Middle school is a challenging time for girls. At no other time does a girl’s body change more than during those years.
In addition to all the changes that go along with puberty, a girl typically has her first menstrual period between ages 12 and 13. And like those changes, her period can be scary, uncomfortable and maybe even embarrassing.
It is important to remember, however, that the onset of menstruation is a normal part of growing up. We spoke with Eduardo Lara-Torre, M.D., a specialist with Carilion Clinic Obstetrics & Gynecology, about what girls can expect from their first period and how to prepare for it.
What is a menstrual period?
When a girl reaches puberty between ages 8 and 14, he explained, her body begins to change and produce hormones that result in a monthly cycle (28 days on average). During the cycle, the lining of the uterus becomes thicker with extra blood and tissue and one of her two ovaries releases an egg.
When the egg is not fertilized, the lining of the uterus breaks down and the blood and tissue flow out of the body over the course of two to seven days.
According to Dr. Lara-Torre, menstruation typically begins between the ages of 12 and 13 – one to two years after the breasts begin to develop. She can expect her first few periods to be on the shorter end of two to seven days, sometimes skipping one. It is not unusual for periods to be unpredictable at first before settling into a monthly cycle.
Some girls experience discomfort, with symptoms that can include:
- A cramping pain in the lower abdomen or back
- Breast tenderness just before and during their periods
- Increased vaginal discharge before their periods begin
- Headaches or dizziness
- Nausea or diarrhea
Home treatments include:
- Over-the-counter pain relievers like ibuprofen
- Heating pads or heat wraps
How to prepare for menstruation
Girls can prepare for their first period by having supplies on hand. They might include:
- Panty liners
- Pads
- Tampons
- Eco-friendly reusable cloth pads
- Silicone menstrual cups
- Period underwear
Tampons and menstrual cups are worn internally, while the other products are external.
The right product, or combination of products, will become apparent over time, as each girl discovers what is right for her, but pads are a common place to start.
Managing periods at school
Most girls are nervous about starting their period at school.
Brooks Michael is a school-based health educator with Carilion Clinic's Adolescent Health team. She points out that area high schools have nurses, health educators and other staff who can help students with the physical and emotional challenges that accompany their changing bodies.
"This includes helping make sure you have what you need should you get your period at school," she said.
Schools in Virginia are required to provide free menstrual products, but for added confidence, Brooks recommends carrying a pencil pouch with a pantiliner, pad and change of underwear inside.
"These are great things to keep in your backpack so you can feel more confident about getting your period at school," she said.
Carilion Adolescent Health provides a range of services to Roanoke students, both at city high schools and in visits to elementary and middle schools. These include:
- Preventive and primary health care services
- Education and guidance on risky behaviors
- Mental health counseling
"In addition to making health care available to students who have financial or transportation-related barriers to care," says Brooks, "Carilion’s health educators are available to all students who need them."
When to see a gynecologist
The ideal time for a girl to begin visiting the gynecologist is between the ages of 13 and 15. According to Dr. Lara-Torre, it is a good way for girls to have a preventive visit, ask questions and begin to develop a medical relationship with a physician who specializes in women’s health throughout life.
It also is an opportunity for a girl to ask questions about her body and sex.
“These visits do not routinely need an exam,” said Dr. Lara-Torre. “They are more designed to counsel adolescents on what is normal and what is not.”
While all teenage girls should see a gynecologist, it is especially important if the girl’s period is not typical, such as:
- Beginning before age 8 or not starting by age 15
- Lasting more than seven days
- Bleeding more than once a month
- Skipping periods after the first year
- Experiencing significant discomfort
- Being significantly overweight
It is also vital if she has been, is or plans to become sexually active.
Navigating puberty should not be hard. It is important for girls to remember that their menstrual experience is unique to them, and that they should not worry if it is different from a friend’s or a sister’s.
Whether your daughter has concerns or merely questions, Carilion’s Adolescent Health and Women’s Health teams are available for help and guidance.
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