First period: How long it lasts, early signs and expert recommened self care tips

First period or menarche is an important milestone for a young girl.It signifies the culmination of changes that she has been experiencing for the past 2-5 years as her young child-like body transforms into an adult.This period of pubertal change is associated with emotional changes in addition to the obvious physical ones. Hence ,it’s important for parents to keep their child abreast about the physical transformation, sexual health, menstrual hygiene and most importantly listen to the emotional turmoil that she goes through during the so called “terrible teens!” Sequence of pubertal changes :A girl will start to experience changes in her body from age 8-15.These changes occur in a sequential order.Breast development/ Thelarche:Development of small breast buds under the nipple is the first change that is noticeable. Pubic and axillary hair( Pubarche):Small fine hair growth in the armpits and pubic area are noticed after the development of breast buds.Growth spurt:Growth spurt begins soon after. A girl attains most of her adult height by the time she gets her first period, although she may continue to grow until 16-20 years of age.First period/ Menarche:The above changes culminate in the first period/ menarche which is often regarded as a child’s official entry into adulthood.She is now capable of bearing a child of her own.A child can start developing breasts and axillary hair between 8-13 years of age. The age of puberty is influenced by genetics,nutrition and socioeconomic conditions .Obese children often tend to attain puberty earlier than children with a normal BMI. Parents can expect their child to get her first period within 2-5 years of the appearance of a breast bud/ axillary and pubic hair.The normal age of first period: 9-15 yearsHowever, the absence of breast development and hair growth at 13years of age needs further evaluation.Similarly, development of breasts and hair growth prior to the age of 8 requires a detailed work up.Menstrual education and hygiene:Educating your little girl about menstruation as soon as you notice changes in her body,what it means, the methods available to maintain menstrual hygiene (sanitary pads, tampons and menstrual cups) along with its pros and cons and most importantly, letting them know that this is a normal phenomenon that every girl goes through, helps her deal with the new change effortlessly. Caring for one’s body and keeping themselves clean during their periods, regular changing/ cleansing of products used for menstruation and their safe disposal are aspects that the child should be aware of before she gets her first period.The first period signifies activation and maturation of the hypothalamo- pituitary- ovarian axis ( the nerve signals between the brain and the reproductive organs) that have been dormant during childhood. This is however not synonymous with egg release/ ovulation.The first few periods are often anovulatory due to an immature hypothalamo- pituitary- ovarian axis and hence tend to be irregular and often delayed. A regular pattern sets in within 5 years of the first period.Bleeding patterns that are normal during this phase:If a girl experiences heavy bleeding lasting more than 7 days or absence of periods for more than 90 days from her first period, she needs to be evaluated for thyroid disorders, PCOS and bleeding disorders to name a few. In 2-5 years time, a normal adult pattern of menstrual cycle with an interval of 21-35 days between two periods sets in.Painful periods/ Dysmenorrhea is often a complaint with young girls. If it is incapacitating, requiring medication or preventing her from doing her normal activity, she needs to get evaluated by a gynecologist. Sex education:Although most parents are uncomfortable with the topic, this is probably the right time to educate your girl on her body , sex , protection and pregnancy.HPV vaccine: The first period could also be a gentle reminder for those parents who haven’t vaccinated their kids with the HPV vaccine to protect them from cervical cancer.As the vaccine is most effective before the onset of sexual activity and is recommended for girls between 9-26 years of age, this would be the right time to protect your child!The first period and the physical and emotional changes that come along with it can be difficult to comprehend for both the parent and child alike.Discussing it with your gynecologist and counsellor if you're not able to cope with the changes or notice deviations from the normal or simply because you’re uncomfortable discussing it with your child , will help you both get clarity on most issues that young girls go through during this phase and will help both of you sail through this phase effortlessly.