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When should I start speaking to my daughter about menstruation?

There is no specific time or age when one should start to discuss menstruation. Most girls start their periods when they are about 11-12 years old, but they can start as early as age 8 years.

It should be brought up early with a gradual build-up of your child’s understanding to make sure she is prepared. Speaking about such personal subjects can make parents and kids feel a little uncomfortable so look for natural moments to speak about the topic. If you feel uncomfortable speaking to your child about menstruation, try watching a video together or ask a trusted family member or doctor to assist with the conversation.

Talk about the changes in her body that are expected to occur with puberty, starting with a growth spurt, breast development as well as armpit and pubic hair. Bathing together may bring about a natural time to raise this topic. Explain that every girl’s body has its own schedule. It usually happens around 2 to 2.5 years after the start of breast bud development.

Reassure her that the blood she may see when mom is menstruating does not mean that she is hurt, it is a normal part of growing up.

Emphasise that there is nothing to be ashamed of. The changes the body goes through are so that she can have a baby when she grows up. Explain that every 28 days or so, one of the ovaries releases an egg. This is called ovulation. At the same time, hormonal changes prepare the uterus for pregnancy. If ovulation takes place and the egg isn't fertilised, the egg passes through the uterus and out of the body, and the lining of the uterus is shed through the vagina. This is called a period.

Prepare her for the symptoms she may experience and explore period supply together. Be hands on about showing her how to use it and teach her how to make a pad out of toilet paper should she not have supplies. Ensure that she is always prepared with a sanitary towel in her bag and a change of underwear, just in case. You may want your daughter to use sanitary pads initially but explain the option of tampons or menstrual cups for when she is older and more comfortable with the idea.

How can I support her?

It is important that her first period is handled with care, positivity and reassurance. Puberty is hard enough as it is, and your child may be struggling with the changes in her body. Here is some advice to help make this experience less scary.

1. Confront the menarche (first period). You may not be present when this occurs but be available to pick her up from wherever she is without creating a disturbance and take her to a place of comfort, such as home.

2. Listen to her. Ask about her concerns or fears and allow her to share whether she is experiencing any pain, irritation or mood swings. Find solutions to minor discomforts by offering her food, a hot water bottle or chocolate to make her feel better.

3. Be warm, reassuring and accepting. She may be scared or traumatised by the sudden experience and may just need a hug. Share your own experiences and normalise periods as much as you can. Reassure her that she can still do everything that she used to do.

What to expect?

Menstruation is associated with a number of undesirable changes that may present challenges to your daughter and the family. These diverse physical and psychological symptoms are collectively referred to as PMS (Premenstrual Syndrome) and up to 90% of females experience them in the week or two before their period.

Irregular periods: For the first few years after starting menstruation, periods may not be regular. They may also be associated with longer periods of bleeding. This is normal and occurs due to the first cycles not being associated with ovulation. This may, however, predispose your daughter to iron deficiency anaemia.

Abdominal cramps: Periods can also be quite painful with abdominal cramps and associated nausea and bloating. This can be managed with application of a hot water bottle or beanbag, or with over-the-counter anti-inflammatory medications.

Mood changes: She may experience anxiety, irritability, tiredness or trouble sleeping and may cry easily. She may just want to be left alone, however some activity in the form of a walk can do her some good.

Body image: Other PMS symptoms such as spotty skin, greasy hair and appetite changes that affect weight gain can affect her body image and self-confidence. Encourage body positivity and cleanliness, clear out any insecurities, help her feel valued and beautiful.

When should I worry?

If your daughter experiences any of the below, please seek assistance from a General Practitioner (GP) or Gynaecologist for further management.

• She is 15 years old and has not had her first period.

• She started developing breasts more than three years ago and has not had her first period.

• Her periods still do not come regularly even though it has been two years after her first menstruation, especially if she misses three or more periods in a row.

• She experiences severe cramps that are not relieved by over-the-counter antiinflammatories and result in her missing daily activities such as attending school.

• She has very heavy bleeding that requires that she change her sanitary pad/ tampon more frequently than advised. She may also be passing blood clots or have symptoms of anaemia such as fatigue, weakness, heart palpitations or dizziness. 

Dr Rori Fortuin is a specialist

Obstetrician and Gynaecologist, who has recently moved from Johannesburg and has started a new practice at Life Kingsbury Hospital. She has a special interest in high-risk obstetrics as well as laparoscopic surgery and charges medical aid rates.

T +27 21 065 1816

E reception@drroriobgyn.co.za

W www.drroriobgyn.co.za