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WOMEN'S HEALTH

Why Do My Nipples Hurt? Causes of Nipple Pain

December 16, 2019

Symptom Guides > Women's Health > Why Do My Nipples Hurt? Causes of Nipple Pain

by

Dr. Zina Semenovskaya

Dr. Semenovskaya specializes in emergency medicine, and received her medical degree from Weill Cornell Medical College. She is currently the medical director at Remote Emergency Medicine Consulting, LLC and splits her time working clinically as an emergency medicine attending in California and Alaska. She is the first of our doctors to be fluent in Russian.

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It may not be a topic you like to discuss with even your closest friends, but nipple pain is a real thing that most people—male and female alike—experience at one time or another. The causes of sore nipples are usually benign, such as discomfort from the material of your bra or due to hormonal changes such as with pregnancy. In rare cases, nipple pain may be a sign of something more concerning, such as an infection or breast cancer. In this article, we will explore the most common causes of nipple pain and what you can do about it.

 

Topics I will cover include:

• What Causes Nipple Pain?
• Nipple Pain Signs and Symptoms
• Diagnosing Nipple Pain
• Treatment Options for Nipple Pain
• What You Can Do at Home
• Related Conditions and Risk Factors
• When to See a Doctor

What Causes Nipple Pain?

Nipples are one of the most sensitive parts of the body, so it is not uncommon for them to sometimes feel sore or painful. Whether it is a sharp nipple pain or more subtle pain, the following is a rundown of some of the most common causes. It is important to note that all of the below (with the obvious exceptions of the menstrual cycle, pregnancy, and breastfeeding causes) apply equally to men and women.

 

 

Friction

 

Maybe your bra is too loose or too tight or maybe you’re wearing a shirt that is too tight and made of itchy material. Any of these issues could cause already sensitive nipples to become irritated and sore. The issue is also common in athletes, such as runners and swimmers, who often have to apply lubricant or other material to their nipples to prevent chafing.

 

 

Menstrual Cycle

 

For some women, sore nipples and breast tenderness is a sign of an impending period. When the hormones estrogen and progesterone rise shortly before your period begins, it can cause your breasts to feel larger and heavier, making your nipples feel sore and painful. You’ll typically feel pain relief shortly after your period begins.

 

 

Pregnancy

 

The hormonal changes that come with pregnancy affect multiple parts of a woman’s body, including the breasts and nipples. It is important to know that breast enlargement and breast and nipple soreness are among the earliest signs of pregnancy.

 

 

Breastfeeding

 

If you are breastfeeding, nipple pain is unfortunately a common occurrence, especially in the beginning. Some women will feel a sharp pain in the nipple when the baby first latches on. If the baby latches correctly, then this pain will disappear after a few seconds. If your baby is not latching on properly, you may feel pain throughout an entire feed and beyond. The pain may be accompanied by cracked and bleeding nipples. It is important to differentiate this regular nipple pain from less benign causes, such as mastitis.

 

 

Infections

 

There are certain infections that can cause nipple pain, particularly in breastfeeding women. The two most common are:

 

  • Mastitis: Mastitis is an inflammation and infection of the breast tissue, and it occurs most often in women who are breastfeeding. In addition to nipple pain and swelling, other symptoms of mastitis include a fever, chills, red streaks on the breast, warmth or burning feeling in the breast, and increased tenderness to the breast tissue.

 

  • Thrush: Breast and nipple thrush is a yeast infection that tends to occur in breastfeeding women, particularly when the nipple is cracked or injured. Thrush can also occur after taking antibiotics. A sharp, stabbing, or burning pain in your nipple, itching, and a light colored or white nipple can indicate a yeast infection. Other symptoms include redness on the breast or nipple and/or dry flaky skin around the nipple.

 

Other common causes of nipple infection include bacterial infections after trauma, such as after a nipple piercing. If you think that your nipples are infected, it is important to see a doctor.

 

 

Skin Conditions

 

If your nipple pain is accompanied by flaking, crusting, or blistering skin in the area around your nipple, called the areola, you may have dermatitis. Dermatitis is a skin condition in which your immune cells create a localized inflammatory reaction. There are several different types of dermatitis. Contact dermatitis is caused by a reaction to an irritant that your nipples come in contact with, such as a detergent or soap. Atopic dermatitis (known as eczema) is a chronic, genetic condition, often associated with allergies and asthma. Eczema causes patchy areas of dry, flaky, and itchy skin, and is rarely confined to just the nipples alone.

 

 

Breast Cancer

 

Nipple pain on its own is very unlikely to be a sign of cancer. But, if you have nipple pain along with a new lump in your breast, bloody discharge from your nipple, if your nipple becomes inverted, or if there is a change in shape or size of one breast, you should check in with your doctor right away.

 

 

Paget’s Disease

 

Paget’s disease is a very rare type of cancer, affecting only 1-4% of people with breast cancer. Although the chances of your nipple pain being Paget’s disease are extremely low, it is worth mentioning to your doctor, particularly if you’re experiencing pain only in the left nipple or only in the right nipple. Like with other types of breast cancer, symptoms may include a flat or turned-in nipple, yellow or bloody discharge from the nipple, and/or a lump in the breast.

Nipple Pain Signs and Symptoms

Individuals may experience and describe their nipple pain differently, with symptoms that include the following:

 

  • Sore nipples
  • Tender nipples
  • Sharp pain in nipples
  • Burning nipple pain
  • Aching nipples
  • Tingling feeling in nipples
  • Throbbing nipple pain

 

Of note, male nipple pain is more likely to be caused by friction or an injury, although men can also get mastitis and even breast cancer.

Diagnosing Nipple Pain

Sometimes diagnosing the cause of nipple pain can be as easy as realizing that your bra or shirt is ill-fitting or that your baby is going through a growth spurt and has had a marathon breastfeeding session.

 

But, if you have considered the possibilities and the pain is not getting better, you should consult with your doctor. To diagnose your nipple pain, your doctor will likely ask questions to help determine what triggers or worsens the pain. Your doctor will examine your breasts and nipples, and, if pregnancy is suspected, will do a blood or urine test for confirmation.

 

In the rare case that your doctor suspects that your nipple pain is a sign of breast cancer, you will likely be sent for a mammogram, ultrasound, and/or biopsy.

Treatment Options for Nipple Pain

Treatment and relief for nipple pain depends on the cause:

 

  • If your nipple pain is caused by friction, relief will come from simply switching to a better-fitting bra or a shirt made of different material. Rash guards, nipple shields, and some ointments can also help.

 

  • Menstrual-cycle and pregnancy related nipple pain will generally resolve on its own over time. Over the counter pain relievers can help, but make sure to check with your doctor before taking any medications while pregnant.

 

  • Sore nipples due to breastfeeding can be relieved by over the counter pain medicines, a warm compress placed on the breast, and lanolin ointment to prevent cracking. Always check with your doctor before taking any medications while you’re breastfeeding. Breastfeeding mothers may also want to check in with a lactation consultant for advice on proper latching.

 

  • Infections such as mastitis and thrush may require antibiotics or other prescription medications. It is generally recommended that a woman continue to pump or breastfeed even with mastitis, as this will help to clear the milk ducts and speed recovery from the infection.

 

  • Dermatitis-induced nipple pain can be treated with steroid creams to bring down the inflammation.

 

  • If it turns out that your nipple pain is caused by breast cancer or Paget’s disease, treatment may include chemotherapy, surgery, and radiation.

What You Can Do at Home

There are a few easy things you can do at home to prevent nipple pain, such as avoiding tight clothes and being fitted for a bra that provides the proper support.

 

If you tend to experience nipple pain before periods, you can try to prevent it by:

 

 

To prevent breastfeeding nipple pain and soreness, you can try:

 

  • Feeding regularly or pumping to prevent your breasts from becoming too engorged with milk.

 

  • Make sure the baby is latching properly, and use a nipple shield to decrease direct trauma from the baby’s mouth and teeth.

 

  • Change the baby’s position regularly.

Related Conditions and Risk Factors

While most nipple pain is uncomfortable but benign and easily treated, it is important to note that you are more at risk for infection requiring treatment if your nipples have already been injured by friction or dermatitis, are cracked or bleeding, or if you are lactating and breastfeeding.

 

 

Nipple Piercing Pain

 

You must also be careful if you have had a nipple piercing and are feeling pain. If the piercing site is simply irritated, the pain should subside within a few days without requiring any treatment. But the piercing site might be infected if the pain does not go away and you experience any of the following:

 

  • The piercing is hot to the touch

 

  • The area is sensitive and painful when touched

 

  • You see green, yellow, or brown discharge coming from the nipple

 

  • Swelling of the piercing site

 

  • Bad odor near the piercing site

 

An infection of a nipple piercing is usually caused by improper care after the procedure, including touching the piercing site too often and not keeping it properly sanitized. It’s also easy for tight clothing to catch or irritate the piercing.

When to See a Doctor

If your nipple pain does not improve with removal of irritants or change of clothing, or if it worsens, you should see a doctor. You should call a doctor immediately if you have signs of infection such as a fever, chills, severe pain, or redness or discharge from your nipple.

 

You should also seek medical help if you notice any breast lumps, unusual growths, discharge, or inverted nipples.

 

As discussed in this article, the causes of nipple pain can often be easily identified and treated. If none of the suggested remedies work, or if you are concerned that there is a more serious underlying cause, you should see your doctor for further evaluation.

"In general, the reason for nipple pain can be easily identified and treated and is not cause for concern."

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by

Dr. Zina Semenovskaya

Dr. Jennifer Nadel is a board certified emergency medicine physician and received her medical degree from the George Washington University School of Medicine. She has worked in varied practice environments, including academic urban level-one trauma centers, community hospital emergency departments, skilled nursing facilities, telemedicine, EMS medical control, and flight medicine.

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