Everyone knows the teen years can be difficult - for both teens and parents. All those physical changes during puberty can make adolescents feel awkward and unsure of themselves.
This is particularly true for girls when it comes to menstruation. For a girl, getting her first period is a physical milestone and a sign of becoming a woman. But it can also be confusing, particularly if she encounters certain problems like irregular periods or premenstrual syndrome (PMS). If you want to help your daughter understand what's happening to her body, it'll help to know what you're talking about first.
Common Problems
Of course, most issues teens confront when they start menstruating are completely normal. In fact, almost every girl and woman has had to deal with some of them at one time or another.
Premenstrual Syndrome (PMS)
PMS includes both physical and emotional symptoms that many girls and women get right before their period, such as acne, bloating, fatigue, backaches, sore breasts, headaches, constipation, diarrhea, food cravings, depression, irritability, or difficulty concentrating or handling stress. Different girls may have all or some of these symptoms, in varying combinations. PMS is usually at its worst during the 7 days before the period starts and disappears once it begins.
Although the exact cause of PMS is unknown, it seems to occur because of changing hormone levels. During the second half of the menstrual cycle, the amount of progesterone in the body increases. Then, about 7 days before the period starts and right around when PMS occurs, levels of both progesterone and estrogen drop.
Cramps
Many girls experience abdominal cramps during the first few days of their period. They are caused by prostaglandin, a chemical in the body that makes the smooth muscle in the uterus contract. These involuntary contractions can be either dull or sharp and intense. The good news is that cramps usually become less severe as girls get older.
Irregular Periods
It can take up to 2 years from a girl's first period for her body to develop a regular cycle. During that time, the body is essentially adjusting to the influx of hormones unleashed by puberty. Remember, what's regular varies from person to person. On average, the monthly cycle for an adult woman is 28 days, but the range is from 21 to 35 days.
Changing hormone levels might make a girl's period short 1 month (just a few days) and long the next (up to a week). She can skip months, get two periods almost right after each other, or alternate between heavy and light bleeding from 1 month to another. (Any girl who is sexually active and skips a period should see a doctor to make sure she's not pregnant.)
Delayed Menarche
All girls go through puberty at different rates. Some begin menstruating as early as 9 or 10 and others will not start until they are 16. So if your daughter is a "late bloomer," it doesn't necessarily mean there's something wrong with her. When she gets her period actually depends a lot on genetics; girls often start menstruating at approximately the same age their mothers or grandmothers did, and certain ethnic groups, on average, go through puberty earlier than others. For instance, African-American girls on average start puberty and get their periods before Caucasian girls do.
Something that can delay menarche is excessive exercising (usually distance running, ballet, or gymnastics) combined with a poor diet, usually resulting in inappropriate weight loss or failure to gain weight during growth. This does not include the usual gym class or school sports team, even those that practice often. To exercise so much that she delays her period, a girl would have to train vigorously for several hours a day, most of the days of the week, and not get enough calories, vitamins, and minerals.
Menstrual Problems
Although most period problems are harmless, a few conditions can be more serious and require medical attention.
Amenorrhea: The Absence of Periods
Girls who have not started their periods by the time they are 16 years old or 3 years after they have shown the first signs of puberty have primary amenorrhea, which is usually caused by a hormone imbalance or developmental problem. Hormones are also often responsible for secondary amenorrhea, which is when a girl who had normal periods suddenly stops menstruating for more than 6 months.
Low levels of gonadotropin-releasing hormone (GnRH), which controls ovulation and the menstrual cycle, can result in amenorrhea - and stress, anorexia, significant weight loss or gain, stopping birth control pills, thyroid conditions, ovarian cysts, and other conditions that can affect hormone levels can make periods stop or become irregular. As mentioned earlier, lots of strenuous exercise combined with a poor diet can also cause both primary and secondary amenorrhea. Of course, pregnancy is the first possible cause to rule out when a girl skips periods.
Menorrhagia: Extremely Heavy, Prolonged Periods
More than just 1 or 2 days of a heavier-than-average flow, this condition usually leads to soaking through at least one sanitary napkin (pad) an hour for several hours in a row or periods that last longer than 7 days. Girls with menorrhagia sometimes stay home from school or social functions because they are worried they won't be able to control the bleeding in public.
