These phenomenon are most commonly due to hormonal changes that fluctuates during a woman's menstrual cycle. Though it should present equally at both nipples and breasts, one side may be affected more than the other. Another possible cause is the presence of fibrocystic disease or fibroadenoma underneath the nipple which can present as hardness and pain. This may be worked up with imaging studies such as mammogram or breast ultrasound. Infection underneath the nipples can also give rise to these symptoms. Lastly, a relatively uncommon condition known as Paget's disease can also present with nipple pain along with superficial changes. This should be diagnosed with a biopsy. I suggest you have this evaluated by your doctor and have it managed properly.
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