What Causes Painful Nipples?

Posted on Thu, 23 Jan 2014

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Thu, 23 Jan 2014 Answered on

Mon, 10 Feb 2014 Last reviewed on

Question : 72 year old male; painful nipples, both sides, if pressed or bumped.

Answered by Dr. Shoaib Khan (50 minutes later)

Brief Answer: A list of causes for you sir Detailed Answer: Hello sir and welcome. Thank you for writing to us. I can understand how this can be slightly restricting at times, and shall surely help you by listing the causes for such a presentation, they are: -Hormonal imbalance -Exercise or activity-related injury -Runners nipple (especially seen in joggers) -Infection of the breast tissue called mastitis -Breast cyst (fluid-filled sac which can be palpated) -Fibroadenoma (rare growth in men) Please write back to me with a more elaborate description of the chest muscle, nipple, areola region (eg. lump, swelling, oozing, etc.). I hope you find my response helpful, please feel free to write back to me for any further clarifications, I would be more than happy to help you. Best wishes.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Shoaib Khan (46 minutes later)

Thank you for your response. Of the six possible causes you listed above, I do not believe the first four are applicable. I have no other evidence of hormonal imbalance, haven't done running since cancer three years ago, and have no apparent evidence of infection. The pain I experience, which occurs when bumped or pushed in the nipple, feels like there is something inside the nipple, perhaps a cyst, or fibroadenoma. Seems like a small lump, like a BB in size. A cyst would seem more unlikely to me because the discomfort, sensitivity, is the same in both nipples. What is fibroademoma and is there an easy test to find out about that?

Answered by Dr. Shoaib Khan (15 minutes later)

Brief Answer: Yes sir, an ultrasound of the affected region Detailed Answer: Hello once again sir. Sure sir, a physical examination and an ultrasoundof the affected region will help diagnose/rule out both a cyst and a fibroadenoma. A fibroadenoma is a small tumor, more common in women of course, but is usually hormone dependant and occurs in the reproductive age group ( when seen in women). But in males it can occur at any age, is just caused due to a raised level of female hormones. If you do not mind me adding this to my recommendations, please also conduct a blood investigation to check on your hormone levels which will also assist in ruling out/diagnosing both fibroadenomas and a hormonal imbalance. I hope this information helps you sir. Please do not hesitate to write to me anytime, I am always available. Best wishes.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Shoaib Khan (12 minutes later)

Thank you again for your helpful response. I had a blood test recently (as a follow-up with urologist from cancer treatment) and, although we weren't looking for it, there was no indicators suggesting hormone imbalance. What assumptions can we make based on the fact that Both nipples are painful in the same way? Is it likely that a cyst or tumor would develop simultaneously in both nipples?

Answered by Dr. Shoaib Khan (17 minutes later)

Brief Answer: Unlikely for cyst or fibroadenoma to present such Detailed Answer: Hello once again sir. It is unlikely for a cyst or fibroadenoma to develop in both breasts simultaneously and cause exactly the same symptoms, as explained by you which is why I was stressing on a possible hormonal imbalance which in many ways fits the description perfectly. But if you feel that your doctors have ruled this out with an elaborate hormonal panel, then there is obviously no doubting that sir. I would also like to add a possible side effect caused by any medications that you were on or are still currently on. Please consider ruling out that possibility as well sir. Best wishes.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar