Especially for Teens – Menstruation

Menstruation is a normal and healthy part of growing up. The discharge of blood and tissue from the lining of your uterus each month is often called the menstrual period. Menstruation can begin as early as age 8 years or as late as age 15 years, but it most often begins around age 11 or 12 years.

The Menstrual Cycle

The start of menstruation is one of many signs that a girl is becoming a young woman.

An average menstrual cycle lasts 28 to 30 days, counting from the first day of one period to the first day of the next. Normal cycles can vary from 21 to 35 days.

Each month, after day 5 of your cycle, the lining of the uterus (endometrium) begins to grow and thicken.

Around cycle day 14, an egg is released from one of your ovaries. This is called ovulation.

Around cycle day 28, if an egg is not fertilized, the endometrium is shed by bleeding. The menstrual blood (a mix of blood and tissue from the inside of the uterus) flows from the uterus through the cervix into the vagina and out of the body. This bleeding is your menstrual period. Your period may last for 3 to 5 days. Some last as long as 7 days.

When Your Period Will Start

Many girls have their first period around age 11 or 12 years. But periods can begin as early as age 8 years or as late as age 16 years. In most cases, the first period is very mild — only a few drops of blood or spotting may occur. Some girls have regular, monthly menstrual periods. Other girls might miss a period or have two periods in 1 month.

How to Keep Track

It is a good idea to use a calendar to keep track of your periods. Mark the first day your period starts on your calendar with an “X.” Count the first “X” as day 1. Keep counting the days until you have your next period. If you do this every month, you will be able to tell how many days there are between your periods.

When Your Period Hurts

Many girls have mild cramps in the lower abdomen or pain in the lower back when their periods start. Cramping gives you a feeling of tightness and pain. This is normal. Some girls also go through other changes in the days or weeks before their menstrual periods start. The most common symptoms are:

* Bloating — a feeling of fullness in the abdomen
* Tender breasts
* Headache
* Feeling tired
* Mood swings
* Food cravings

There are ways to relieve your cramps and other symptoms. You can:

* Take over-the-counter pain medicines, like ibuprofen, acetaminophen, or aspirin
* Exercise
* Place a heating pad or hot water bottle on your stomach

Problems

Severe Cramps

Mild cramping with your period is normal. If you have severe cramps, nausea, or pain so intense that you cannot do your usual activities during your period or pain medication does not help, see your doctor.

Amenorrhea

Some girls do not menstruate during their teenage years. For instance, some girls’ periods may never start or they may stop having periods completely. This is called amenorrhea.

There are many other reasons for a missed period. The most common reason is pregnancy.

A young woman should see her doctor if she has not started having periods by age 15 years or if she has not had a period for 3 months.

Heavy Bleeding

Some girls have heavier bleeding than others. If your periods are heavier than usual or go on for longer than a week, they may not be normal.

Finally…

Menstruation is a normal, healthy process. In most cases, it does not affect your day-to-day activities. If you have any concerns about your menstrual cycle, discuss them with a trusted adult or your doctor.

This excerpt from ACOG’s Patient Education Pamphlet is provided for your information. It is not medical advice and should not be relied upon as a substitute for visiting your doctor. If you need medical care, have any questions, or wish to receive the full text of this Patient Education Pamphlet, please contact your obstetrician-gynecologist.

To ensure the information is current and accurate, ACOG titles are reviewed every 18 months.

This information is provided for your information. It is not medical advice and should not be relied upon as a substitute for visiting your doctor. If you need medical care, or have any questions, please contact your obstetrician-gynecologist.