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Soreness of nipples
Last reviewed: 23.04.2024
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Many women experience painful nipples at certain times. It can cause different reasons, because the nipples are one of the most sensitive areas of the body. And in many cases, hormones are to blame. Thus, the soreness of the nipples in the middle of the cycle in women of childbearing age is one of the signs of the coming pregnancy.
However, the matter is complicated by the fact that this may be a symptom of the disease. Most of the symptoms code for the ICD 10 is not assigned. And from a medical point of view, soreness is the occurrence of discomfort and pain sensation in any physical action, for example, touch, pressure, or palpation by a doctor.
Causes of the nipple soreness
All the causes of soreness of the nipples can be divided into hormone-dependent and not dependent on hormones. Cyclic morbidity reflects the state of the mammary glands, which is determined by the level of steroid hormones such as estrogen, estradiol, progesterone, prolactin, and pituitary-produced luteotropic hormone.
The hormone-dependent causes of soreness of the nipples, manifested in the monthly discomfort in the mammary glands of women and soreness in the nipple region, is a sign of natural hormonal fluctuations during the menstrual cycle (and part of the premenstrual syndrome). For more information, see - Mammary glands before menstruation, and - Chest pain before menstruation.
Soreness of the nipples in the middle of the cycle is also most often associated with menstruation, as many women begin to prepare for ovulation (the exit from the ovary of a ripe egg) in the middle of the menstrual cycle. This process takes from a few days to a week or more after the last day of menstruation. If women are prevented from unwanted pregnancy for a long time by drugs containing hormones, they too may experience symptoms of soreness of the nipples.
A sharp reduction in the production of estradiol and progesterone, gynecologists explain the soreness of the nipples after ovulation.
The intensity of soreness of the nipples after menstruation may be different as a sign of pregnancy, see for more details - Pain after menstruation, and symptom of fibrous formations in the mammary gland. And the soreness of the nipples in menopause is a consequence of the age-related decline in the hormonal background. But even if the levels of estrogen in the body before the onset of menopause are lower than before, it remains the dominant sex hormone in the female body, and the first signs of the coming menopause may manifest painful sensations in the nipples.
To particular cases of periodic painful sensations in the field of juices is the woman's removal of the uterus, during which her neck and ovaries have not been removed. According to medical statistics, complications of such operations in 90% of patients are various pathologies of the mammary glands, including fibrocystic mastopathy.
[Pathogenesis
The pathogenesis of non-cyclic morbidity does not have a hormonal factor. On the top of the nipple is more than a dozen milky pores that actively work only during lactation, and the nipple skin is tender and sensitive, as it is provided with a variety of nerve endings. The soreness of the nipples during feeding causes their cracks - see the detailed article. Pain in the nipples of the chest.
To the painful sensations outside the period of breastfeeding can lead any traumatic effect - synthetic fabrics or bra stitches, detergents, etc. In addition, non-hormone-dependent causes of soreness of the nipples include such dermatological pathologies as:
- allergic or idiopathic eczema, see - Eczema on the nipples;
- lesion of the skin of the nipple Streptococcus agalactiae and development of streptodermia (impetigo);
- superficial candidiasis;
- localized on the nipple of herpesviral lesions;
- Folliculitis (inflammation of closely located hair follicles areola).
In connection with the gradual involution of mammary glands in mature women, tenderness in the nipple region can develop due to the expansion of the milk ducts - for more details, see Ectasia of the mammary ducts.
The most dangerous cause of soreness of the nipples is Paget's disease (cancer), the signs of which at first are very similar to the symptoms of eczema.
The soreness of the nipples in men also has many reasons, among which doctors note: direct injuries to the nipple; constant irritating friction of the nipple that surrounds the chest with sports clothes ("nipple runner" syndrome); gynecomastia (enlargement of mammary glands due to imbalance of male and female hormones in the body); reception of anabolics.
But in adolescents and young men the soreness of the nipples when touching has a hormonal character, and after the onset of sexual activity this condition completely passes. However, with overweight or with diabetes mellitus, the symptoms of nipple soreness can manifest for years.
In the absence of treatment of non-cyclic soreness of the nipples, there may be complications that depend on the nature of the infection and can lead to the development of a serious inflammatory process. Its consequences can lead to a different kind of mastopathy, which will require surgical treatment.
Where does it hurt?
Diagnostics of the nipple soreness
Standard diagnosis of nipple soreness is based on anamnesis, physical and palpatory examination of the mammary glands.
In cases of soreness of the nipples associated with lactation, the diagnosis does not cause difficulties, and obstetrician-gynecologists successfully cope with this task. But, given the factor of hormone dependence of this condition, in other situations, tests can be prescribed:
- enzyme immunoassay for hormones;
- a blood test for the presence of IgM antibodies to herpes simplex virus;
- Bactose from the skin of the nipple to coccal infection and Candida Albicans;
Instrumental diagnosis includes, mainly, mammography (breast x-ray) and examination of the condition of the milk ducts (duktografiyu).
If there are reasons to assume Paget's disease, differential diagnosis is performed and a blood test is performed on the proteins of tumor cells (oncomarkers), and ultrasound of the breast is performed.
What do need to examine?
Who to contact?
Treatment of the nipple soreness
A set of measures, including the treatment of soreness of the nipples, must necessarily include prevention. Sometimes it is sufficient to change synthetic cotton underwear or refuse to irritate the skin with soap, and the symptoms of soreness of the nipples quickly pass.
The soreness of the nipples during feeding is in the fight against cracks, for which the doctors recommend external means that moisturize and soften the skin, and also promote its regeneration, for example, Panthenol Ointment with vitamin B5 and lanolin (trade names - Dexpanthenol, Pantoderm, Panthenol); gel or ointment Actovegin, etc.
Medicines for dermatological diseases that cause soreness in the nipple area are prescribed by a dermatologist: in eczema it is solutions of silver nitrate, zinc sulphate or resorcinol (for nipple treatment), as well as ointments with corticosteroids Dexamethasone, Fluorocort, Trimistan, Sinalar, etc. With streptoderma or folliculitis need ointments with antibiotics - Levomekol, Metiluratsil, emulsion of synthomycin, etc. And in the fight against Candida fungi, ointments with nystatin (Nystatin, Mikostatin) or imidazole (Clotrimazole, Mycosporin, Funginal, etc.) help.
Specific drugs for herpes - ointment Acyclovir (Gerpevir, Zovirax, Violetx and other generics) are exceptionally symptomatic, however, they are contraindicated for lactating women.
Alternative treatment is also widely used. First of all, external application of an aqueous solution of propolis (healing crack and relieving irritation), aloe juice (removing inflammation), tea tree oil (killing bacteria), dehydrating essential oils of geranium, sage, verbena is recommended. When eczema juice is advised to apply a mixture of sunflower oil with salicylic-zinc ointment.
Herbal treatment consists in treating the nipples and the parasol zone with decoctions: chamomile flowers, calendula and arnica, St. John's wort and celandine, white willow bark and walnut leaves (a tablespoon of dry raw material for a glass of boiling water).
Among the external remedies that homeopathy suggests to reduce the intensity of this symptom, it should be noted ointments based on the same calendula and St. John's wort, the root of comfrey, and inside - Natrium muriaticum (table salt).
Prevention
Prophylaxis of soreness of the nipples is possible only in cases of its non-hormonal etiology, and the main thing here is personal hygiene, the observance of which can protect against infections. And when a person takes care of their health, the forecast is always favorable.
But if the nipple's soreness develops into constant pain, do not try to solve the problem yourself: the faster you turn to specialists, the more likely it will be to make a successful decision.