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Easing Anxiety Over First Periods

by Sue Hubbard, M.D.

I saw a number of “tweens” this week so that meant a lot of discussions about development, puberty and periods.

Once a girl begins her first periods, which typically occur around the age of 12 ½ years, it is not uncommon to have irregular menstrual cycles. I try to explain this to young girls before their periods start, so that they are not concerned if they have their first period and then worry if they don’t have another one in 28 days.

A “normal” menstrual cycle occurs every 28 days +/- 7 days. In other words everyone is a little different and some women have 22-day cycles, while others may have 34-day cycles and these are both considered to be normal variations.  Not everyone is the same, so that is important to explain to a young girl, as they are comparing notes with friends all of the time.

When a girl has her first period (menarche) she typically may not have regular cycles due to the fact that she does not ovulate regularly. Many menstrual cycles in the first two years are described as being anovulatory. This actually occurs anywhere from 55 to 85 percent of the time during those two years after menarche. Even after five years of menstruation, 20 percent of cycles may be anovulatory.

All of this leads to the reason that young girls often have quite erratic cycles, and it really “bugs” them. Another interesting fact is that girls that begin their periods at a younger age have a shorter duration of anovulatory cycles, and may therefore be telling their 13-year-old friend “I have regular periods already, what is wrong with you?”  Again, you just need to understand that we are all different.

The hormonal changes that occur with ovulation are different than those during an anovulatory cycle and that is why bleeding may be different and irregular. You need “mature” hormonal feedback to ultimately begin regular cycles.

Other events in a woman’s life such as stress, lack of sleep, an illness or extreme weight loss may even effect menstrual cycles. Explaining all of the “nuances” of periods is important because many girls think they will get a period, and they will bleed every 28 days for many years. They really do get quite “freaked” out if things are different than they expected. Giving them a little anticipatory guidance seems to put them more at ease and will hopefully prevent anxiety, which may only mess up their periods a little more. Oh what a tangled web!

That’s your daily dose, we’ll chat again tomorrow!

Send your question to Dr. Sue!

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