Ouch, my chest! Advice please, Cold-Climate Mefites?

December 17, 2012 2:39 PM

Severely painful nipples in the cold! I’m as rugged-up as I’m going to get. What can I do?

Anon because of the possible TMI in this question.

I’ve recently moved to a cold climate, and am having a delicate problem. My nipples get extremely sore in the cold sometimes, and the pain stays for days afterwards. It's unpredictable - I can be fine in the snow, but occasionally it even happens when I’m inside with the heater on - when I’m cool, but not freezing cold.

I think they’re contracting really hard and then sore from that maybe? But I can’t really put more layers on because the rest of my torso is too warm. What do I do to prevent this?

It happened yesterday: I went out a couple of times in no less than four layers of clothing including thermal top and warm coat. The rest of my torso was on the warm side of comfortable. But by the I got to the grocery store (which would’ve been 70 degrees inside) in the evening, my nipples were so sore I was barely able to keep from crying.

It didn’t stop after getting inside where it was warm. Even after a hot shower when I got home and spending the rest of the night with a heat pack pressed to my chest, I was hurting so much that I couldn’t sleep without taking Tramadol. I was still awake for a couple of hours after that kicked in because of the soreness, and every time I rolled over I wanted to cry out from pain.

I’m still sore today, and from experience it'll last until tomorrow or the next day. My pain tolerance is high according to doctors (I've been told off for under-reporting), but this is acute and really bad even by my standards.

I’ll be working outdoors in the cold several more nights this week. I even thought about those hand-warmer heat packs, but I can't keep them stuffed under my work outfit because it'd look weird - my coat's thick, but fitted. I don’t want this to keep happening - help!

My nipples are not rubbed raw, nor dry & cracked. There are no visible indicators of this pain. I’m not chafed - that’s happened before and this feels different. I am not pregnant - most of the search results I’ve found are on pregnancy & breastfeeding forums. I don’t have Raynaud’s Phenomenon - my circulation is bad and my fingers/toes are cold most of the winter even in milder places, but I don’t get the dramatic discoloration thing on hands/feet. (I didn’t check my nipples in the store of course!)

Possibly helpful info: I’ve always been, well, perky. Even padded bras don’t stop my nipples from being visible through clothing - none of the usual solutions work, so I’m just resigned to dealing with comments from people here & there. I’m fairly sensitive and don’t like intense stimulation of the nipples in sex (the idea of nipple clamps makes me cringe - ow ow ow!). Never had kids. The tightness of clothes doesn’t make a difference - it’s not that they’re too squashed or tightly bound.

So what is this and what can I do about it? I don’t want to be in this much pain very often!

posted by anonymous to Health & Fitness (18 answers total)

I sometimes get a similar problem but the hurting for days afterward seems really extreme, I don't get that. Anyway, I find that having a hot drink like tea or coffee is the only quickly effective fix (works much better than dressing more warmly or turning up the heat), and that cold drinks will make it worse.
posted by phoenixy at 2:53 PM on December 17, 2012

The extreme pain seems very unusual to me, so you might want to ask your doctor about that.

And I know they don't seem rubbed raw or chapped, but I find that even if I'm not seeing it, shea butter on my nipples after the hot shower, if it's cold outside, REALLY helps to keep them moisturized and it seems to make the soreness of contraction less.
posted by WidgetAlley at 3:02 PM on December 17, 2012

See a doctor! In the meantime, things to check:
Are you using any kind of hormonal birth control? Has the dosage been changed recently?
Are your bras new?
Are you using a different detergent?
You're in a new place, the water you wash in probably has different minerals in it.
Have you tried different bras? Maybe a sports bra with wicking fabric?
Shea butter, olive oil, something very simple might help.
posted by mareli at 3:07 PM on December 17, 2012

Oh, also, I did see a doctor, who helpfully suggested, "dress warmer". So come back and let us know if you do see a doctor and do get actually helpful advice.
posted by phoenixy at 3:14 PM on December 17, 2012

I know that marathon runners often tape or band aid their nipples to prevent rubbing. (They can rub until they bleed on some folks)

I can tell you that when I got mine pierced I ended up band-aiding them any time I was going to be in the cold or baking. (metal conducts both heat and cold)
posted by poe at 3:36 PM on December 17, 2012

Ouch! I can't say if silicon nipple covers would necessarily help the hurty problem, but they're something to consider if you haven't tried them already (you might have, given your description of trying things) because:

* they would help keep the area warmer than otherwise, without more layering of clothes
* in my opinion, they help reduce stimulation, because they stay stuck in one place and don't let fabric rub over the nipple itself
* as a bonus side effect, they could prevent you from visibly nipping out
posted by foxfirefey at 3:57 PM on December 17, 2012

Here's some silicone nursing pads. Numerous other kinds available, they would just add another layer where you need it most.
posted by mareli at 4:02 PM on December 17, 2012

Check out nipple vasospasm. I had this happen once, during the worst flu of my life which lasted two weeks. I saw the doctor a few times, who told me I just had to ride it out (even though I was have daily fevers of 102-103 degrees). When my fever would break, I would end up freezing and trembling from being so cold. And my finger tips would get blue, and my nipples would ache severely. When I told my doctor about this weird symptom, he told me I was likely having nipple vasospasm, because I was so ill, and my circulatory system was impaired.
posted by kimdog at 4:51 PM on December 17, 2012

Also, that article is in the context of breastfeeding, but it can definitely happen to non-breastfeeding women.
posted by kimdog at 4:52 PM on December 17, 2012

I get this, but the pain subsides in a few hours. I agree that something like a hot shower or hot tea helps, but mostly I just try to wear a fleece top when it's cold or ride it out.
posted by ldthomps at 4:55 PM on December 17, 2012

Raynaud's syndrome can affect the nipples only - you don't need to have the hand/feet symptoms as well. If it happens again, try to find a location where you can discreetly check for blanching. If it is some type of vasospasm, a prescription for nifedipine may help - definitely ask your doctor about this.
posted by Mallenroh at 5:23 PM on December 17, 2012

I can't believe I know this but they sell little nipple cover thingees in the lingerie department-it was near the bra extenders and such at Macy's in our town. Worth a try maybe?
posted by St. Alia of the Bunnies at 7:46 PM on December 17, 2012

Oh. Nobody's suggested this, but painful nipples are also a symptom of pregnancy. You might want to rule this out.
posted by glasseyes at 8:15 PM on December 17, 2012

I'd try fabric nursing pads, too. You could put an extra layer or two in your bra without making everything else even warmer. Okay, I would actually not ever go find nursing pads, I would cut up the softest warmest old sweatshirt I could find into circles and stack a couple in each side of my bra.
posted by artychoke at 8:27 PM on December 17, 2012

Seconding Mallenroh, Raynaud’s Phenomenon can just affect the nipples without affecting fingers or toes. Next time you feel the pain check for colour changing: white to purple to pink. Then see your doctor and tell them you are experiencing vasospasms. There are prescriptions that will help.
posted by saradarlin at 10:48 PM on December 17, 2012

I get raynaud's in just my nipples, the rest of my circulation isn't great, but it's worse in my nipples. I was going to suggest the silicone nipple pads as well, put them on a bit before you go out so they warm to your body temp. The lotion they make for breastfeeding moms might also help if dryness is a factor, and you may not realize your nipples are dry, so it may be worth just trying.

Maybe if you are going to be out for a while you can also rig something up with those hand warmer packets too, one for each nipple, but you'll want to test it our first so you don't burn them.
posted by katers890 at 7:12 AM on December 18, 2012

I suggest trying baths over showers. Baths will warm you all the way in, rather than just your skin.
posted by Gor-ella at 7:16 AM on December 18, 2012

From the OP:

Thank you all for your thoughts.

When I asked that question, I'd just gotten back from my pain specialist, whose entire office was stumped by the issue (I know because they asked every doctor & nurse who was available, to my embarrassment!).

My Primary Care doc had never heard of this happening to nipples either, but suggested lidocaine cream (Emla or the sort that's used for hemorrhoids) to treat them.

He also suggested asking my gynecologist; she immediately confirmed that it sounded like Raynaud's, and suggested hand-warmers or Thermacare patches for the inside of a bra as a preventative. I normally go bra-less, but I'm hoping this'll work with a tank-top or a thermal.

So it took three doctors to get them, but there are a couple of ideas for future MeFites who're unfortunate enough to have to look this up!

It turns out that my nipples were indeed losing colour/turning white, but only on the very front - I couldn't see it when I looked down at them, but caught it in the mirror after a shower. That seemed worth mentioning, too.

I was actually in this climate last winter as well; I knew I wasn't pregnant since this happened then - and even once or twice in my warmer former location. I can also confirm the nipples weren't cracked because I did try putting aloe vera on them - and realised only after application that I'd used the gel with the alcohol in. So I would've known very quickly. This is not recommended as a way of testing for damage, however!

For what it's worth, I've found hot drinks, baths vs showers, and the silicone pads to make no difference. They're obviously helping some people, though, so worth a shot?

Thanks again, and may your sensitive bits stay warm!

posted by goodnewsfortheinsane at 12:03 AM on December 25, 2012