In most cases, yes. Nipple pain is extremely common and usually tied to hormonal shifts, friction, or skin irritation rather than anything serious. It affects people of all genders and ages, and the cause is often identifiable once you know what to look for.
Hormonal Shifts Are the Most Common Cause
Fluctuating levels of estrogen and progesterone throughout the menstrual cycle are the single biggest reason nipples become sore. You’re most likely to notice it in the week leading up to your period, though some people feel tenderness around ovulation as well. The pain is typically in both nipples, feels dull or achy, and resolves once your period starts.
Pregnancy can trigger nipple sensitivity even earlier than you might expect. Breast changes, including soreness and swelling, can begin as soon as two weeks after conception, though four to six weeks is more typical. The hormonal surge that supports early pregnancy increases blood flow to breast tissue and causes rapid changes in the milk ducts, which is why tenderness can feel more intense than a normal premenstrual ache.
Certain medications also shift hormone levels enough to cause breast and nipple pain. Oral contraceptives, hormone replacement therapy, antidepressants (SSRIs like fluoxetine), some blood pressure medications, and water pills are all known to cause this as a side effect. If nipple soreness started around the same time you began a new medication, that connection is worth exploring.
Friction and Physical Irritation
Repetitive rubbing from clothing is so common among runners that it has its own name: jogger’s nipple. Cotton shirts are a frequent culprit, especially once they get heavy and wet with sweat. Cold weather makes things worse because nipples become more erect and rub more against fabric. Even a stiff shirt logo sitting in the wrong spot can do it.
Prevention is straightforward. Switch to lightweight, moisture-wicking fabrics and wear a well-fitting sports bra or snug shirt that limits movement. Covering nipples with simple adhesive bandages before a run works well, and a thin layer of petroleum jelly creates a lubricating barrier that reduces friction. If you’re getting irritation regularly during exercise, these small changes typically solve the problem completely.
Skin Reactions and Contact Dermatitis
The skin on and around the nipple is thinner and more sensitive than most of the body, which makes it especially prone to eczema and contact dermatitis. Common triggers include scented laundry detergents, harsh soaps, lotions with artificial fragrances or dyes, and certain synthetic fabrics. The result is redness, itching, flaking, and soreness that can come and go with exposure.
If you suspect a skin reaction, try switching to unscented laundry detergent made for sensitive skin and cutting out scented body products for a few weeks. Nipple eczema tends to flare when irritants are reintroduced, so the pattern of improvement and return often confirms the cause.
Breastfeeding-Related Pain
Some nipple soreness in the first week or two of breastfeeding is expected as tissue adjusts. Pain that persists beyond that, or that’s sharp and intense during feeds, usually points to a specific problem.
A poor latch is the most common culprit. When a baby doesn’t take enough breast tissue into their mouth, the nipple bears the brunt of the suction and gets compressed, cracked, or blistered. An improperly fitting breast pump flange causes the same kind of damage. Fixing the latch or flange size often resolves the pain within days.
Vasospasm is another possibility. Blood vessels around the nipple constrict, usually triggered by cold air hitting a wet nipple after a feed. You’ll notice the nipple tip turning white, then possibly blue or purple, before returning to its normal color. The pain feels like it radiates deep into the breast. Keeping nipples warm immediately after feeding and avoiding cold exposure helps. Nicotine can make vasospasm worse.
Bacterial overgrowth in breast tissue, called subacute mastitis, causes a deep, aching pain that spreads from the breast to the nipple. It may also produce small white spots on the nipple called blebs. This is different from the acute mastitis most people have heard of, which involves fever and a hot, red area on the breast. Subacute mastitis is subtler and more chronic.
Nipple yeast infections (thrush) have traditionally been blamed for burning, shooting pain and cracked skin during breastfeeding, but more recent evidence suggests yeast doesn’t commonly grow on nipple skin. What looks like thrush may actually be bacterial or related to skin damage from a poor latch. If you’re experiencing persistent pain with visible skin changes, getting a proper assessment matters because the treatment differs depending on the actual cause.
Nipple Pain in Men
Men experience nipple pain too, and the most common cause is gynecomastia, a growth of breast tissue driven by a hormonal imbalance between testosterone and estrogen. It typically feels like a firm, button-sized lump right behind the nipple that’s tender to the touch. Gynecomastia is especially common during puberty and in men over 50, when hormone levels naturally shift.
Certain medications can trigger it, including heartburn drugs, some blood pressure medications, finasteride (used for hair loss or enlarged prostate), and antifungal medications. Liver disease, thyroid problems, kidney disease, and low testosterone are also associated with gynecomastia. If you’re a man noticing new breast tenderness or a lump, the cause is almost always benign, but identifying the underlying trigger helps guide the right approach.
Friction-related nipple pain is also common in men, particularly during endurance exercise, since many men run or cycle without a fitted base layer.
Signs That Need Attention
Most nipple pain is harmless, but a few specific patterns warrant a closer look. Paget’s disease of the breast is a rare form of cancer that mimics common skin conditions like eczema. The key differences: it almost always affects only one nipple, doesn’t respond to typical eczema treatments, and progresses over time. Look for flaking, crusty, or thickened skin on or around one nipple, a nipple that has become flattened or inverted, and discharge that is yellowish or bloody. Itching and tingling are common early symptoms.
More broadly, nipple pain that is one-sided, persistent, and accompanied by visible changes to the skin or shape of the nipple is worth getting evaluated. The same goes for any spontaneous nipple discharge, especially if it’s bloody or occurs from only one breast. These symptoms don’t automatically mean something serious, but they overlap enough with conditions that benefit from early detection that checking is worthwhile.