Is this normal?

Breasts come in all different shapes, sizes, and colors. Yours will undergo a number of changes throughout your lifetime specific to you and your body. From their development in puberty through pregnancy, breastfeeding, and beyond, your nipples may darken or change in a variety of ways.

Even different medical conditions, like diabetes, may make your nipples darker. Although we’ll continue to refer to nipples for clarity’s sake, the area on the breast that’s darkening is actually called the areola. This term refers to the skin around the nipple.

Keep reading to learn what may be behind this change in color, other symptoms you might notice, and when to see your doctor.

1. Puberty

You may first notice darkening nipples during puberty. At this time, your ovaries have begun to make the hormone estrogen. This hormonal change leads to fat accumulation within your breast tissue. As your breasts grow, your nipples may become raised and the areolae may become darker in color. By adulthood, your breasts should be fully developed.

2. Menstruation

With puberty comes menstruation. Once you start ovulating regularly, your breasts continue to change. They mature and form glands at the end of milk ducts. The hormones estrogen and progesterone may make your breasts become swollen or tender before and during your period, which comes on average every 21 to 35 days.

Some women also notice that their nipples darken before their menstrual periods or during ovulation — when hormones are shifting.

Other symptoms of menstruation

Besides the menstrual period itself, some women experience symptoms one to two weeks leading up to bleeding. This is called premenstrual syndrome (PMS).

In addition to dark nipples, you may experience:

  • acne
  • fatigue
  • bloating, constipation, or diarrhea
  • headache or backache
  • cravings or appetite changes
  • pain in joints and muscles
  • memory or concentration issues
  • irritability or mood swings
  • feelings of anxiety or depression

Doctors don’t know exactly what causes all these symptoms, but it likely results from a mix hormonal changes and chemical changes within the brain. The American College of Obstetricians and Gynecologists estimates that some 85 percent of women experience at least one of these symptoms before their periods. And some women develop more intense symptoms or premenstrual dysphoric disorder (PMDD).

3. Oral contraceptives

Taking birth control pills may also affect your breasts and areolae. Why? Pills contain different mixes of estrogen and progesterone. These hormones occur naturally in the body. When you’re taking supplements, they may affect the nipples and areolae in a similar way to puberty, menstruation, and other hormonal changes.

Skin pigment changes you experience while on oral contraceptives are referred to as melasma. Generally, the darkening you experience won’t away unless you stop taking the medication. Though there isn’t research to support this claim, some women report that taking progesterone-only pills may help.

Other symptoms of oral contraceptives

Along with breast changes, women may also experience a range of side effects while taking birth control pills. These may fade as your body adjusts to the medication.

Common symptoms include:

  • breakthrough bleeding or spotting
  • elevated blood pressure
  • headaches
  • nausea

See your doctor if you notice:

  • abdominal or chest pain
  • lumps in your breasts
  • severe headaches
  • blurred vision
  • fainting

4. Pregnancy

When you become pregnant, your breasts go to work preparing to produce milk for your baby. Estrogen and progesterone help develop the milk duct system. The areolae darken and your breasts may become sore, swollen, or tender. Around the sixth month of your pregnancy, your breasts may begin to produce colostrum.

You may also develop melasma on your face, forearms, or neck. The darkness should fade over time after you deliver without treatment.

Other early symptoms of pregnancy

Along with breast changes, a missed period is one of the earliest and most reliable signs women experience when they become pregnant. Other symptoms may vary from woman to woman or pregnancy to pregnancy.

Possible symptoms include:

  • nausea with or without vomiting
  • frequent urination
  • fatigue
  • mood changes
  • bloating
  • constipation
  • implantation bleeding or cramping

If you suspect you may be pregnant, visit your doctor or take a home pregnancy test. If the test shows a positive pregnancy result, see your doctor. They can walk you through your options and discuss any concerns you may have.

5. Breastfeeding

Whether or not you choose to breastfeed your baby, your areolae will likely be dark after you deliver. Some scientists have hypothesized that young babies can’t see well, but they can mostly tell the difference between dark and light. As a result, dark areolae may help guide them to their food source — the nipples — for breast milk.

Just as with other pigmentation issues during pregnancy, your nipples should return to normal over time.

Other symptoms of breastfeeding

You may experience a variety of breast changes with breastfeeding, especially as your milk comes in those first days and weeks. These sensations typically develop within the first three to five days after delivery.

These changes include:

  • engorgement
  • leaking
  • nipple sensitivity

Many of these changes are normal and should ease with time. But if you’re experiencing redness, warmth, pain, or lumps, you should see your doctor.

This may mean you have developed a blocked milk duct or a condition called mastitis that requires antibiotics to treat. In more severe cases, you may need to visit your doctor to have a duct or breast abscess drained.

If you do experience pain or difficulty with breastfeeding, reach out to your local lactation consultant for help with anything from tips for easing your symptoms to instructions on better latching.

6. Diabetes

Hyperpigmentation of the skin is a possible symptom of diabetes. It develops in response to insulin resistance. The condition is specifically called acanthosis nigricans, and it often affects the folds in skin around the armpits, groin, neck, and limbs. The areolae may darken and develop symmetrical lesions or velvety plaques.

There isn’t any particular treatment for this symptom. Instead, managing diabetes may help your skin return to its normal color and texture.

Other early symptoms of diabetes

Increased thirst and frequent urination may be some of the earliest signs you have diabetes. You may even find that wounds take longer to heal or that you have frequent infections.

Other symptoms include:

  • increased hunger
  • weight loss
  • fatigue
  • irritability
  • blurred vision

If you’re experiencing any of these symptoms, see your doctor for diagnosis.

When to see your doctor

Dark nipples aren’t necessarily a reason for concern. Changes in your breasts and areola are common throughout life and different situations, like puberty or breastfeeding.

Still, it’s a good idea to share any differences you experience with your doctor, especially if they’re accompanied by other symptoms. Dark nipples may be a sign of medical conditions like diabetes or they may mean you are pregnant.

You should also see your doctor if you experience any signs of infection, including fever, pain, redness, or warmth.