SSome say it feels like a sudden burst of anxiety; others compare it more to homesickness. The sudden onset of a sinking, upset feeling from nipple stimulation is known anecdotally as sad nipple syndrome (SNS), and for Sandra, it can be triggered by something as mundane as putting on a shirt.
“I was probably a child when I first noticed, ‘Why does touching my nipple make me sad?’ “, says the 28-year-old young woman. The sensation seemed to happen randomly, and without the words to describe it, she kept it a secret. It wasn’t until college that she found the courage to Google it. “I realized I wasn’t crazy,” she says.
There are many others like Sandra (who, for privacy reasons, asked to use a pseudonym). Breastfeeding mothers, queer lovers, and cis men have all searched for an explanation for this phenomenon.
What is sad nipple syndrome (SNS)?
Sad nipple syndrome is often discovered in private. People describe it as a sudden dysphoria (a deep state of unhappiness or unease) that follows nipple stimulation. This problem is often resolved within minutes, but can cause confusion and disruption.
I spoke to four people who were victims of SNS and each described similar negative feelings. Sandra described it as “a dread, a nostalgic sadness or the feeling of a bad memory.” Salma Zaky, a New York-based comedian who has spoken about her SNS on stage, says she can “tell if a woman has been there – she will light up or clap.” Zaky compares it to a mixture of homesickness or nostalgia.
For Sandra, the most common trigger is light, unexpected contact when changing clothes or drying a towel. Its intensity may vary depending on the circumstances. For example, if she triggers the feeling on her own with a light touch, “negative feelings tend to linger for more than a few seconds,” says Sandra. If there is sustained friction with her clothing, she sometimes feels “deep sorrow.”
Their feelings are reflected in thousands of online posts asking if anyone else is feeling the “punch of disaster.” In the absence of a formal clinical diagnosis, most people understand sad nipple syndrome through word of mouth or online discussions.
“Reddit helped me by just saying, ‘Oh, I’m not a crazy person,'” Zaky says. “Other people feel this way too.”
According to scientists, what is happening in social networks?
SNS is not an official medical diagnosis and scientific research remains scarce. That said, awareness is growing, even among researchers and doctors.
As with many conditions that primarily affect women’s intimate or hormonal experiences, there isn’t much medical curiosity, funding, or research. “Although there is no explanation yet, we can assume that the hormone oxytocin is involved in some way, since stimulation of the nipple leads to its release,” explains Dr. Vladimír Kraus, PhD., Department of Gynecology and Obstetrics of Pavol Jozef Šafárik University.
Oxytocin is often called the “love hormone.” Largely responsible for bonding and increased emotional connectivity, it is triggered by physical contact such as a hug, massage or sexual intercourse, as well as after uterine contractions during childbirth or breastfeeding. Regarding its role in the SNS, Kraus theorizes that “certain subtle changes may cause dysfunction of the (oxytocin signaling pathway) and (could) be responsible for the surprisingly rapid and very negative feeling experienced.”
There are no studies specific to SNS, but there are two other well-studied conditions that are similar enough to help us understand it. The first is the dysphoric milk ejection reflex, or D-MER, which occurs during breastfeeding. This is an emotional response to milk flow, as milk begins to flow from the milk duct. People commonly describe the sudden rush of emotions like homesickness, sadness, loss of hope, worthlessness, shame and guilt, according to Alia Macrina Heise, a certified international lactation consultant and D-MER expert in Naples, New York. “It disrupts the duration of lactation and the mother’s experience of breastfeeding and bonding,” she says.
SNS and D-MER present identically and are also similar to postcoital dysphoria, Heise explains. While the SNS and D-MER focus on nipple stimulation, the negative feelings experienced by people with post-coital dysphoria occur after the hormonal peak of orgasm. Anyone suffering from one of these conditions “will describe embodied emotional sensations in the same way, even if the cause and trigger are different,” Heise says.
The prevailing theory is that these three conditions involve a “hormonal cocktail inside the body,” Heise says.
The two most important hormones are prolactin and dopamine. This cocktail that Heise refers to affects every human being in multiple ways. “Prolactin and dopamine have a known relationship inside the human body – male, female, breastfeeding, non-breastfeeding, sexual arousal, orgasm,” says Heise. Prolactin also contributes to weight control, immunoregulation, adaptation to stress and maternal behavior.
Meanwhile, dopamine drives the brain’s reward system, playing a key role in movement, pleasure, desire, motivation and thinking. “Dopamine is often called the gatekeeper of prolactin,” explains Heise. For prolactin to circulate in the body, dopamine must let prolactin pass in order to complete its action. one of his many jobs.
It’s possible that what’s happening in the SNS, D-MER, and post-coital dysphoria is related to how prolactin and dopamine carry out their daily tasks. One possible explanation is “inappropriate dopamine activity,” says Heise, who first heard a colleague mention SNS in the 2000s. “Because dopamine is a mood stabilizer, this inappropriate activity causes mood destabilization that lasts for a very short time.”
There is a growing body of research focused on D-MER, but to truly understand these conditions we need more specialized studies. Without a clearer picture, patients feel alone and “crazy.” Even if they find the courage to talk to their doctor, most healthcare professionals don’t have enough experience with these conditions to recommend treatment.
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Techniques to reduce the severity of symptoms are mostly experimental. “One of the tricks that we’ve found to be most helpful in also targeting the dopamine system is cold therapy,” says Heise, who has worked with thousands of breastfeeding mothers with D-MER. “Moms who drink ice water or put cold wraps around the back of their neck and cool their facial and mouth receptors before indulging in ejection significantly alleviate symptoms because it increases prolactin levels.” But it’s unclear whether this trick works for people with SNS.
How do SNS affect people?
Unexplained physical phenomena can be confusing and distressing, especially when they involve intimate parts of the body. The impact of SNS extends beyond brief sensations to shame and confusion about what they might mean.
Without formal answers from the medical community, many have developed theories about the causes, including forgotten sexual trauma, questions about sexuality and marital doubts. These unfounded explanations can cause real damage.
Kraus says SNS is rarely discussed in his practice, but those who experience it often feel preoccupied “about their mental state or worry that they don’t love their partner or gender.”
As with any sexual preferences or personal boundaries, clear communication is essential, experts say. It may also feel difficult or personal for partners of people experiencing SNS.
“It’s not about you, and it’s not a rejection,” says Dr. Jennifer Lincoln, a board-certified obstetrician-gynecologist and author in Portland, Oregon. “Talk about it outside of the room, agree on a cue to pause or change what’s happening, and let the person with the reaction lead.”
It can be difficult to bring up something that you may not even know the name of, that you’re ashamed of, or that makes you confused. But talking about it can be helpful.
“Just naming (Sad Nipple Syndrome) helps a lot, because a lot of people think they’re going crazy – or with D-MER, that they’re a bad mother,” Lincoln says. Similarly, shame can arise when social media leads to negative experiences during sex and intimacy.
“Now I avoid any nipple stuff during sex, and everything is fine,” Zaky says.
“It had almost no impact on my sex life,” says Sandra. “I think the hardest part was just feeling like a weird freak and having a reaction that can’t be explained.”
Ivana Rihter is a Chicago-based writer whose work has appeared in Vogue, Vanity Fair, Slate, Nylon and more.
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