Beginning menstrual periods is a normal change that comes with puberty. Some girls can’t wait to start their period while others are anxious or scared of this change. Parents need to know what is normal so they can better help their adolescent with this transition. It is a complicated hormonal process that causes these changes but knowing some of the basics will help you and your daughter know what to expect.
When a girl starts her period for the first time will depend on many variables and family patterns are common, but knowing what is normal will help guide parents in knowing when medical attention is merited. It is common to observe some irregularities in bleeding patterns during the first 1 to 2 years of starting periods but most adolescents (88 to 94%) become fairly regular without heavy or prolonged bleeding within the first year of starting their cycle. The American Academy of Pediatrics (AAP) and American Congress of Obstetricians and Gynecologists (ACOG) have come together to define what is a “normal” pattern of bleeding in young females. NOTE: Professional organizations vary a little on what is considered “normal”, so if you have questions about your child’s cycle specifically, please talk to your provider.)
| Average | |
| Onset of periods | 12.4 years old(range of 8 to 15 years of age) |
| Number of days between cycles | 32 days(range of 21 to 45 days) |
| Length of cycle | 7 days or less |
| Expected Flow | 3 to 6 pads or tampons in 24 hours |
See your provider if your daughter:
- has not started having periods before turning 16 years old
- has not started menstruating within 3 years after breast growth began, or if breasts haven’t started to grow by age 13
- initially has regular periods but then become very irregular or if her period suddenly stops for more than 3 months
- has periods that come too frequently (more often than 21 days) or too infrequently (more than approximately 35 days apart)
(Notice the professional discrepancy here. Depending on age, further testing may be warranted.)
- bleeds for more than 7 days during her cycle or bleeds between periods
- bleeds more heavily than usual or is continually saturating more than 1 pad or tampon every hour or two
- has severe pain during her cycle
- suddenly gets a fever and feels sick after using a tampon
There are multiple factors that affect how much and how often bleeding occurs, hence, one abnormal period isn’t typically concerning but if the pattern of menstruation is problematic, you should seek medical care. Further testing and evaluation will depend on the individual symptoms and age. Early treatment for menstrual problems during adolescence may help preserve the ability to get pregnant in the future. We are happy to go over the specific needs and concerns of every young woman. See the following articles for more reading and understanding or make an appointment with any of our experts at Canyon View Women’s Care.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2644006/
http://www.womenshealth.gov/publications/our-publications/fact-sheet/menstruation.html
