Why Do I Have Sore Nipples in Perimenopause?!

August 21, 2020.

It is not a clean, easy split when we say goodbye to our ovarian function. Most of us struggle physically, mentally, and emotionally in the years before we can officially say the final goodbye to our menstrual period. And, this separation is often met with a slew of emotions. Some women are thrilled to see their monthly cycles cease, whereas others may feel sad or even mourn this season of life.

And like most goodbyes, it is sometimes even painful. Many women struggle with physical pains in menopause, and that pain can afflict your joints, head, breasts, and sore nipples. This article is for all of you wonderful women who struggle with sore nipples in menopause. 

Community Question: “Why are my nipples so sore?”

Surprisingly, we get this question a lot. Many women struggle with sore nipples when they are in perimenopause. The female breast and nipples are highly sensitive to fluctuations in estrogen. As the primary female sex hormone, estrogen is responsible for the growth and development of the breasts in puberty, pregnancy, postpartum, and menopause. Estrogen even causes monthly physical changes in your breasts that follow your menstrual cycle. 

One of the ovaries’ primary functions is to produce estrogen and progesterone (through the corpus luteum). During perimenopause, estrogen and progesterone can fluctuate erratically because ovarian function begins to decline.

Once you reach menopause, your ovaries cease to function. Thus, only minimal amounts of estrogen are secreted into your bloodstream in the postmenopause years.

When estrogen levels spike in perimenopause, it can cause your breast tissue to become sore. Fortunately, breast soreness usually improves once you stop having periods, and your ovaries cease to produce estrogen. Women who take hormone replacement therapy with estrogen are likely to continue having breast soreness until they stop using this treatment.   

Related: Am I In Menopause? Take Our 4 Minute Quiz

Different Stages of Menopause 

We know there is a lot of confusion around the different stages of menopause, and sometimes terms are used interchangeably, which can further add to the confusion. Here is some clarification on the difference between the stages of menopause:

Perimenopause – This stage occurs during the 5-8 years (on average) before a woman reaches menopause. The average age a woman enters perimenopause is between ages 44-48. Many women struggle with the 34 frustrating perimenopause symptoms, such as brain fog, irregular periods, and breast soreness. 

Menopause A woman is considered in menopause when she has been period-free for at least 12 months. The average age of menopause is 51. You can still experience symptoms like hot flashes and night sweats for a few years after you reach menopause. 

Postmenopause Usually starts about 3-5 years after a woman’s last menstrual period. By this time, menopause symptoms usually clear up, and most symptoms are related to low estrogen levels, such as osteoporosis and vaginal dryness.

When estrogen levels spike in perimenopause, it can cause your breast tissue to become sore. Fortunately, breast soreness usually improves once you stop having periods, and your ovaries cease to produce estrogen.


Are sore nipples a sign of menopause?

Sore nipples are indeed a sign that your hormones are behaving differently. However, other symptoms are more likely to signal the start of perimenopause, with irregular periods being the hallmark sign. Other common signs of menopause include:

To diagnose sore nipples menopause, your doctor will want to know how frequently your nipple soreness occurs, if anything triggers it, and the type of pain (sharp, stabbing, sensitivity, etc.).

Therefore, it is helpful to keep a journal of all your symptoms, especially if you are trying to figure out if you are in perimenopause. There is no perfect perimenopause test, so women often rely on their symptoms and age to determine if they are in perimenopause.

Other Causes of Nipple Soreness

Of course, sore nipples can be related to other things as well, such as

    • Breast infection
    • Cysts in your breast tissue
    • A side effect of certain medications like SSRIs, and some diuretics
    • Weight gain
    • Large breast size
    • Poorly fitting bras
    • Noncancerous lumps like fibroadenomas

Nipple soreness and increased sensitivity are normal in menopause. However, if you notice your nipples have a discharge or are bleeding, it is important to talk to your doctor and have a complete breast exam. Rarely, nipple soreness is a sign of breast cancer. Nonetheless, checking with your doctor early on can help you learn how to manage this discomfort and treat other causes.

Treatment Options

Download our free perry app to find evidence based guidance to treat sore nipples.

Disclaimer: This is not medical advice, does not take the place of medical advice from your physician, and is not intended to treat or cure any disease. Patients should see a qualified medical provider for assessment and treatment.

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Julia Walker
perry expert Julia (RN, BSN, BA) is a registered nurse based in Colorado. Julia's nursing background in women’s health has ranged from neonatal and postpartum care to labor and delivery, to outpatient gynecological medicine for both adolescent and adult populations. She specializes in helping women optimize their health during perimenopause and beyond.

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