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Breasts and Nipples—Information Men and Women Need To Know
Episode 219th July 2023 • Real Dude Radio • Paul Joannides, Psy.D.
00:00:00 00:16:27

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We look at whether breast size makes a difference in how sensitive a woman’s breasts are, breast symmetry, how hormones can influence if a woman wants you to caress her breasts, what nipple covers are, and why you should know about breast density. Here's what dense breasts look like on a mammogram:  



Hi I’m Dr Paul and welcome to the Real Dude Radio podcast for men that’s about women, sex, psychology and medicine.


Today, we’ll be looking at women’s breasts and some of the things that most men and some women don’t know about women’s breasts—which are things I didn’t know about them until recently, and I’ve got a chapter on women’s breasts that’s in my book about sex that’s been used in some medical schools.


But first, in next week’s podcast, we’ll be talking about the cervix, which is the small dome of tissue that’s at the back of a woman’s vagina that the head of your penis probably knows it quite well if you’ve had intercourse with a woman.


For today’s podcast, we will start by discussing how smaller breasts tend to be more sensitive than larger breasts and why that’s so. We’ll look at how changes in hormones can impact whether a woman does or doesn’t want you to touch her breasts, and we’ll finish up with a look at what breast density is, and why it’s so very important for women and men to know about this.


I should warn you that while I have read more than twenty studies to prepare for this podcast and have been fortunate to have communicated with some of the world’s top breast researchers, please be aware that nothing I say in this or any other podcast should be taken as medical or psychological advice.


All women are born with a similar number of nerve endings in their nipples and breasts, regardless of what size of breasts they end up having. Once a girl goes through puberty, her breasts will grow in size, but she will still have the same number of nerve endings whether the cups of her bra can fit a plum or a watermelon. So regardless of whether a woman’s breasts are big, small, or somewhere in between, they all have the same number of nerves and nerve endings.


This means that small breasts are more likely to be more sensitive than large breasts, because in smaller breasts there’s less skin for the nerve endings to be spread over and the nerve endings are closer together and more compact, which results in greater sensitivity. In breasts that are bigger, the nerve endings are stretched out over a larger amount of skin, which causes them to be less sensitive than if the woman had smaller breasts.


This doesn’t mean that a woman with larger breasts will necessarily want a greater amount of stimulation than a woman with smaller breasts, but it is something to be aware of, and it’s one of several reasons why you should ask a partner to give you feedback about what she does and doesn’t like when it comes to breast stimulation.


Most of the research on breast sensitivity has been done by surgeons who are trying to learn which nerves to leave intact so a woman’s chest doesn’t feel numb if she needs to have a mastectomy, or is she wants a breast reduction, or if she needs to have some other kind of surgery on her breasts.


A couple of these surgeons in Europe have reported that most of women they have interviewed about sex and breast sensitivity have said that having their breasts stimulated by a partner is by no means essential to their pleasure or anything they particularly enjoy by itself. What they do find arousing is being able to see how much their partner gets turned on when he’s stimulating their breasts. So for a lot of women, it’s more about watching their partner and his arousal rather than it feeling all that great.


On the other hand, we know that breast and nipple simulation can cause parts of the brain that are associated with erotic sensation to light up. I’ve also seen a study that reported how some women like to have the upper quadrant of their breast kissed and caressed more than they like having their nipples stimulated.


As for what a quadrant is, think of dividing each breast into four equal parts, like if you took a circle and made a cross over it by drawing a horizontal line and a vertical line. The reason I’m telling you about this is because researchers have found that sensations from the quadrants of each breast that are on the outside of a woman’s body register in a slightly different area in the brain than the quadrants that are toward the center of her body. Also, the nerves in the skin that make up the quadrants are different from the nerves that innervate a woman’s nipples.


This can help explain why one woman might prefer you to stimulate her nipples, and another might prefer it if you stimulate the upper quadrant that’s between her nipples and arm pit, and a third woman might want you to kiss and caress the area on the lower quadrants that are below her nipples.


Rather than losing my mind trying to describe for you all of these different and often contradictory findings about breast and nipple sensitivity, what I can tell you with absolutely certainty is that the kind of breast and nipple stimulation that one woman finds to be a total turn on, might cause another women to have a big yawn, and might actually feel painful or a turn off for a third woman.


So the absolute best and most sensible approach is to ask your partner to kiss and caress your chest and your nipples in the same way that she wishes you might kiss and caress hers. Then, try to do the same thing to her, but with her giving you lots of feedback.


Another thing that I found really surprising, and what surprised the researchers as well, is that men have the same number of nerve endings in their nipples and chest area that women have in their breasts. And that stimulation of men’s nipples and their chest area registered in the same parts of their brain and in the same way that stimulation of women’s nipples and breasts registered in their brains. Yet men rarely ask women to kiss and caress their nipples and chest, and women seldom offer.


But neurologically, it should feel just as good or just as bad, for a man to have his chest stimulated as it does for a woman. In fact, a man’s chest area might even be more sensitive than a woman who has large breasts, because the same number of nerve endings are spread out over a larger area in her breasts than on his chest.


As for breast symmetry or the lack of it, 90% of women have breasts that are different from each other in size, shape, or in how they are positioned on a woman’s chest. Usually the left breast is larger than the right one, and in almost 25% of women, the larger breast is at least one cup size bigger than the other one. So if you have a partner and she’s particularly crabby after having gone bra shopping, this might be one of the reasons why.


Over the course of a woman’s lifetime, her breast size will change up to six or seven times, and it is not unusual for a woman’s breasts to change in consistency and sensitivity from week to week during her monthly cycle.


The reason I said monthly cycle instead of menstrual cycle is because a lot of guys assume that a menstrual cycle is when a woman is having her period, but her period is just one part of a 21 to 38 day menstrual cycle that includes her period and then keeps repeating until she goes through menopause. So it’s a bit confusing that the term “menstruation” is when a woman is having her period, but her “menstrual cycle” is going on all of the time whether she’s having her period or not.


So why am I talking about menstrual cycles in a discussion about women’s breasts? The reasons is because a woman’s breast tissue is very sensitive to the hormones estrogen and progesterone, and these hormones are constantly changing over the course of each menstrual cycle. This is why it’s perfectly normal for women’s breasts to change in consistency and sensitivity from week to week.


For instance, during the first half of a woman’s monthly cycle, her ovaries produce a lot of estrogen. And estrogen causes the milk ducts in her breasts to grow.

Sorry about that. Milk “ducts.” I’m not going to be able to get that correct. Milk Ducts— “ducts” as opposed to the kind of ducks that go “quack, quack.”


During the second half of her monthly cycle, there’s an increase in progesterone that stimulates the milk glands in her breasts. As a result, just before she has her period, a woman’s breasts can swell and feel so sensitive that driving over a speed bump can feel painful. And when she’s having her period, her breasts might feel a bit lumpy as they return to their baseline state.


This is why it can be really helpful and thoughtful if you ask a female partner if there are times during the month when she’d rather you not touch her breasts. Given that a woman’s menstrual cycle can range from 21 to 38 days, these no-touch days might be different each month, so it will probably be best if you and she agree on a signal that she can give you on days when her breasts are feeling more tender.


For the next minute or so, let’s talk about silicone nipple covers. During Covid, a lot of women were working from home, which means that they didn’t need to wear a bra. In order to prevent the kind of chafing that might happen when their nipples are rubbing against their clothes, or to keep her nipples from showing if a woman is conscious about that, some women started to wear adhesive nipple covers that are made out of silicone. The reason I say this is in case you are having sex with a woman for the first time and you encounter a silicone dome that’s covering her nipple and maybe half of her breast, there’s no reason be concerned. Simply ask her if she wants you to take them off, or if she wants to take them off herself. Either way, once they are off, find a safe place for them, especially if you’ve got a dog or a cat who might think you brought them a new play toy.


Also, we just talked about how men’s nipples are just as sensitive as women’s nipples, and that’s why they have silicone nipple covers for male athletes who often experience nipple chafing, like marathon runners and some surfers. So if you’re a guy who has that issue, do a browser search for nipple covers for men.


Lets finish up today with breast density, which is actually very important, given that almost 50% of women have breasts that can be classified as dense.


So what is breast density? Women’s breasts are made up of three types of tissue:


One type is called glandular tissue. It contains the lobes that make milk and the tubes that carry the milk from the lobes to a woman’s nipples.


The second type of breast tissue is called fibrous tissue. It makes up the framework that holds the glands and glandular tissue in place.


The third type of tissue in women’s breasts is fat or fatty tissue. Fat is what gives breasts their shape and size.


When a woman has dense breasts, it means her breasts contain a substantial amount of glandular and fibrous tissue, more so than a woman whose breasts are classified as being fatty.


Almost 13% or 1 in 8 women will get breast cancer during her lifetime, and women who have dense breasts have a greater chance of getting breast cancer than women who have fatty breasts. So having dense breasts is a risk factor for breast cancer.


If that weren’t concerning enough, having dense breasts makes it very difficult for a routine mammogram to find breast cancer until it is in the later stages. That’s because glandular and fibrous tissue look white on a mammogram, and so does breast cancer. This creates a situation where the cancer is being masked because the radiologist is mostly seeing white on white.


So where a routine mammogram can often detect breast cancer in its earliest stages in a woman who has fatty breasts, it can be months and often years before a routine mammogram can detect cancer in women who have dense breasts. And I think we all know how important it is to detect and treat cancer as early as possible, regardless of what type of cancer it is.


You might assume that it would be easy to tell dense breasts from fatty breasts just by feeling them. That’s what I assumed until one of the world’s top researchers in breast density told me that even the most highly trained healthcare provider can not tell if a woman’s breasts are dense based on how they feel. She said it doesn’t matter if a woman’s breasts feel lumpy, thicker or more compact, it is impossible to tell whether a woman has dense breasts without doing a mammogram. And where a mammogram does a good job of telling if a woman has dense breasts, mammograms do not do a good job of finding cancer in a women who have dense breasts.


If you want to see for yourself how challenging this is for a radiologist, I’ve included a post at that shows how cancer looks in mammograms of women whose breasts are NOT dense vs. breasts that are dense. I guarantee, you’ll be blown away by how difficult it is to see a tumor in mammograms of a woman whose breasts are dense. Just enter the word breasts or dense in the search at

14:00 Until the world of medicine comes up with something new, radiologists will need to do a breast ultrasound or a breast MRI in addition to a mammogram in order to adequately screen for cancer in a woman who has dense breasts.


But that’s only in women who know they have dense breasts and who insist having on the additional tests.


Another problem is that few women under the age of 40 get mammograms, so most young women who have dense breasts and have a higher risk of getting breast cancer have no idea that they have dense breasts, although research does seem to indicate that a young woman’s chances of having dense breasts are higher if her mother has them also.


Fortunately, the FDA in the United States and some governments in Europe, are now requiring that the people who do mammograms must inform a woman and her healthcare provider if she has dense breasts. Without having that information, she won’t know if she also needs to have additional tests like a Breast Ultrasound or Breast MRI in order to screen for breast cancer.


What’s really bizarre is why the FDA had to intervene and require healthcare providers to inform women about this. You’d think radiologists would want women to know. Perhaps it’s telling that the radiologists who do mammograms in Ireland were told that they should not tell women about their breast density because they were worried women would want to know more about this and that the radiologists wouldn’t have time to answer women’s questions. Talk about a group of professional morons.


Given how most women don’t know what breast density is, even though almost 50% or half of women have dense breasts, please, talk to the women in your life about this. If they think you’re being creepy, have them look at my post on breast density at In addition to showing actual mammograms, I’ve also included links to resources about breast density that every woman should be aware of.


If your partner does have dense breasts and her healthcare provider wants her to have a breast ultrasound or a breast MRI, but her insurance company declines the request, please encourage her to appeal the decision and support her in any way possible.

Thanks for listening, I’m Dr. Paul for