Heather Little-White, PhD, Contributor
As a girl approaches puberty, she can expect her menses (period) at any time. When her breasts start to develop and her physical form starts to change, her parents should prepare her for this new and sometimes frightening experience.
Many girls may have first menses at school, and teachers and guidance counsellors are often equipped to help them through the first period. Menstruation should be an important part of sex education, as its onset moves a girl's development through puberty to womanhood and, in the process, she should be aware that she can become pregnant at any age if she engages in sex without using a condom.
Menstruation, or period, is a girl's or woman's monthly bleeding. Each month the body prepares for pregnancy, but if no pregnancy takes place the uterus or womb sheds its lining. The period is a combination of blood and tissue from inside the uterus, passing it through the vagina and the period usually lasts from three to five days (Medline Plus).
Poor nutrition
Menstruation is part of the cycle which prepares the body for pregnancy each month. The cycle varies from one female to the next, with some persons having 25 days while others may have up to 34 days between the start of one menstrual flow to the start of the next. Some young women have flows for up to 60 days resulting from stress, weight loss, poor nutrition and regular, strenuous exercise, all of which can alter hormone levels.
During the cycle, hormones rise and fall. In the fist half of the cycle, the female hormone and oestrogen levels start to rise to make the lining of the womb thicken and grow. At the same time, an egg in one of the ovaries starts to mature, and by day 14 or so of the cycle, the egg leaves the ovary in a process called ovulation and travels through the Fallopian tube to the uterus. It is during ovulation that pregnancy can take place, when a man's sperm may fertilise the egg and attach it to the wall of the uterus. If the egg is not fertilised it will break apart and hormone levels drop, and the lining of the uterus will shed during the period.
Menstrual records
It is important to keep records of your menstrual cycle, which will be useful to diagnose problems that may occur during development. The doctor can determine the cycle pattern and any changes or symptoms that may appear. Doctors are usually interested to know the first day of the menstrual period to help with diagnoses of gynaecological problems, or if there is a missed period.
Missed periods are not only caused by pregnancy but may be associated with the lack of release of an egg from the ovary. This is called anovulation. At times, you may not be sure when is the first day of the period, as spotting may occur before in a short, light flow of blood. On the menstrual record, this could be recorded as 'spotting'. When the flow begins, you can record 'flow'.
Physical problems
As the periods begin, girls may experience problems such as:
Amenorrhea - lack of the period. The term also relates to women who have not had a period by age 15, or those who used to have a period, but have had none for 90 days. Causes include pregnancy, hormonal changes, stress, breastfeeding, excessive weight loss and serious illnesses.
Dysmenorrhea - pain with periods, including severe cramps. Teens often experience cramps which are caused by too much of the chemical prostaglandin. In older women, the pain may be caused by fibroids or endometriosis. Over-the-counter drugs are usually available to ease the pain.
It is recommended that as a young girl starts her period, she should be taken to the family physician to discuss the new experience and get comfortable with the doctor's environment, so she can freely discuss any future problems she may experience. Preventative health visits during adolescence will give a doctor the opportunity to discuss and educate parents and teens about problems with puberty, menarche (onset of menses) and the menstrual cycle.
Premenstrual syndrome
Several young girls and women will experience a number of symptoms a week or two before the period. This is known as premenstrual syndrome, or PMS. According to Medline Plus, symptoms may include an outbreak in acne, tenderness of the breasts, bloating, weight gain, headaches, pain in the joints, food cravings, irritability, mood swings, crying outbursts and depression. The exact cause of PMS is not known, but hormonal changes activate symptoms which can be relieved by over-the-counter pain relievers for cramps, back pain, headaches and breast tenderness.
Some parents are wary about allowing their young daughters to use a tampon, out of fear that it will tear the hymen, which is usually broken when virginity is lost. However, the evidence is not conclusive, and whether tampons or sanitary pads are used for the flow of the menses, they should be changed as often as needed before the pad or tampon is soaked with blood. Each person knows what works best but care should be taken with the use of the tampon to prevent Toxic Shock Syndrome (TSS). The tampon should be changed frequently but no longer than eight hours.
Toxic shock syndrome
Young women who use any kind of tampons at any absorbency are at greater risk to get TSS than those who use sanitary pads. To lessen the risk of TSS it is best to alternate between tampons and sanitary pads. The warning signs of TSS include sudden high fever, diarrhoea, muscle ache, vomiting, dizziness, fainting, sore throat or bloodshot eyes.
Menstruation will continue into the reproductive years and will be interrupted by pregnancy, when the endometrium must nourish the foetus. Menstruation will resume after childbirth, and at age 50 or so oestrogen levels start decreasing, the ovaries no longer produce eggs and eventually menstruation stops. The continuum of menstruation from puberty to menopause can be a natural experience for some, while others may find the menses a monthly horrific experience.
