health to know that most women do not have problem periods and when they do , it is more common for it to occur later on in life , so she is likely to be absolutely fine and be able to carry on with all her normal activities , sport and school in just the same way .
2 . Get practical
• There are a wealth of options out there for girls and women to manage periods from pads to tampons to period pants and menstrual cups . Whichever she chooses is a matter of personal choice and comfort .
• Pads are often the easy go to option when girls first start their periods . Try different brands to find one that balances absorbancy with not being too bulky to achieve a comfortable fit and always pick a higher absorbancy for night use .
• Whilst there may be cultural reasons for avoiding tampons , there is no medical reason she can ’ t try this option if she feels comfortable to do so . Sporty girls , in particular , may find this a more attractive option . It is worth looking at the instructions and some female anatomy diagrams together so that she knows where the vaginal opening is . You can also use a small mirror so that she can see for herself . Remember the vagina slopes gently backwards so the tampon needs to be directed up and slightly back . She might find starting off with tampons with applicators easiest . It is important she remembers to change her tampons regularly ; it isn ’ t uncommon for one to be forgotten and whilst this doesn ’ t usually pose a health risk , there is a small risk of toxic shock syndrome . Less mature girls may find grappling with all of this a bit much . If so , she can always try again at a later date .
• Menstrual cups require practice to get used to even for adults and may be an ambitious starting choice for most young girls . Having said that , there is no reason why a mature , motivated girl can ’ t try them .
• Having to deal with leaking or periods starting unexpectedly is also something that every woman will have to deal with and being well prepared can help prevent any embarrassing episodes . It might be helpful to have a small “ period pack ” kept in her school or sports bag that has a spare pair of underwear , a few sanitary pads or tampons and perhaps some wipes or tissues for these occasions . Teaching her how to fashion a temporary “ pad ” from tissue paper is also worth doing in case she is caught out completely .
3 . When to worry
• The average age for periods starting is around 12 but it is not uncommon for it to follow a familial pattern ; girls of mothers that started their periods late often follow a similar pattern but do see a doctor if her periods haven ’ t started by 15 ( or 13 if there are no signs of puberty at all ). Periods starting before the age of 8 should always prompt a doctor ’ s visit .
• It is completely normal for periods to be irregular and less frequent for the first few years after they start , as the body ’ s hormonal control mechanisms are not fully mature . They usually become more regular over time . However , if her period does not come for six months ( or three if they have previously been regular ), seeing a doctor is advisable .
• Every girl will have different perceptions of what constitutes a heavy flow , but if she experiences significant leaking and or needs to change an average absorbancy pad or tampon more than once every one to two hours , then she may have genuinely heavy periods that may require further action . In addition , and especially for the non-meat eaters , if you notice her becoming more lethargic and fatigued , she should be checked for iron deficiency .
• It isn ’ t uncommon to experience cramping pains in the first day or two of the period . She may also experience bloating , a change in her stools , fatigue and mood changes . I would usually expect simple pain relief ( paracetamol and anti-inflammatory medication ) during this time to help with the physical symptoms and allow her to be relatively normal in terms of her activities . Anything more than this warrants a doctor ’ s visit .
Key take aways :
• Don ’ t be scared ; this is a normal part of growing up and most girls manage perfectly well .
• Be prepared ; start having the chat about periods before they start , and once they do , make sure she is armed with everything she needs with spares in every bag .
• Each girl and woman are different and so periods will also vary in lengths , timings , intervals and flows . But if something doesn ’ t seem right , do seek advice from her doctor .
Dr Natalie Hutchins gained her medical degree from Imperial College , London and completed rotations in hospitals including St Mary ’ s Paddington , The Chelsea and Westminster and Charing Cross . She then spent four years as a specialist trainee in Obstetrics and Gynaecology and became a member of the Royal College of Obstetricians and Gynaecologists . After having children , Dr Hutchins changed specialty to General Practice and became a member of the Royal College of General Practitioners . She has written articles for both medical and popular literature , and appeared as a medical commentator on various topical issues on television . Dr Hutchins now practices at Central Health .
Spring 2021 47