Menarche in girls - an FAQ
Menarche is a significant event in the life of a girl, that signals a host of changes that the body is embarking upon – a journey towards motherhood.
There are many age-old beliefs and practices associated with menarche in our societies. This write-up is an attempt to address some of the genuine queries around the practical aspects of menarche that parents will have and help approach menarche in an informed manner.
What is menarche?
A girl’s first menstrual period is called menarche and is one of the major changes of puberty. Menarche indicates that the uterus (WOMB) has started preparing itself for a pregnancy.
Subsequent to menarche, every month the uterus, under the influence of hormones, prepares for a pregnancy. If pregnancy does not happen, the body sheds off the soft lining prepared in anticipation of pregnancy. This appears as bleeding through the vagina, known as menstrual period.
When does menarche happen?
Menarche typically happens within 2 to 3 years of breast development (1st sign of puberty). Average age of menarche is around 12 to 13 years. However, girls (usually in urban setting) are observed to be attaining menarche as early as 9 to 10 yrs. This may be attributed to the urban lifestyle and body weight issues in children.
What about menarche should I discuss with my little girl and when?
71 % of adolescent girls in India are unaware of this event until they get it! Even well educated mothers are usually reluctant to discuss this topic with their little ones. This will create considerable anxiety, fear and embarrassment among girls when they start of with their periods.
It is not healthy to have this as a surprise to her. It is a must to start the conversation around this and warm her up to the event well before it happens. Onset of pubertal changes would be a good time to proactively start this. In cases where they are expressing curiosity about the body changes, you could use it as a starter for the conversation.
Make her aware on what to expect, how to deal with it and reassure her that it is normal. Prepare her for the exigency of dealing with the event temporarily in your absence – say, keeping a pad in the schoolbag. There are menstrupedia comic books which you and your daughter can go through together and discuss and make her informed and prepared.
What is the bleeding pattern to expect in a menarchal girl ?
After menarche, the initial cycles for an adolescent girl will be 21 to 45 days with a flow duration of 2 to 7 days. It will take 2 to 3 yrs for the cyclicity to regularize to an adult pattern of 21-35 days.
What are the abnormal bleeding patterns in an adolescent girl that needs a medical visit?
- Menstrual cycle
- Happening less than 21 days frequently
- Delayed more than 45 days frequently
- Happening more than 90 days apart even for one cycle
- Flow lasting more than 7 days every cycle
- Heavy flow -if she needs to change more than one pad / tampon every 1 to 2 hours
My daughter is putting on weight with menarche. Is there anything to be concerned?
If the child is gaining weight along with some other changes like pimples, oily skin, unwanted hair growth, blackish discoloration in the armpits/groin/behind the neck and menstrual irregularities, a medical visit is advised. This is to look for hormonal disturbances very common in young girls – mainly, PCOS (Polycystic ovarian syndrome) which can be controlled with early intervention.
We will discuss on menstrual hygiene and use of different sanitary products in the next post.
Other related readings
- Puberty related changes in girls
- Menstrual hygiene
- Perineal / Genital Hygiene In Women
- HPV vaccination
- Adolescent gynecology at Cura Femina