Pain caused by hormonal changes associated with menstruation can be treated with over-the-counter pain relievers like acetaminophen or ibuprofen. Most people feel relief after 24 or 48 hours.
Understanding Nipple Pain: Causes, Treatment, and More
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There are many possible causes of sore nipples. Some are as benign as a poorly fitting bra. Others, like breast cancer, are more serious. That’s why you should see your doctor about any nipple soreness that doesn’t improve.
Read on to learn about causes of nipple pain and what you can do to manage this symptom.
One of the easiest explanations for sore nipples is friction. A loose bra or tight shirt can rub against your sensitive nipples and irritate them. If friction isn’t the cause, here are a few other conditions to consider.
Menstrual periods
Some women notice that their breasts get sore just before their period. This soreness is caused by a rise in the hormones estrogen and progesterone, which causes your breasts to fill with fluid and enlarge. The pain should go away once your period arrives or shortly thereafter.
Pregnancy
Pregnancy is a time of change in your body. You’ll notice several changes, from sore breasts to swollen ankles, as your body’s hormone composition changes to support your growing baby. Breast enlargement and soreness are among the earliest signs of pregnancy. You might also see some small bumps pop up around your nipples.
Other signs that you might be pregnant include:
- missed periods
- nausea or vomiting, including morning sickness
- urinating more often than usual
- fatigue
The soreness should pass, but your breasts will likely keep growing as your pregnancy progresses.
Eczema or dermatitis
Crusting, flaking, or blistering around your nipple in addition to pain may indicate that you have a skin condition called dermatitis. Eczema is one type of dermatitis.
Dermatitis happens when immune cells in your skin overreact and cause inflammation. Sometimes you can get dermatitis from coming into contact with irritating substances like detergents or soaps.
Breast cancer
Nipple pain is one sign of breast cancer. Along with the pain, you might also have symptoms like these:
- a lump in your breast
- nipple changes like redness, scaling, or turning inward
- discharge from the nipple other than breast milk
- change in the size or shape of one breast
Nipple pain is most likely not cancer. If you have other symptoms of breast cancer, it’s worth getting checked out.
Your treatment will depend on what’s causing the nipple soreness. If the cause is friction, switching to a better-fitting bra or shirt may help. Dermatitis is treated with steroid creams and lotions that bring down inflammation.
Try these tips to relieve nipple tenderness caused by breastfeeding:
- take pain relievers like acetaminophen (Tylenol) or ibuprofen (Advil, Motrin)
- hold a warm, moist compress to your breasts
- use a lanolin ointment to prevent nipple cracking
Breast cancer may be treated with one or more of the following:
- surgery to remove the lump or the entire breast
- radiation therapy, which uses high-energy rays that destroy cancer cells
- chemotherapy, or drugs that travel through the body to kill cancer cells
- hormone therapy, which are treatments that block the hormones that certain types of breast cancer need to grow
- targeted therapies, which are drugs that block specific changes in cancer cells that help them grow
If you can’t trace nipple soreness back to an obvious cause, like your period or an ill-fitting bra, and the pain doesn’t go away, see your doctor. You can see your primary care doctor or an OB-GYN for tests.
Your doctor will ask about your symptoms and what seems to trigger the soreness. For example, they may ask if your nipples hurt right before your period or when you breastfeed. Then the doctor will examine your breasts and nipples. If you suspect you might be pregnant, your doctor will do a blood test to confirm it.
If the doctor thinks you might have cancer, you’ll have one or more of these tests:
- Mammogram is a test that uses X-rays to look for cancer in your breast. You can have this test as part of a regular screening or to diagnose breast cancer.
- Ultrasound uses sound waves to look for changes in your breast. An ultrasound can tell whether a lump is solid, which could be cancer, or fluid-filled, which could be a cyst.
- Biopsy removes a sample of tissue from your breast. That tissue is examined in a lab to see if it’s cancerous.
Women who breastfeed can sometimes develop sore nipples from the suction, especially when your baby first starts to latch on. Expressing milk with a breast pump can also cause nipple pain if the shield is ill-fitting or if the suction is too high.
Pain in the nipples could also be a sign of one of these infections:
Mastitis
Mastitis is an infection that makes the breast swell up, turn red, and become sore. Other symptoms include a fever and chills.
You can develop mastitis when milk gets trapped in one of your milk ducts and bacteria start to grow inside. Your doctor can prescribe antibiotics to treat the infection.
Untreated mastitis can lead to a collection of pus in your breast called an abscess. See your doctor right away if you’re breastfeeding and have pain in your nipple along with any of these symptoms:
- fever
- breast swelling or warmth
- skin redness on your breast
- pain while nursing
Thrush
Another cause for sore nipples while breastfeeding is thrush. Thrush is a yeast infection you can get if your nipples dry out and become cracked from breastfeeding. When you have thrush, you’ll feel a sharp pain in your nipples or breasts after your baby feeds.
Your baby can also get thrush in their mouth. It shows up as white patches on their tongue, gums, and other surfaces inside the mouth.
Thrush is treated with an antifungal cream that you rub on your nipples after you breastfeed.
Avoiding tight clothes and wearing a more supportive bra can help control nipple pain. Every time you buy a new bra, try it on. It can help to visit a store where the salesperson measures you to make sure you get the right fit. Breast size can change over time, so it’s worth having your size rechecked from time to time.
If the pain happens before your periods, here are a few ways to prevent it:
- Avoid caffeine, which may contribute to growths called cysts in your breasts.
- Limit salt during your period. Salt can cause your body to hold onto more fluid.
- Exercise more often to help your body remove excess fluid.
- Ask your doctor about going on birth control pills, which can sometimes help prevent soreness.
To prevent soreness while breastfeeding, try these tips:
- Feed your baby regularly or pump to prevent your breasts from getting too engorged with milk.
- Nurse your baby on the sore side first to relieve the pressure.
- Make sure your baby latches on properly.
- Change your baby’s position regularly.
If you’re having trouble helping your baby to establish a good latch, or if you can’t find a comfortable position to hold your baby, considering talking to a lactation consultant, your doctor, or your child’s pediatrician. They can watch you breastfeed and provide tips and guidance to help make it easier.
Sore Nipples
Sore nipples and nipple pain can be caused by many things like pregnancy and breastfeeding, allergic reactions or infection. In rare cases, it’s a sign of cancer. Treatment for sore nipples depends on the cause.
Overview
Why are my nipples sore?
Many things can cause nipple soreness or painful nipples. Along with discomfort or sensitivity, you can also experience itching, redness or changes in the texture of your skin around your nipple.
In most cases, sore nipples are caused by hormonal changes from pregnancy or menstruation, allergies or friction from clothing. In rare cases, it can be a sign of a serious disease like breast cancer. Your healthcare provider should evaluate any pain that’s accompanied by discharge or lumps as soon as possible.
Everyone experiences nipple soreness or tenderness differently. Some may describe their nipples as being:
- Very sensitive to touch.
- Throbbing or stabbing.
- Aching.
- Burning.
- Tender or sore.
- Red or swollen.
- Itchy.
Possible Causes
What are the most common causes of sore nipples?
Symptoms of nipple pain or tenderness vary from person to person depending on the cause.
Menstruation or other hormonal changes
The hormonal changes that occur as part of menstruation can cause breast tenderness and sore nipples. Most cases of breast or nipple tenderness occur just before menstruation begins (in the days just before your period). This is because estrogen and progesterone cause your breast tissue to swell.
Similarly, other life events like menopause or beginning puberty can also cause your hormones to shift, triggering side effects like nipple pain.
Hormonal birth control can also cause changes that lead to nipple soreness.
Pregnancy
Pregnancy is a common reason for many bodily changes, including changes to your breasts. Nipple and breast soreness may be an early sign of pregnancy due to the sharp increase in hormones. Your nipples may become larger, darker and more sensitive during pregnancy.
Breastfeeding (chestfeeding) or pumping breast milk
A bad latch causes most cases of nipple pain or soreness related to breastfeeding (nursing). A latch is how your baby is positioned on your breast. A good latch involves your baby accepting your entire nipple and areola in their mouth. If your baby is sucking on just your nipple, it can make breastfeeding extremely painful. If your pain continues beyond the first few weeks, talk to your healthcare provider. Most breastfeeding pain resolves within the first month of breastfeeding.
If you’re pumping breast milk, you can experience nipple pain from using a breast shield (also called a breast pump flange) that’s the incorrect size. A breast shield is a plastic piece that fits over your areola and nipple. Strong suction makes a poor-fitting breast shield even worse.
Check with your healthcare provider or a lactation consultant if you believe nursing or your breast pump is causing your nipple pain.
Friction from clothing
Bras or shirts can rub against your nipples and cause soreness and pain. It’s especially common in runners (joggers nipple) and athletes. The friction from clothing or poor-fitting bras can cause your nipples to get dry, red or chapped. Wearing a bandage over your nipple during exercise or applying a petroleum-based ointment can help prevent nipple chafing.
Trauma
Trauma to your nipple during sex or from nipple piercings can cause pain and irritation. If you have a piercing, check for signs of infection like swelling or pus-like discharge. If nipple soreness is caused by rough foreplay, it should improve over time.
Infection
Cracked and sore nipples are prone to infection because the open skin allows for bacteria to get in. Your nipples can become cracked for several reasons, such as during breastfeeding or from trauma. Common reasons are:
- Mastitis: Lactation and breastfeeding can increase your chances of developing mastitis, a painful breast infection. Other symptoms include fever and hard, red spots on your breast.
- Thrush: A yeast infection called thrush can also cause nipple pain, stinging or soreness. Your baby may also develop thrush on their tongue, cheeks or throat.
- Folliculitis: Clogged hair follicles around your nipples can also become infected and cause soreness.
Allergic reactions or skin rashes
Reactions to skin irritants like detergents, soaps, perfume or lotions are a common cause of nipple soreness or itching skin. If the pain is accompanied by blisters, scaly patches or redness on your nipple area, it could be a skin condition called dermatitis. Contact dermatitis is caused by products or irritants touching your skin. Atopic dermatitis (or eczema) is usually related to allergies or your immune system. Both can affect your nipples.
Disease or cancer
Paget’s disease of the breast or breast cancer can cause nipple pain. In addition to sharp pain or itching, you might also have nipple discharge, lumps on your breast or your nipple may change shape (turn inward or become inverted). Although nipple pain caused by cancer is rare, you should contact your healthcare provider if you experience any of these symptoms.
Does ovulation cause sore nipples?
Ovulation can cause sore nipples due to hormonal changes that occur during your menstrual cycle. However, it’s more common to experience nipple tenderness in the days just before your period.
Why are my nipples sore to touch when I’m not pregnant?
There can be several reasons your nipples are sensitive to touch other than pregnancy. If you’re not pregnant, other causes could be hormonal shifts due to menstruation or birth control, trauma or infection. If you experience prolonged soreness that’s accompanied by a lump or nipple discharge, contact your healthcare provider right away.
Care and Treatment
How do doctors diagnose nipple pain?
In most cases, you can pinpoint the cause of your nipple soreness. If you can’t, or the pain and soreness persist for several days, you may need to see your healthcare provider. Your provider may ask you questions about when the pain started or if the pain is related to your period, clothing or previous nipple trauma.
If the cause can’t be determined, your provider may order a mammogram or ultrasound to look at your breasts.
How are sore nipples treated?
It depends on the cause. Sometimes all your nipples need is some time to heal. Your healthcare provider may recommend medications or ointments to speed up the healing process.
Pain caused by hormonal changes associated with menstruation can be treated with over-the-counter pain relievers like acetaminophen or ibuprofen. Most people feel relief after 24 or 48 hours.
Nipple pain caused by poor-fitting bras or shirts can be treated by changing fabrics or purchasing new clothes. Placing a bandage or petroleum-based ointment over your nipples can reduce chafing or rubbing.
If you’re nursing or pumping breast milk, visiting a lactation consultant may be beneficial. They can help with your baby’s latch or feeding positions and ensure your breast pump fits correctly. Other solutions for nipple pain during breastfeeding include lanolin ointment and cold compresses. Antibiotics are used if the pain is being caused by an infection like thrush or mastitis.
A topical anti-inflammatory cream may help with inflammation and pain caused by an allergic reaction. Similarly, an oral antihistamine can help reduce symptoms caused by allergies.
In the case of cancer or other breast diseases, treatment could involve radiation, chemotherapy, surgery or a mastectomy (surgically removing your breasts). Sore nipples alone don’t mean you have cancer. Along with nipple pain, you might also have nipple discharge, lumps on your breast or your nipple may turn inward.
Why Do My Nipples Hurt?
Nipples are sensitive, and they can hurt for lots of reasons. Tight clothes, rashes, and infections can all irritate the tender skin. For women, sore nipples are common during periods, pregnancy, and breastfeeding.
Any pain in your nipples can make you wonder if you have breast cancer. It’s rare for it to be the main symptom of the disease, but you should still see your doctor to have nipple pain checked out if it doesn’t go away.
Here are some of the most common causes of nipple soreness and how to treat them.
Poorly Fitting Clothes
A loose shirt or bra can rub against your nipples and irritate your skin, especially with repeated motion like long-distance running. Too much friction could make your nipples bleed.
Avoid this problem by wearing tops and bras that fit you well. Before you run, cover your nipples with waterproof bandages or nipple guards to protect them.
When chafing causes soreness, apply an antibiotic ointment. Then cover the nipple with sterile gauze.
Skin Conditions
Soreness plus an itchy rash and swelling around your nipple could be signs of skin irritation called dermatitis. Allergies and irritants in your environment cause this common condition.
- Eczema, also called atopic dermatitis, happens because of dry skin, genetics, and problems with the immune system.
- Contact dermatitis starts when something touches your skin and irritates it, like a chemical in perfume, soap, or jewelry.
Treating eczema will ease any soreness it causes. Your doctor might give you:
- Steroid creams
- Creams or lotions that calm your immune system
- Light therapy (phototherapy)
If your dermatitis is caused by an allergy or irritant, your doctor may suggest antihistamine pills, moisturizer, and a corticosteroid cream for your skin. An oatmeal bath can ease soreness, too.
Call your doctor if your symptoms don’t get better in a couple of weeks or if they get worse. Also call if you have these signs of an infection in your nipple:
- Fever
- Pus
- Severe pain
- Redness that doesn’t get better
Menstrual Periods
Sore nipples and breasts can be signs that your period is coming. Rising estrogen levels cause breast tissue to swell. The pain should stop once you get your period or shortly afterward.
Pregnancy
Hormone changes also cause nipple tenderness during pregnancy. But the main signs that you’re pregnant include:
- Missed periods
- Nausea and vomiting
- Feeling tired
- Peeing more often than usual
Your breasts and nipples will also swell. They may leak fluid as you get closer to delivery.
Choose a maternity bra that fits well. If your breasts really hurt, ask your doctor which pain relievers are safe for you to take during pregnancy.
Breastfeeding
As your baby latches onto your breast, you may feel a short burst of pain in your nipple. The pain should stop after a few seconds.
If your baby doesn’t latch on correctly, the pain could last through the whole feeding. It might feel like a sharp pinch. Your nipples can also crack and bleed.
Your symptoms should get better as your baby gets the hang of feeding. But there are a few ways you can ease soreness:
- Gently squeeze out a few drops of milk and rub them over your nipples to soften them before you nurse.
- Put a balm or ointment, such as lanolin, on your nipples.
- Let your nipples air dry after each feeding. Change your breast pads often to keep them dry.
- Wear a comfortable cotton nursing bra. Make sure it fits well so it doesn’t rub against your nipples.
- Try different feeding positions until you find one that’s comfortable.
If you’re having trouble getting a good, non-painful latch, your doctor or a lactation consultant can help you and your baby make some adjustments to make you more comfortable.
Infections
Intense pain in your nipple could be a sign of an infection.
Mastitis is an infection of the milk ducts. It happens when bacteria grow inside blocked ducts. It’s most common during breastfeeding, but women can get it during other times of life. Men can sometimes have mastitis, too.
Other symptoms are:
- A fever of 101 F or higher
- Chills
- Redness or red streaks on the breast
- Warmth or burning in the breast
- Swollen breasts
You’ll need antibiotics to treat the infection. Make sure to take the whole dose your doctor prescribes, even if you start to feel better.
Thrush is a yeast infection of the breast and nipple that can happen when you’re breastfeeding, especially if you have cracks in your nipple. You can also get it after you’ve taken antibiotics.
Pain from thrush feels like a stabbing, shooting, or burning in your nipples. You might also see:
- Redness on your nipples or breast
- Dry or flaky skin around the nipple
Your baby can catch thrush while breastfeeding, or they can pass it to you. It can look like a white coating on their tongue and cheeks.
Antifungal medicine treats thrush. Your baby will also need treatment if they’re infected.
Breast Cancer
Any pain in your breast could make you worry about breast cancer. Although nipple pain can be a sign of the condition, it’s rarely the main symptom. You’re much more likely to have a painless lump in your breast.
- A nipple that turns inward
- Redness or scaling of the skin over the breast or nipple
- Discharge from the nipple that isn’t breast milk
- Swollen lymph nodes under your arm
Call your doctor if you notice any changes like these in your breasts. Men should stay alert too, because they can also get breast cancer.
- Surgery
- Chemotherapy drugs
- Radiation
- Hormone therapy
- Targeted therapy
- Immunotherapy
Paget’s Disease
The odds of nipple pain being Paget’s disease are very low. This rare cancer affects only 1% to 4% of people with breast cancer.
Paget’s usually affects only one breast. It looks a lot like dermatitis, with red, flaky, and itchy skin around the nipple. It may also cause symptoms like:
- A flat or turned-in nipple
- Yellow or bloody discharge from the nipple
- A lump in the breast
- Thickened skin over the breast
See your doctor for symptoms like these. Men can get Paget’s too, and they should also ask the doctor about nipple changes.
Doctors treat this cancer with surgery to remove the nipple and the colored area around it, called the areola, along with part or all of the breast. Radiation or chemotherapy afterward kills any cancer cells that are left behind.
Show Sources
American Academy of Dermatology: “What is eczema?” “Contact dermatitis.”
American Cancer Society: “Breast Cancer Signs and Symptoms.”
Australian Breastfeeding Association: “Sore/cracked nipples.”
Breast Cancer Care: “Breast changes during and after pregnancy.”
Cancer.Net: “Breast Cancer: Treatment Options.”
CDC: “How Is Breast Cancer Treated?”
Cleveland Clinic: “Thrush.”
KidsHealth: “Breastfeeding FAQs: Pain and Discomfort.”
Mayo Clinic: “Contact dermatitis: Symptoms & causes,” “Dermatitis: Diagnosis & treatment,” “Dermatitis: Symptoms & Causes,” “Mastitis: Diagnosis & treatment,” “Mastitis: Symptoms and Causes,” “Paget’s disease of the breast: Diagnosis & treatment,” “Paget’s disease of the breast: Symptoms & causes,” “Symptoms of pregnancy: What happens first.”
National Cancer Institute: “Paget Disease of the Breast.”
NHS: “Breastfeeding and thrush,” “Sore or cracked nipples when breastfeeding.”
Ochsner Clinic Foundation: “How to Avoid Nipple Chafing While Running.”
Susan G. Komen: “Warning Signs of Breast Cancer.”
The Royal Women’s Hospital: “Breast & nipple thrush.” “Breast soreness.”
UpToDate: “Common breastfeeding problems.”
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