Menarche (the first period) is very significant for young women. Still, many do not understand what it is and why it happens. Some girls are confused about what to expect, especially since the experience of menstruation varies greatly from girl to girl. Without understanding the process, it is easy to feel either embarrassed or that you are not normal.
Haven't got your period yet? A period is the blood that comes from your vagina
three to seven days every month. It is hard to tell just by looking at it
that menstrual blood (or menses) is made up of both tissue and blood.
Blood and tissue come from the uterus, a muscular organ where a baby can grow. Menstrual blood flows down into your vagina, and onto your underwear if you are unlucky to be caught without protection! Still, try not to worry. Since the first period is usually very light, the red or brown spot in your underwear should wash out easily.
The tissue comes from the lining of the uterus, called the endometrium. If an egg were to be fertilized, it would attach and grow in the endometrium. This lining is shed as a period when your hormones are in a particular balance.
The ovaries produce both eggs and a hormone called progesterone. If your ovaries are making enough progesterone, the lining stays in place. However, if an egg released by the ovary is not fertilized, the progesterone level falls and the lining is shed.
The blood in your period comes from spiral arteries reaching into the lining. When the walls of the spiral arteries break down, blood flows into the surrounding tissues. Once the lining has been completely shed, a new cycle begins. An egg begins to develop in the ovary and secretes the hormone estrogen. Estrogen makes the lining develop again. If no pregnancy occurs, the cycle repeats itself once progesterone levels fall again.
For most North American women, puberty starts between the ages of eight and 13. If you are 14 years old and your breasts have not started to develop, go see your family doctor. Your family doctor can investigate why you have not started puberty yet. Treatment can help, since many causes of delayed puberty are reversible. A part of the brain that regulates puberty may have stayed inactive or the ovaries may not yet be working properly.
If your breasts have developed but there has been no sign of your first period by the time you are 16, you should also see your doctor. Those who do not have a period but experience other signs of puberty may have a medical condition. An inappropriate feedback mechanism between the brain and the ovaries can mean an egg is not released. Jump-starting the hormones under the care of a doctor can treat the condition. Certain problems present at birth or several medical conditions can also lead to breast development in the later teens but no period. Again, this is a sign that a doctor should be consulted.
Once you start your periods, you can watch for clues that signal when your next period will begin. Periods are irregular at first. Sometimes, it takes a few years before they can be predicted. Once periods are regular, many women can calculate reliably when they are going to menstruate, often to the day. Certain pre-menstrual symptoms give women hints that their period will start soon. Bloating, breast tenderness, pelvic pain, and mood swings are all among the signs. In most cases, menstrual flow is very light in the first few hours, so you should have enough time to grab a sanitary napkin or tampon.
The range for normal cycle length is 28 days, plus or minus seven days. If you have your period every 20 days or less, or every 36 days or more, consider seeing your doctor.
Getting your first period means that your body is maturing into one capable of reproduction. In other words, you might get pregnant if you engage in unprotected sex. The eggs in your ovaries are able to mature and be released, monthly, into your reproductive organs. Around mid-cycle, two weeks before the first day of your period, a fertile egg is released from an ovary (called ovulation). The egg travels through a fallopian tube into the uterus. You are most fertile at this time.
Although menstrual cycles without the release of an egg are common in the first 12 to 18 months of menstruation, you can still get pregnant if you have sex. It is not a good idea to try to avoid pregnancy by not having sex on days when you think you might be most fertile. Pregnancy can result from intercourse on any day of the cycle. Find out more about pregnancy and contraception by talking to your doctor or a sexual health consultant.
If you have never experienced menstrual cramps, you are lucky. Unfortunately, many women develop regular menstrual cramping a few years after their first period. Cramps are a dull, achy pain usually in the pelvic area, during the first day or two of menstruation. Substances called prostaglandins stimulate the muscle of the uterus to contract and this causes the pain. Cramping is almost always associated with cycles when an egg is released one reason why most women only begin having cramps a few years after the start of their periods.
Menstrual cramps are very common. For most women, the pain is not severe enough to prevent normal activity. Exercise, over-the-counter pain relievers (such as ibuprofen or acetominophen), stretching, and general activity can help.
Some cramps can be severe enough to prevent normal activity and require over-the-counter or prescription medications to control. This is called dysmenorrhea.
If you think you are experiencing dysmenorrhea, see your doctor to find out why. Depending on the cause, your doctor may prescribe stronger pain relievers. Dysmenorrhea can signal endometriosis, pelvic inflammatory disease, stenosis (narrowing) of the cervix (the lower part of the uterus) or abnormalities in the wall of the uterus.
Many women have heard of endometriosis and wonder if severe menstrual cramps mean they have it. Endometriosis occurs when bits of uterine lining settle and grow on the ovaries, the outside of the uterus or even parts of the bowel or bladder. It can reduce fertility. With endometriosis, cramping pain usually begins a week or two before your period. It peaks a day or two before the first day of menstruation and subsides as or just after the flow starts. Women with endometriosis can also experience pain with intercourse, particularly before a period begins. Oral contraceptives are the treatment of choice, which stop the release of an egg and decrease prostaglandin production. Surgery is the only sure way to diagnose endometriosis and does not change long-term treatment options.
Having irregular periods for a few years after the start of menstruation is very normal. However, if your body does not settle into a 28-day cycle, plus or minus seven days, seek medical advice.
If you stop having periods, with or without occasional spots of blood (spotting), medical attention may be necessary. Pregnancy is by far the most common reason to stop having periods. Women with low body fat or who do strenuous exercise can also shut down the hormone feedback system that regulates menstruation.
On the other hand, suddenly bleeding much more than usual is also cause for concern. Bleeding for more than seven days is abnormal, as is gushing or open faucet bleeding. However, several studies have shown a difference between a woman's judgment of her menstrual blood loss and the actual amount lost. It can be hard to tell whether you are a heavy bleeder or not without someone carefully measuring blood loss to the milliliter. The most concerning symptoms are those that are abnormal for you and signal a major change from your regular cycle.
Some adolescents enter puberty early while others are late bloomers. Although nothing may seem normal when you are going through puberty, rest assured that your body is developing as it should. It can be stressful having your period. You may worry about leaking, cramping, breast and back pain, mood swings, and keeping your period hidden. If you have concerns or feel that your period is truly interfering, ask your doctor for help.