What Are Sore Nipples a Sign Of?

Most women encounter breast pain, fullness, or nipple pain at some point in their lives.
Most women encounter breast pain, fullness, or nipple pain at some point in their lives.

Most women encounter breast pain, fullness, or nipple pain at some point in their lives.

Sore nipples are typically easy to treat, but sometimes, they can be a sign of something serious.

Sore nipples can be a possible sign of

  • Hormonal fluctuations around periods: Hormonal fluctuations are the number one cause of sore nipples in women. Increasing estrogen levels cause the breast tissue to swell a few days before the menstrual period. The pain usually stops once the woman gets her period.
  • Pregnancy: Along with other signs such as missed periods, breast tenderness along with sore nipples is one of the earliest signs of pregnancy for many women. The surge in hormones caused naturally by pregnancy is responsible for it.
  • Breast injury: Nipples may get injured during sexual activity (nipple play) or because of an accident. The woman may feel a sharp, shooting pain at the time of injury.
  • Improper sucking of the breasts by the baby: During breastfeeding, the baby may aggressively or improperly suck on the woman’s breast. This may cause pain that goes away after the baby finishes their feeding. If the baby doesn't latch on correctly, the woman may get sore nipples, and the pain may last throughout breastfeeding. Sore nipples due to breastfeeding usually get better as the baby gets the hang of feeding.
  • Mastitis: Mastitis is an inflammation of the breast tissue that may be the result of an infection. It mainly affects breastfeeding women. It causes swelling, redness, and pain in one or both breasts. Sometimes, fever and chills are also observed. If left untreated, mastitis can lead to a breast abscess.
  • Fungal infection: Nipple thrush is a fungal (yeast) infection of the breast and nipple that can occur during breastfeeding. The condition can cause strong nipple and breast pain.
  • Ill-fitted bras: Wearing bras that fail to provide adequate support to the woman’s breasts can be the cause of her sore nipples. Overstretching of the breast ligaments due to an ill-fitted bra can cause her breast to ache. This is more important in women who are involved in sports activities and exercises such as jogging.
  • Dry, cracked or chafed skin: A woman may develop sore nipples if she suffers from skin conditions such as atopic dermatitis (eczema) and contact dermatitis that affects her breasts. Atopic dermatitis happens due to allergy to certain irritants, genetics, and problems in your immunity system. Contact dermatitis develops when the woman has an allergy to the material of her bra (usually synthetic) that she is wearing. Both these conditions usually cause itchiness.
  • Paget’s disease: Paget's disease of the nipple is a rare condition that occurs in breast cancer. It causes drying and redness of the nipple and areola (area of darker skin surrounding the nipple).
  • Cancer: A sore on the nipple that does not get better may be a warning sign of breast cancer that involves the nipple. The sore may be painless and accompanied by a lump in the breast.

When to see a doctor for your sore nipples?

Most causes of nipple soreness are treatable. For example, moisturization of the skin over the nipples when they are dry and irritated provides a soothing effect. For skin conditions such as mild forms of dermatitis, over the counter medications can help. If the cause is friction in joggers and athletes, wearing the correct size and shape of a bra will prevent sore nipples.

In most of the patients, nipple soreness is a sign of minor problems. In the case of additional concern, it’s important that the patient talks to their doctor. Accompanying signs such as fever, lump, severe itching, and any worsening nipple pain warrants a visit to the doctor.

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References
Diagnosis and Management of Candida of the Nipple and Breast. Available at: https://www.medscape.com/viewarticle/527409_2

Common breastfeeding problems. Available at: https://www.uptodate.com/contents/common-breastfeeding-problems-beyond-the-basics

Paget Disease of the Breast. Available at: https://www.cancer.gov/types/breast/paget-breast-fact-sheet#: