Helping teens with first menstruation

Donya Betancourt, Pediatrician, drdonya@hotmail.com

Girls aged between 10 and 16 must be prepared for their first menstruation. Discussing this natural, but private, function with a preteen girl can be awkward, particularly in nontraditional families, where mom is not always around.

To ease your discomfort, take time to prepare. You can expect, however, to get sidetracked by questions. If your preteen is comfortable enough to ask them, you are already doing well. When do you start? The average age to begin menstruating is approximately 12.5 years, but anytime between 10 and 16 is normal.

At least a couple of years before menstruating, girls experience other changes of puberty, including pubic hair growth and breast development. Therefore, that is the time that many girls should learn about menstruation.

In fact, by the time you talk to your preteen, she may already know a little or a lot about puberty and menstruation from talking to her friends, older sisters or schoolteachers. It's important to address the topic early so that she will not have the trauma and potential embarrassment of starting her period in complete ignorance.

Because the topic of menstruation is very sensitive and personal, have this discussion in a private setting where the two of you can take your time and speak freely about the physical and emotional aspects of reaching puberty.

To start, if you're a mom, you may want to begin by sharing when and where you first got your period and any fears you had during that time. An alternative starting point would be to ask your adolescent about what she has heard or learned at school about puberty, menstruation and even sex. If you are nervous and tense, she may be too. Generally, answering specific questions is more effective than long lecturing.

Let her know that it is a natural part of life and of becoming a mature woman.

Explain how the menstruation cycle works, at least they will want to know when to expect their periods from month to month and how long they will bleed each month. An average menstrual cycle is 28 days long and it can range from 23-35 days. It lasts 4-5 days but it also can be as short as 2 days or as long as 7 days. Also mention that it may take several months for her menstrual cycles to regulate and that she may experience some unpredictability in the meantime.

Tell her that many women experience some of the signs and symptoms of PMS (premenstrual syndrome) before their period, such as cramps, headache, changing appetite or weight.

Advise her to tell you if her period seems unusually heavy, painful or prolonged. Extremely irregular periods also are a cause for concern. All these problems warrant medical attention. Sometimes medication, including oral contraceptives, are used to regulate flow and decrease symptoms. If she wishes to be seen by a doctor after beginning menstruation, and if possible, give her the option of seeing a female doctor.

Explain how to use tampons and pads. Show samples of a few different types and brands. Young girls may also be worried about having an embarrassing menstrual accident at school, at camp or during a sporting activity. Keep an extra pad or tampon tucked away in your school bag, desk or purse at all times. If you have an accident, you can usually rinse off a stain with cold water.

Use a calendar to demonstrate how she can track and predict when her period will begin and end each month. This tracking information can be helpful at medical evaluations.

Explain that girls and women who menstruate are usually fertile. That is why she needs to know about sexual intercourse, contraception and prevention of sexually transmitted diseases. You do not need to be an expert to talk to an adolescent about menstruation. Young girls want to talk. It is important that you keep an open-door policy so that she feels comfortable asking additional questions as she grows and matures.

If you sense that all the information is a bit overwhelming, bring the conversation to an end and pick up the thread again later. At the very least, you will have identified yourself as a resource for her when she is ready to talk.