There’s a lot of misinformation about menstruation. Parents and kids often have lots of questions. What’s normal? What’s not? When should you worry about periods being irregular, or about cramping? How do you help your child know what to expect?
As a pediatrician, I want to help answer these questions for my patients and their parents. I encourage parents to talk with their kids about normal puberty and what to expect BEFORE the first period starts (which is usually between the ages of 9 to 14).
These are a few of the top “myth busters” I’d like to share to help you guide your child through these changes:
1. Myth: Periods should be regular from the start.
It can be normal to have irregular cycles for the first 2 years after menarche (the first period). After that, irregular periods can be a sign of other issues that may need to be addressed – especially if periods that were regular and predictable become irregular or stop.
Sudden nutritional changes or weight loss, significant illness, and even stress can affect period regularity. If it’s been more than 2 years since your child’s periods started and they’re still irregular, bring this up with your pediatrician.
2. Myth: Periods should come every month.
A normal menstrual cycle is anywhere from 21 days to over 35 days. This means in a single calendar month some people will have two periods and others won’t have one at all. Period apps on phones are helpful for tracking the cycle to understand if it is “regular” or “irregular.”For people using hormonal birth control, it can be normal (and safe) for periods to be irregular, or even go away completely while using the medication.
3. Myth: Periods should last a week.
Typical periods last anywhere from 3 to 7 days. Talk with a doctor if your child’s bleeding lasts longer than 7 days each month.
4. Myth: PMS just is an excuse for being moody.
Premenstrual syndrome (PMS) is related to normal changes in hormones, and its symptoms are real. People may experience moodiness, fatigue, headaches, and breast tenderness in the days before or during the period. It varies from person to person, but more than half of menstruating people may experience these symptoms. Eating a normal, healthy diet, drinking lots of water, regularly exercising and resting as needed is the best way to manage these symptoms.
About 5% of people will develop Premenstrual Dysmorphic Disorder (PMDD), which is extreme mood swings associated with periods. If mood symptoms interfere with daily activities, please contact your child’s doctor because there are treatment options.
5. Myth: Teens can’t use tampons.
Tampons are totally safe for preteens and teens to use. While many kids don’t like using them (it does take some practice), there’s no “right age” for tampons. Reassure your child that tampons can be used by those who’ve never had intercourse, have nothing to do with virginity, and can’t “get lost” inside their body.
It’s not necessary to stop being active or playing sports during a period, and many athletes (like swimmers, dancers, and gymnasts) find tampons much easier to use than pads. Menstrual cups and period underwear or period swimwear can be great options for active teens, too.
6. Myth: You should “just deal with the pain” during periods.
While cramping with periods is common, it shouldn’t be ignored, especially if it’s severe enough to miss school. There are ways to help manage the discomfort, including medications. Period cramping in preteen and teen years usually isn’t due to an underlying medical problem, as it may be later in life. But it’s important to talk with your pediatrician about managing menstrual cramps if they’re affecting your child’s everyday life.
7. Myth: Only girls and women get periods.
All individuals born with a female reproductive system (ovaries and uterus) can have menstrual periods. This includes people who identify as gender-fluid, non-binary, or male. Pediatricians understand the importance of talking with all children about what changes may happen with their body during puberty.
Regular checkups with your child’s pediatrician will help monitor growth and puberty and are a good time to ask questions about menstrual cycles. If your child doesn’t start their period by age 15, let their pediatrician know.
Resources for Parents
American Academy of Pediatrics
Concerns Girls Have About Puberty
U.S. Department of Health and Human Services Office on Women’s Health
Menstrual Cycle
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Featured Author
Dr. Lindsay Frost's biography reads: I joined the pediatrics team at Kaiser Permanente South Sacramento in 2018 to help kids thrive. Outpatient pediatrics is a unique and rewarding medical specialty. I enjoy being able to foster long-term relationships with patients and their families, providing care in both health and illness as children grow. I believe that it is important to truly partner in health care with patients and their families; this allows not only for the best possible care but also for me to continue to learn and grow as a pediatrician. A professional interest of mine is to support breastfeeding families as an International Board Certified Lactation Consultant (IBCLC). During my medical training, I also pursued a degree in public health/health promotion - a field which applies to every patient visit in pediatrics. Yet, some of my most relevant experiences as a pediatrician has come from my two children, who have “trained” me first-hand on the challenges of parenthood and in finding the balance between evidence-based recommendations and reality to achieve optimal childhood growth and development. Being part of Kaiser Permanente allows physicians and patients access to integrated care and resources that are not readily available with other health systems. Kaiser Permanente’s commitment to preventive care is also an important piece of my personal care philosophy. I am proud to be part of the team at South Sacramento and I look forward to getting to know you and your family.Read more at https://mydoctor.kaiserpermanente.org/ncal/providers/lindsayfrost
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