A girl’s first period is a major milestone that marks the shift from girlhood to womanhood. However, it can also be a scary and confusing experience if she is unsure of what to expect.

—Dr. Lisa Joels

Understanding What is Happening

Menstruation, commonly referred to as your period, signifies the start of a female’s menstrual cycle when a woman bleeds for anywhere between 3 to 8 days. A cycle begins on the first day of one period and ends on the first day of the following period. This timeframe is around 21 to 28 days. During the menstrual cycle, an egg is released by one of two ovaries, which then travels to the uterus through one of the fallopian tubes. Body tissue and blood cells form a thin layer of material on the walls of the uterus to protect the egg, however, if an egg remains unfertilised, the body will no longer need this protection and shed the lining during menstruation.

The average age for starting your menstrual cycle is12 years old but there is some variance. If your daughter hasn’t shown any of the early signs of puberty (i.e. growth spurt, body odour, mood swings) by the age of 14, there can be reason for concern and she should see a doctor who understands the stages of puberty. If she has had some body changes, then you should not be too worried unless she has not started periods by age 16.

Note:

It is important to have the contraception conversation early on as girls can still get pregnant even before their periods have regulated.

The first few periods in puberty are usually irregular. If after a year her periods do not settle down into a regular pattern this is only really a problem if this is interfering with her schooling or extra-curricular activities, or if the gap between periods is longer than three months.

What to Have on Hand

It is important to talk to your daughter about what to expect from her period. The first few periods are not usually heavy, and she can expect to change a pad or tampon three to four times a day. Heavy periods can be managed with a non-hormonal tablet to reduce the flow, which is highly effective with very few side effects or risks. Really resistant problems may need a progesterone hormone but it’s important to avoid the contraceptive pill for a couple of years after the start of periods – unless of course she needs contraception too. The reason being that you may interfere with the final stages of puberty, which are full breast development and achieving full adult height.

Some girls experience period cramps the day before or during the first two days of menstruation, and the experience can be frightening at first. Typically, cramps are felt in the lower tummy and back area and sometimes at the top of your thighs. Pain can be managed with a combination of paracetamol and ibuprofen as they work together with an additive effect.

Complications

Occasionally painful and/or irregular periods can indicate an underlying condition such as endometriosis or polycystic ovary syndrome. Both conditions can occur in teenagers but diagnosing them is a real challenge, and should only be done by a doctor with expertise in adolescent gynaecology to avoid over-diagnosis. The focus should be on managing symptoms and allowing your daughter to achieve her full potential, rather than giving her a label.