Home Women's Health Why Are My Nipples Hard? 13 Possible Causes of Pain

Why Are My Nipples Hard? 13 Possible Causes of Pain

Written by Charmaine Canlas, RPh

You may wonder what causes hard nipples. It may happen frequently, or you don’t even notice that you suddenly have erect nipples in the middle of the day.

For general knowledge, the nerves in the nipples react to stimuli.

It may be naturally caused by your body or brain’s physical or psychological reaction.

As simple as the cold temperature, sexual stimuli, or friction can make nipples hard. Anatomically, the appearance and sensitivity of nipples vary for every woman.

Erect nipples may be a symptom of an underlying disease.

Some health issues that can influence the breast and areola can range from mild to severe.

Fortunately, there are other symptoms and telltale signs that accompany erect nipples.

Familiarizing yourself with the possible diseases or health issues that affect your breasts and nipples will help you know when to see a doctor and require treatment early.

Erect Nipples? Perky Nipples? What Men and Women Really Need to Know

Should You Be Worried About Having Hard Nipples?

This is totally normal if you have erect nipples responding to the cold, tactile stimulation, and sexual activity.

It is a temporary reaction of the body.

Like how the skin reacts to stimulation and causes goosebumps, the nipple works in a similar mechanism.

Individuals can have varying responses to stimuli and sensitivity.

If you are worried about the appearance of your nipples and how they seem to stand out more, this is also a normal characteristic in some.

As much as there are different breast sizes and shapes, the nipple can vary in appearance based on a person’s genetics.

However, any changes that come along should not be ignored.

Some conditions can alter the appearance of your nipple as an effect of a disease.

During hormone changes in women, the breasts and nipples are monitored to prevent or diagnose any issues.

Anatomy Of Nipples

The nipple is a sensitive part of the breast.

They have thousands of nerves that make nipples hard in response to intense sensory innervation.

Studies on the mechanism of nipple erection state by activating the sympathetic nervous system and smooth muscle contraction.

Protruding nipples are the most common type. It is what a lot of people perceive a nipple would look like.

They stick out and are noticeable under clothes.

A few people may have flat or inverted nipples.

It is a condition of the nipple where it is retracted into the breast. An inverted nipple may protrude with stimuli in some cases but not in others.

Both men and women can have inverted nipples. A plastic surgeon can treat nipple inversion if the appearance bothers you.

However, studies state that the characteristics of a nipple are important for mothers that need to breastfeed.

A minimum of seven millimeters is the best standard for breastfeeding.

Short, flat, or inverted nipples may have physical and psychological negative effects for breastfeeding mothers.

Why You Have Hard & Erect Nipples

1) Sexual Arousal

Sexual stimulation is a very prominent cause for erect nipples as they are, after all, an erogenous zone for many women.

A study was made on young men and women on the influence of breast and nipple stimulation on sexual arousal.

The pleasurable sensation from the stimulation of the nerve endings on the nipple sends signals to the same part of the brain that receives the same signals coming from your genitals when aroused.

Nipples get hard when your muscles in the area contract.

On the other hand, it may also be psychological and not only by touch or friction.

Typically, just sexual thoughts can give a person erect nipples.

Stimulation of the nipples may be beneficial because of its positive effects on your health.

Proper and regular stimulation of the nipple and the breast can reduce cancer risk and prevent more psychological and mental problems like depression and sexual dysfunction.

There is research on the potential of how the sensation from breasts and nipples can release oxytocin.

This can be done by self-stimulation or sexual activity with a partner.

Nipples react to stimulation and blood flow during sex the same way the rest of your erogenous zone responds to it.

2) Temperature

Cold weather is a common culprit for nipple erection as temperature drops.

The tiny muscles attached to your hair follicles cause hairs to stand on end with low temperatures.

The same way the nipple and breast tissue contract, perking up your breasts altogether.

Just like how when you get goosebumps, the cold weather triggers the nerve endings in your nipples that are stimulated by it.

This is more apparent as erogenous zones have more nerves than any other body part.

3) Allergy or Sensitivity

The clinical spectrum of atopic dermatitis looks at the effect of a person’s immunity and allergic reaction to irritants.

Although not everyone would have such problems, sensitivity on the skin around the nipples can vary among people.

Your nipples can get hard from allergic reactions to certain fabrics or topical products.

A reaction to shower gels, soap, detergent, or other irritants might occur in the form of symptoms such as itchiness, tenderness, sensitivity, or pain.

Other visible symptoms may include dryness or chapping of the skin around the breast, nipple, overly erect or swollen nipples, rashes, and redness.

Whether it’s due to the use of laundry detergents, soaps, topical creams, and lotions or wearing certain clothes that would trigger an allergic reaction.

4) Nipple Piercings

Nipple piercings are an aesthetic accessory pierced through the areola.

Having a nipple piercing does not mean your nipples get hard permanently.

Nevertheless, it can make nipples stick out and sensitive. Nipple piercings make the sensation around it more sensitive to stimuli, making nipples get hard more often.

However, it also comes with the risks of infection or skin damage.

5) Medications

Nipples get hard as a side effect of medicines such as:

  • Birth control or Oral contraceptives
  • Opioids
  • Antihypertensives
  • Antidepressants
  • Antipsychotics
  • Herbal supplements

Side effects of birth control pills affect the hormone levels of women. It is similar to the symptoms of pregnancy. Prescription medicines for anxiety and depression can cause nipple pain and other symptoms in the breast and nipples.

6) Breastfeeding

Women who plan to breast feed can condition their nipples six weeks before their due date.

Research states that nipple rolling, friction with cloth, and airing can help ease breastfeeding in mothers.

Symptoms accompanying erect nipples are nipple pain, chafing, and cracking.

This can lead to inflammation and infection of the breast tissue.

Nipple pain is a common reason that mothers stop breastfeeding their children.

Excessive nipple movement due to suckling from a baby can be associated with nipple pain and other symptoms.

7) Pregnancy

During pregnancy, women undergo anatomic and physiologic changes of their nipples and breasts to prepare for lactation.

The first trimester is when the milk ducts expand into the adipose tissue because of the increase in estrogen.

Estrogen also causes elevated levels of prolactin.

This stimulation eventually causes the production of milk for the baby.

Physical changes in pregnancy include

  • Erect nipples
  • Darkened areola
  • Increased breast size
  • Tender, sore and sensitive breast or nipples
  • Leaking of colostrum from the breasts (yellowish liquid)

8) Ovulation

Ovulation causes different changes to the body.

It happens when the ovary releases an egg for fertilization.

Ovulation is part of the menstrual cycle. Hormonal imbalance occurs during this period and causes symptoms that affect nipples and breasts. 

As the levels of progesterone and estrogen increase a week before a period.

The following symptoms are found:  

  • Tender and sore breasts or nipples
  • Pain and sensitivity 
  • Changes in cervix
  • Pelvic pain or cramping
  • Increased libido

9) Menopause and Perimenopause

Menopause is the stage in a woman’s life when the mother has multiple issues with the development of their body and emotions.

Ovaries reduce estrogen production with age, and this results in hormonal imbalance.

Nipples will become stiff, tender, and erect.

The changes in your breast and nipples are the common signs of perimenopause.

Symptoms accompanying irregular periods, insomnia, hot flashes, mood changes, decreased libido, and other reproductive changes.

Duct ectasia tends to occur around these periods when a woman is close to her menopause.

This condition causes the milk duct to be enlarged and blocked. The nipples become affected and may lead to mastitis.

10) Post Menstrual Syndrome

Postmenstrual syndrome is similar to premenstrual syndrome.

The symptoms common are frequent erect nipples, breast swelling, and tenderness.

You may also experience along with it some psychological and physical symptoms.

Mood swings, changes in appetite, bloating, tiredness, muscle pain, cramps, and indigestion are accompanying symptoms.

11) Breast Abscess

This is when there is a build-up of pus around the infected area around the breast.

Breast abscess can be seen as a yellowish liquid forming inside the affected area on the breast around the nipple.

This is a common issue with lactating women and people who get their nipples pierced.

A breast abscess is a form of infection that forms either in the skin cracks from bacteria, cracked nipples, or nipple piercings.

This can get infected until a sac forms underneath the affected area, and the puss fills up.

This is the breast’s abscess, and it would feel like a lump on the breast.

A breast abscess can be extremely tender, with erythema and induration of the skin around the nipple.

12) Breast Cancer

It is the most common type of cancer in women, with an incidence rate of 12%. Most breast lumps are benign.

A thorough assessment is required to diagnose breast cancer.

You should be given attention to changes in the nipple, such as hardness, redness, thickening discharge, and pain.

These symptoms may be accompanied by overlying skin.

Although nipple hardness or pain rarely signals breast cancer, being cautious of the changes in your body will help you determine the need for a check-up.

Nipple discharge is the most important association with breast cancer.

Your doctor will ask for examinations to diagnose the disease correctly.

13) Paget’s Disease

Paget’s disease is a rare disease that can cause changes in the nipples.

Symptoms included in Paget’s disease are hardness, pain, sensitivity, itching, redness, crusting, and other changes in the nipple.

Paget’s disease is a disorder that can affect the nipple-areola complex of the breast.

Eczematoid changes on the nipples and persisting soreness or itching are changes that lead to the suspicion of Paget’s disease.

The Bottom Line

Nipples develop as we grow and age, like how the body changes with puberty.

We are familiar with some of the changes we experience.

But the nipples along with the breasts are crucial to breastfeeding. The cause can range from physiological, sexual, and hormonal. 

Moreover, an erect nipple can be a symptom of an underlying disease or a side effect of a medication.

Although these cases are rare, the consequences of ignoring early symptoms can be regretful. 

Monthly breast self-examination is a good way to support your health routinely. Tell your healthcare provider if you have severe or persistent side effects.

Some causes may be easily managed, but the possibility of breast cancer should be strictly assessed. 

Inform your doctor about your symptoms, diseases, medications, and family history for professional medical advice.

The information provided here is for educational purposes only and should not be considered an official diagnosis.

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