Nipple pain is almost always caused by something harmless, most commonly hormonal shifts during your menstrual cycle, friction from clothing, or breastfeeding-related irritation. Less often, it signals an infection, a skin condition, or a medication side effect. Understanding what’s behind the pain usually comes down to timing, what the skin looks like, and whether you have other symptoms alongside it.
Hormonal Changes During Your Cycle
The most common reason for nipple soreness is the rise and fall of estrogen and progesterone throughout your menstrual cycle. Nipples tend to be most sore in the week leading up to your period, when progesterone peaks and causes breast tissue to swell slightly and retain fluid. Ovulation (roughly mid-cycle) can trigger the same thing. This type of pain is typically dull or tender rather than sharp, affects both sides, and resolves once your period starts.
Early Pregnancy
Sore, tingling nipples are one of the earliest signs of pregnancy, sometimes appearing before a missed period. The nipples may darken, and the veins across the breast can become more visible. This happens because hormone levels rise rapidly in early pregnancy, causing breast tissue to expand and blood flow to increase. If your period is late and your nipples have been unusually tender for more than a week, a pregnancy test is a reasonable next step.
Friction and Chafing
Repetitive rubbing from clothing is a well-known cause of nipple pain, sometimes called “jogger’s nipple.” Every stride shifts fabric slightly across your chest, and over the course of a long run or workout, that friction can chafe the skin raw or even crack it. Sweat-soaked shirts that stick to the chest make this worse, and cold weather can too, since nipples become more erect and exposed to rubbing.
Prevention is straightforward. Moisture-wicking, snug-fitting shirts reduce fabric movement. A supportive sports bra adds another layer of protection. For extra insurance, placing a simple adhesive bandage over each nipple before exercise creates a barrier. Petroleum jelly or a sport-specific anti-chafe balm applied beforehand also works well.
Breastfeeding-Related Pain
Sore, cracked nipples are extremely common in the first weeks of breastfeeding, usually because of a shallow latch. When a baby doesn’t take enough of the areola into their mouth, the nipple bears the brunt of the suction and compression. Correcting the latch often resolves the pain within days.
If you’re dealing with cracked or damaged nipples, a few simple measures speed healing. A warm saline soak after feeding (half a teaspoon of salt in a cup of warm water, applied for no more than five to ten minutes) helps clean the area without drying it out. Applying a thin layer of medical-grade lanolin or even expressed breast milk keeps the skin’s internal moisture intact, which promotes repair. Between feedings, let nipples air-dry when possible, and swap out nursing pads as soon as they get damp. Cold compresses before latching can briefly numb the area and make that initial latch-on less painful.
Thrush
A yeast infection called thrush can develop on the nipple, especially during breastfeeding. The hallmark is a burning pain that flares after every feed, rather than during it. You may also notice itching, shiny or flaking skin on the nipple or areola, white patches or tiny blisters, and sometimes a loss of color in the nipple. On darker skin tones, the redness typical of thrush can appear as a deeper brown, purple, or grey, which makes it harder to spot. Thrush passes easily between a nursing parent and baby, so both typically need treatment at the same time.
Mastitis and Breast Infections
Mastitis is an infection of the breast tissue that causes a painful, red, swollen area, often accompanied by fever, chills, and a racing heart. It most commonly affects people who are breastfeeding, though it can occur outside of breastfeeding too. The pain tends to concentrate in one region of one breast and can spread outward. If you develop a fever lasting more than 24 hours along with a hot, tender area on the breast, that warrants prompt medical attention, since bacterial mastitis generally requires antibiotics.
Skin Conditions
Eczema and contact dermatitis can affect the nipple just as they affect skin anywhere else on the body. Rough fabrics, fragranced soaps, laundry detergents, or body lotions are common triggers. The skin may look red, dry, and flaky, and it usually itches more than it hurts. Switching to fragrance-free products and wearing soft, breathable fabrics often clears it up.
A rarer condition called Paget’s disease of the breast can look similar to eczema at first, with flaky, crusty, or scaly skin on the nipple. The key differences: Paget’s disease affects only one breast, may produce a straw-colored or bloody discharge, and doesn’t improve with standard eczema treatment. A nipple that becomes inverted (turns inward) or breast skin that thickens are additional warning signs. This condition is associated with an underlying breast cancer and needs a biopsy to diagnose.
Medications That Cause Nipple Soreness
Several classes of medication list breast or nipple tenderness as a side effect. Oral contraceptives and hormone replacement therapy are the most common culprits, since they directly alter estrogen and progesterone levels. Certain antidepressants (SSRIs like fluoxetine), some antipsychotics, and the blood pressure medication spironolactone can also cause it. If your nipple pain started shortly after beginning a new medication, that connection is worth raising with whoever prescribed it.
Nipple Pain in Men
Men and boys experience nipple pain too, and the most common cause is gynecomastia, a swelling of breast gland tissue driven by an imbalance between estrogen and testosterone. The nipples become tender, sensitive to clothing, and the tissue behind them may feel firm or puffy. This happens most often during three life stages: infancy, puberty, and older age, all times when hormone ratios naturally shift.
Beyond natural hormonal fluctuations, several substances can trigger gynecomastia. Alcohol, anabolic steroids, marijuana, and amphetamines all alter hormone balance enough to cause breast tissue growth. Health conditions including an underactive thyroid, kidney failure, liver disease, and low testosterone (hypogonadism) can do the same. In teenagers, the tenderness usually resolves on its own within six months to two years as hormone levels stabilize.
Simple Relief for Sore Nipples
Regardless of the cause, a few general strategies help manage nipple pain. Over-the-counter pain relievers like ibuprofen reduce both pain and inflammation. Wearing soft, well-fitting clothing minimizes friction. Keeping the skin moisturized with a fragrance-free balm or petroleum jelly prevents further cracking and irritation. If the skin is broken, gently cleaning the area once daily with a mild, unscented soap and rinsing thoroughly helps prevent infection without stripping natural oils. Avoid prolonged soaking in water, which can over-hydrate the skin and actually promote cracking.
Nipple pain that affects only one side, lasts more than two to three weeks without an obvious explanation, involves bloody discharge, or comes with a visible lump is worth getting checked. For the vast majority of people, though, the cause turns out to be hormonal, mechanical, or easily treatable.