What causes nipple pain?
Nipple pain can occur as a normal symptom of the menstrual cycle as breasts, and sometimes nipples in particular, become more sensitive with changes in levels of the hormones estrogen and progesterone. Another frequent cause is nipple irritation or surface abrasion from friction with fabric if you don’t wear a bra or if you wear an ill-fitting bra.
A frequent cause of nipple pain is breastfeeding. The nipples can easily become dry and cracked. Furthermore, if the nipple surface becomes cracked, bacteria can enter and lead to an inflammatory disorder, which causes additional nipple and breast pain.
Friction causes of nipple pain
Nipple pain may be caused by abrasions due to friction including:
- Not wearing a bra, particularly during exercise or physical activity
- Rough handling
- Wearing an ill-fitting bra
Physical causes of nipple pain
Nipple pain can also be caused by physical changes including:
- Breast-alteration surgery
- Drying or cracking of the nipple or areola
- Hormonal changes during the menstrual cycle
- Inverted or prominent nipple (normal conditions that can cause positional friction in some cases)
- Onset of puberty
Disorder-related causes of nipple pain
In some cases, nipple pain may be a symptom of a specific disorder. These include:
- Breast abscess or Zuska’s disease (rare condition of abscesses around the nipple)
- Breast and nipple inflammation (mastitis)
- Contact dermatitis
- Galactocele (a benign cystic tumor in the breast)
- Galactorrhea (spontaneous discharge of milk in a nonbreastfeeding woman)
Serious or life-threatening causes of nipple pain
In some cases, nipple pain may be a symptom of a serious or life-threatening condition including:
- Breast cancer
- Paget’s disease of the nipple
Questions for diagnosing the cause of nipple pain
To diagnose your condition, your doctor or licensed health care practitioner will ask you several questions related to your nipple pain including:
- How long have you felt pain in your nipple? When did you first notice it?
- Does the pain occur in association with pain in another part of the breast?
- Does the pain occur cyclically? Does it come and go at predictable intervals, or is it constant?
- Is the pain bilateral or unilateral (occurring in just one nipple or in both)?
- Do you experience fever or chills with the pain?
- Do you have any other symptoms? Any redness? Heat at the site? Swelling? Hardening?
- Do you have any new or unusual lumps in your breast? Under your arms? In your neck?
- Do you have any nipple discharge?
- Have you experienced a recent injury to your nipple or breast?
- Have you ever had breast surgery?
What are the potential complications of nipple pain?
Complications of nipple pain are rarely life threatening. You can avoid complications related to any inflammation by treating the inflammation promptly. If you are breastfeeding, practice good hand and breast hygiene, especially around the nipple area, and continue nursing unless your physician orders otherwise. Often, nipple tenderness is greatly reduced by more frequent breastfeeding to relieve the milk ducts.
Because nipple pain can be due, in a few cases, to serious diseases, failure to seek treatment can result in serious complications and permanent damage. Once the underlying cause is diagnosed, it is important for you to follow the treatment plan that you and your health care professional design specifically for you to reduce the risk of potential complications including spreading of a malignancy (if present) or complications of untreated infectious diseases, which include:
- Disfigurement and scarring
- Sepsis (life-threatening bacterial blood infection)
What is nipple pain?
Nipple pain can describe any discomfort in the nipple area and can result from mild physical surface abrasion from such activities as breastfeeding, engaging in physical activity (for example, exercise or jogging) without a bra, wearing a poorly fitted bra, or participating in any activity that produces friction on the skin of the breast.... Read more about nipple pain introduction