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| |    Menstrual Periods in Tweens and Young Teens by Marjorie Greenfield, M.D. reviewed by Marjorie Greenfield, M.D. Menarche (pronounced MEN-ar-kee) is the time of the first menstrual period. Normally, this can be anywhere from age 8 to age 14 1/2, and usually occurs about two years after breast development begins. No matter when the cycles start, it normally takes a few years to become regular. The symptoms of a first period can vary widely from girl to girl. The flow can be moderately heavy or light. It can last a day or a week. The blood may be bright red or brown or any shade in between. Some girls will experience cramping, although that usually isn't the case. The next period may be exactly four weeks later or may occur anywhere from three weeks to a few months. In fact, some girls get their first period and then don't bleed again for many months. It is important for parents to make sure that girls are well informed and prepared for the start of menstruation. I have heard innumerable stories of young girls who thought they had cancer or some other horrible disease, or even feared that they were dying, when they got their first period. Some were ashamed to tell their parents and lived with this fear for months. While many schools provide some health education, you should not rely on it as your child's only source of information. Once your daughter shows signs of puberty, it's a good idea to find out what she knows about menstruation and to provide her with some sanitary pads and an explanation of how to use them. (If she gets her period for the first time while at school, the school nurse will more than likely have pads on hand, even in elementary schools where they may not be available in the bathrooms.) Irregular cycles The irregularity so often seen in young girls' cycles can seem strange to some--especially when most adults have periods that follow a consistent pattern. The reason for this is that the menstrual system matures slowly over time. Menarche actually takes place before the whole cycle of releasing eggs each month has fully matured. And so it's not regular ovulation that usually causes early menstrual periods, but rather changing hormone levels. As hormone levels go up, the uterine lining builds up, and then when the levels drop, there is a period. This process is not as standardized as ovulation cycles, however, so the periods are often irregular and the flow may vary from month to month. Excessively heavy bleeding--that is, bleeding that lasts longer than eight days or periods that come less than three weeks apart--can lead to low blood counts (anemia) and can be very stressful for girls who are just getting used to managing their periods. A visit to the doctor can help sort out if the situation is anything to worry about. An important side note: Keeping a menstrual record for a few months may help you and your doctor clarify if there is any cause for concern. Menstrual cramps Because menstrual cramps are related to ovulatory cycles, many girls who get cramps have them early on with some periods and not others. Or they may not get cramps at all for the first year or two of menstruation, until regular ovulation is established. Cramps that are painful should be treated with comfort measures and over-the-counter medications. If these measures are not adequate, a doctor can provide other alternatives.
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