Vasospasm of the nipple–a manifestation of Raynaud’s phenomenon: case reports

Laureen Lawlor-Smith, Carolyn Lawlor-Smith

BMJ 1997;314:644

Raynaud’s phenomenon was first described by Maurice Raynaud in 1862. It is defined as intermittent ischaemia affecting the acral parts of the body, most commonly the fingers or toes. It is much more prevalent in women, with a female to male ratio of 9:1. It is common in healthy women of childbearing age, affecting up to 22% of healthy women in the 21-50 year age group. Nipple pain is the most common symptom in breastfeeding women and is the second most common reason given for abandoning breastfeeding, exceeded only by perceived low milk supply. We report on five women with Raynaud’s phenomenon affecting their nipples.

Five breastfeeding patients presented to us in 1994-5 with signs and symptoms suggesting a diagnosis of Raynaud’s phenomenon affecting their nipples. The major presenting complaint of each of the five women was severe, debilitating nipple pain. Three of the patients had had identical pain when breastfeeding a previous child. One had abandoned breastfeeding at six weeks because of pain; the others had continued breastfeeding for 14 and for 7 months in spite of pain.

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