Do your nipples hurt? It’s not uncommon for women to experience sore nipples during periods, pregnancy and breastfeeding. But men can also face nipple pain.
Some guys feel awkward discussing it, but there’s no need to be embarrassed. People of all ages deal with sore, tender or uncomfortable nipples. Plus, it’s a valid health concern to get checked out.
“Pain usually means something isn’t right,” said Randy Gelow, MD, a family medicine physician with Banner Health. “Nipple pain isn’t just about a problem with a nipple; other body areas could cause it. It’s important to talk about it with your health care provider.”
The good news is that there are things you can do to tackle nagging nipple pain. Dr. Gelow explains why men and people assigned male at birth might experience nipple pain and what to do about it.
Seven causes of nipple pain in men
1. Hormone changes
“Imbalances or shifts in estrogen and testosterone levels can lead to nipple tenderness or pain,” said Dr. Gelow.
Estrogen is often considered a “female hormone,” but men also have small amounts. When it is higher than it should be, it can lead to nipple tenderness or pain. There are quite a few reasons why this can happen that you and your provider can investigate together.
On the other hand, testosterone – often seen as a “male hormone” – helps balance out estrogen. A drop in testosterone levels (known as low T) can also lead to nipple pain and changes to breast tissue.
Some hormonal causes can be related to:
- Puberty: Hormonal changes during puberty can cause brief nipple pain or tenderness in boys as their bodies adjust to new hormone levels.
- Aging: As you age, your testosterone levels drop. This imbalance might cause nipple pain.
- Gynecomastia: Sometimes referred to as “man boobs,” this common condition causes boys’ and men’s breasts to become larger than usual. It often happens to preteens and teenagers but can also occur in adults.
- Pituitary conditions: The pituitary gland, located at the base of the brain, regulates the release of various hormones like prolactin. “When you have too much prolactin, it can lead to conditions like hyperprolactinemia or prolactinomas, two conditions that can cause symptoms such as nipple tenderness and breast tissue changes,” said Dr. Gelow.
2. Friction and chafing
Continuous rubbing or friction against clothes, especially during physical activities, can result in nipple pain. Chafing might happen due to poorly fitting workout clothes or repetitive movements without proper protection.
Nipple pain can also happen after sex because of skin-on-skin friction or from nipple stimulation (touching, rubbing or sucking on nipples during sex).
3. Skin conditions
“There are different skin cancers that can develop around the nipples as well and look like an infection but are skin cancers,” said Dr. Gelow.
In rare cases, your symptoms could be caused by a rare, slow-growing skin cancer that affects the breast called Paget’s disease.
Cracks or openings in the skin from skin conditions, injuries or nipple piercings can allow bacteria to enter, increasing the risk of infection.
Although rare, bacterial infections can lead to mastitis in men. This infection may cause redness, swelling, warmth, fever and pain in the breast area.
Certain medications can cause nipple pain or breast-related side effects in men. These may include:
- Hormone/testosterone replacement therapy (HRT/TRT): Testosterone replacement therapy is designed to address low T in men. “However, too much testosterone can convert to estrogen, leading to hormonal imbalances that cause nipple tenderness,” said Dr. Gelow.
- Transmasculine and transfeminine hormone therapy: Male-to-female and female-to-male transitions can potentially involve changes in hormone levels that may cause some nipple pain or sensitivity.
- Anabolic steroids: Using steroids can lead to hormonal imbalances and affect the endocrine/hormone system, causing many side effects like changes in breast tissue.
- Other medications: Medications to treat anxiety and other mental health conditions, as well as prostate conditions, may affect hormone levels or cause side effects like nipple pain.
6. Breast cancer
Though rare, nipple pain or tenderness may be a sign of breast cancer in men.
“About 1% of breast cancer cases develop in men or those assigned male at birth,” said Dr. Gelow. “That’s one in every 833 individuals.”
In male breast cancer, the symptoms are similar to those in women. They may include a lump in the breast, changes in the size or shape of the breast, nipple discharge including blood, nipple pain or tenderness and nipple inversion changes.
7. Being overweight
Obesity is not typically a direct cause of nipple pain. However, it might lead to nipple area sensitivity due to increased fat (adipose tissue) and hormonal changes.
Excess body weight can also lead to skin folds and increased friction in the areas where the skin rubs against itself.
Next steps: Talk to your health care provider
If you have nipple pain, the pain doesn’t go away or you notice some unusual symptoms like bleeding, fever or changes in how your nipple looks, talk to your health care provider. They’ll ask you questions, look at your chest and might do special tests like mammograms, blood work and/or ultrasounds to understand the issue.
Once your provider knows what’s going on, they’ll have a plan to help you feel better.
“If problems are caught early, your outcomes and treatment options are generally better,” said Dr. Gelow. “Sometimes, breast changes – including size increase in breast/nipple tissue – can be permanent if treatment is delayed.”
Treatment options might include medications, lifestyle and dietary changes, surgery and other interventions, depending on the cause of your nipple pain.
Discussing nipple pain might be awkward, but it’s important for your overall health. Contact your health care provider or a Banner Health specialist with questions or concerns.