Nipple pain in middle-aged women can be caused by nipple trauma, breast enlargement and mastitis. 1. Nipple trauma: If the nipple is squeezed and rubbed or scratched for a long time, it will lead to nipple pain in middle-aged women. 2. Mammary hyperplasia: When mammary hyperplasia occurs, the glands localized in the breasts proliferate. When the glands in the nipple areola region proliferate and produce painful symptoms, it can manifest as nipple pain in middle-aged women. 3. Mastitis: When an infection occurs in the breast, it is easy to cause suppurative lesions in the breast, and there will be symptoms of redness and swelling of the localized skin of the breast. If the lesion is close to the nipple or located under the nipple, it can cause nipple pain in middle-aged women. It is recommended that the patient should go to the Breast Surgery Department of the regular hospital in time to identify the cause of the disease and take targeted treatment under the guidance of professional doctors.