2020 has taught us a very important lesson – our health matters! While many of us have heard about breast cancer, and that is great, we also need to think about breast health overall. This article focuses on nipple and breast health. It also provides information about when you might want to seek medical care.

Areola vs. Nipple

The areola is the darker, colored area on the breast that surrounds the nipple, while the nipple is usually in the center of the breast. However, this is not always the case, nipples can vary in size. They can be flat, inverted, protruding, and, in women, are linked to the mammary gland. Nipples are not identical. In fact, it is possible to have an inverted nipple and a protruding nipple or other combinations. Some things to keep in mind include: nipple sensitivity to pain and pleasure, discharge, and appearance.

Pleasure & Pain
The nerves around the nipple and areola can lead to pleasurable feelings. Women commonly report engaging in nipple stimulation and this activity can lead to experiencing an orgasm. Some women also enjoy piercing their nipples for added pleasure or for improving their feelings related to body image.

On the other hand, nipple pain (or soreness) is also common among women, especially as hormonal changes occur during one’s menstrual cycle. Nipple pain can also be associated with breastfeeding, skin irritation, and friction from clothing. Cracked nipples, meaning red, itchy, or flaky nipples, can be a result of breastfeeding or wearing incorrect clothing during strenuous exercise. Nipple pain can be relieved with over-the-counter topical medications. Pain that lasts more than a few days should be reported to a medical professional.

Discharge
If you are experiencing nipple discharge, discuss this with a medical professional, especially if the discharge is bloody. Other examples of discharge can include fluid that is milky, clear, yellow, or green. Discharge related to breastfeeding or postpartum pregnancy should also be discussed with a medical professional to ensure the amount, frequency, and color are appropriate.

Appearance
In addition to the size and location, it is important to pay attention to the appearance of your nipples. It is common to have small bumps around the nipples. Fluctuations in hormonal levels can cause these bumps to become more noticeable. They can also cause the growth or darkening of nipple hair. Hormonal changes can cause the color of the areolae and nipples to change. Pregnancy and menopause can lead to changes in the appearance of areolae and nipples.

Breasts

When it comes to breast health, it is important to understand lumps, pain, and preventative measures, like self-breast exams and mammograms. Similar to nipple health, breast health begins with the shape, size, and color. Breast health is best when engaging in healthy lifestyle activities, such as exercising, limiting alcohol and other drugs, eating foods that will aid in maintaining a healthy weight, and performing self-breast exams. These exams are helpful to identify small bumps and lumps. While breast pain is common during one’s menstrual cycle, ongoing pain can be an early sign of disease. To monitor your breast health, examine them for size, sensitivity, and shape. Medical professionals recommend that you perform monthly self-breast exams and get routine exams (either at your well woman’s appointment or a scheduled mammogram, as directed by your doctor).

Cancer and other conditions

While nipple cancer is rare, changes in the shape of the nipple should be discussed with a medical professional. Other issues that can affect the nipples include irritation, infection, and injury. As mentioned earlier, nipple irritation can be caused by friction from clothing and hormonal changes. Nipples can also become irritated from friction, rubbing, biting, or unusual pressure during sexual activity. If nipples become irritated or injured, this can lead to infection. Nipple irritation or soreness may also be a side effect of certain medications.

Breast cancer is the second most common cancer among women. Reports estimate that approximately 1 in 8 women (12%) in the US will develop breast cancer in their lifetime. However, it can be treated successfully, especially if detected early. Common risk factors include: first full term pregnancy after age 30, high breast tissue density, estrogen replacement therapy, early onset of menstruation or late menopause, genetics (BRCA1 or BRCA2 gene), and/or a family history of breast, ovarian, or endometrial cancer. Keep in mind that 85% of women with diagnosed breast cancer do not have a family history. Please pay attention to the risk factors listed above. Remember! Early detection saves lives.

Ashley Townes

Ashley Townes

PhD, MPH, Epidemiologist at Centers for Disease Control
Dr. Ashley Townes (she/her/hers), is a native of Cincinnati, Ohio. She attended Walnut Hills High School and the University of Cincinnati, where she received both her Bachelors and Master of Public Health degrees. She received her doctorate degree in Health Behavior and Epidemiology from Indiana University.

Dr. Townes has experience working as a Community Health Educator and Disease Intervention Specialist in Cincinnati and the surrounding areas. She has worked on several initiatives related to the dissemination of national HIV prevention and care campaign materials tailored for African Americans, Hispanic/Latinx, and transgender women of color. Dr. Townes has taught collegiate-level Human Sexuality courses, served as an Epidemiologist at the Ohio Department of Health, and currently works as an ORISE Postdoctoral Research Fellow in the Division of HIV/AIDS Prevention’s Epidemiology Branch at the Centers for Disease Control and Prevention in Atlanta, GA.

Ashley’s research background includes work on the sexual experiences of African American/Black women accessing health information and utilizing sexual health services. In 2018, she received grant funding from the Patty Brisben Foundation for Women’s Sexual Health to translate sexual health research data into educational materials. Her career interests are aimed at providing quality sexual education and working towards health equity.