cause compression and expression of remaining fluids from the ducts out through nipple. Breast tissue is affected by both oestrogen and progesterone which you have continued from last 6 months so complete stoppage of secretion never actually occurred under hormonal influence. Unless the discharge is coloured or blood tinged one should not be worried and breast secretion has never been a definite sign of pregnancy ever. So to confirm pregnancy get a serum beta hcg test done.
regards

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