Persistent Nipple Pain: When to Seek Medical Advice

Nipple pain?

Hello, doctor.
During my last menstrual period, I noticed that my right nipple would hurt every time I accidentally pressed on it.
The pain was quite uncomfortable and lasted for several seconds before gradually subsiding.
At first, I thought it was due to my period, but now, nearly two weeks after my period has ended, I still experience pain, while the left side is not painful at all.
This is the first time I've experienced this.
What could be the cause? If I need to see a doctor, which specialty should I consult? Thank you.

Xiao Fang, 20~29 year old female. Ask Date: 2001/01/30

Dr. Zhan Deqin reply Obstetrics and Gynecology

Nipple pain before and after menstruation is common.
If you have concerns, you may consult a general surgeon or a breast surgeon.
An ultrasound examination may be performed if necessary.

Reply Date: 2001/01/30

More Info

Persistent nipple pain can be concerning, especially when it lasts beyond the menstrual cycle. It’s important to understand that nipple pain can have various causes, ranging from hormonal changes to more serious conditions. Given that you are experiencing pain in your right nipple that has persisted for two weeks after your menstrual period, it’s advisable to seek medical attention.

Possible Causes of Nipple Pain
1. Hormonal Changes: Hormonal fluctuations during your menstrual cycle can lead to breast tenderness and nipple pain. However, if the pain continues after your period, it may not be solely related to hormonal changes.

2. Infections: Conditions such as mastitis or a breast abscess can cause localized pain, swelling, and sometimes discharge. These are more common in breastfeeding women but can occur in others as well.

3. Fibrocystic Changes: Many women experience fibrocystic breast changes, which can cause lumpiness and tenderness in the breast tissue, including the nipples.

4. Injury or Trauma: If there has been any recent trauma to the breast area, even minor, it could lead to localized pain.

5. Dermatological Issues: Skin conditions affecting the nipple area, such as eczema or dermatitis, can also cause pain and discomfort.

6. Paget's Disease of the Nipple: This is a rare form of breast cancer that can present with symptoms such as nipple pain, itching, or changes in the skin of the nipple. While this is less common, it is a condition that should be ruled out, especially if the pain persists.

When to Seek Medical Advice
Given the duration and nature of your symptoms, it is recommended that you consult a healthcare professional. You should consider seeing a primary care physician or a gynecologist first. They can perform a thorough examination and may refer you to a breast specialist or mammography if necessary.

What to Expect During the Consultation
During your visit, the doctor will likely ask about:
- The nature of the pain (sharp, dull, throbbing)
- Any associated symptoms (discharge, swelling, redness)
- Your menstrual cycle history
- Any recent injuries or changes in breast tissue
- Family history of breast conditions
A physical examination will be conducted, and if deemed necessary, imaging studies such as a mammogram or ultrasound may be ordered to assess the breast tissue further.

Conclusion
In summary, while nipple pain can often be benign, persistent pain warrants a medical evaluation to rule out any serious conditions. Early diagnosis and treatment can significantly improve outcomes and provide peace of mind. If you experience any additional symptoms such as discharge, swelling, or changes in the skin of the nipple, seek medical attention promptly. Remember, it’s always better to err on the side of caution when it comes to your health.

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