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Nipple pain in men: When to raise the red flag
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Nipple pain in men: When to raise the red flag

Nipple pain in men is often not discussed due to the stigma attached to it. The pain, however, may be a sign of serious issues including breast cancer, say experts
A major reason for male nipple pain is hormonal imbalances, common in boys going through puberty.
Friction from clothing is the most frequent cause of nipple pain in men.

Nipple pain in men can stem from various causes like injury, inflammation, or hormonal imbalance. However, most tend to hesitate to address the pain due to the stigma attached to it. Nipple pain could be an indication of more serious conditions such as breast cancer, say experts.

Causes of nipple pain in men

Friction from clothing is the most frequent cause of nipple pain in men. This is commonly faced by athletes.

“We call it runner’s nipples; the irritation or pain of the nipples caused due to friction between clothing and the skin while running or exercising for a prolonged time,” says Dr Manish Itolikar, consultant physician, Fortis Hospital, Mulund, Mumbai. “Sometimes certain skin conditions like dermatitis or eczema in the nipple area can cause discomfort.”

Men may develop nipple pain from conditions such as breast fat necrosis, a condition characterized by the breaking down of fatty tissue in the breast, causing lumps or pain.

“As the dead fatty tissue may lead to inflammation and pressure on surrounding structures, including nerves in the breast area, it manifests as nipple pain in affected men,” explains Dr Itolikar.

Hormonal imbalance and nipple pain in men

Another major reason for male nipple pain is hormonal imbalances, common in boys going through puberty.

“Hormonal changes are normal during puberty,” says Dr Sudeep P Manohar, consultant endocrinology, Apollo Speciality Hospital, Bengaluru. “The surge in oestrogen and testosterone levels during puberty in boys may lead to breast enlargement [known as gynecomastia] and nipple pain.”

According to Dr Manohar, there is no need to take any action about it because it normally goes away on its own as the hormone levels stabilize.

The rise in prolactin hormone can also cause breast enlargement and nipple pain in men. The specific hormone that helps women during pregnancy and breastfeeding shows a surge in men due to factors such as pituitary gland tumours or medication side effects.

“The normal oestrogen-to-testosterone ratio could be disrupted by this hormonal imbalance, which can lead to breast tissue growth and pain in the nipple region,” says Dr Manohar.

When not to ignore nipple pain in men

Even major conditions like breast cancer also manifest in the form of nipple pain, and it is important to understand and differentiate the causes of nipple pain, like hormonal fluctuations, and other potentially serious conditions.

“Apart from nipple pain caused due to breast enlargement in boys during puberty, breast enlargement and nipple pain at any other age is abnormal,” says Dr Manohar.

“It is urgent to see a doctor right away if there is a hard lump underneath the nipple, scarring in the nipple, or discharge. These signs and symptoms raise serious suspicions about something sinister,” he adds.

Diagnosis

“When someone comes to us with nipple pain, we do a clinical examination,” says Dr Itolikar. “We look for any local infections or trauma in the area and also check the patient’s medication history to rule out the possibility that any medicine is the source of the pain. When there are any warning symptoms, such as a hard lump or discharge, we prefer to use mammography, ultrasound, and occasionally a biopsy of the nipple or lump to rule out cancer.”

Since gynecomastia is common during puberty in boys, it is not very alarming.

“Due to factors including a sedentary lifestyle, obesity, alcohol consumption, smoking, substance addiction, etc., the number of nipple pain instances in men is rising in the modern day. The first step is to identify the cause. In certain instances, it can be fixed with lifestyle adjustments and weight loss. If these interventions fail to remove breast fat, corrective surgery (gynecomastia surgery) is an option,” adds Dr Itolikar.

Takeaways

  • Runner’s nipples, caused by friction between clothing and skin, is the most common cause of nipple pain in men.
  • Sometimes certain skin conditions like dermatitis or eczema in the nipple area can cause the pain.
  • Hormonal imbalances are another major contributing factor to male nipple pain and are common in boys during puberty
  • It is important to distinguish between the various causes of nipple pain because even serious illnesses like breast cancer can manifest itself as nipple pain.

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