Adolescence and early puberty: How parents can help girls prepare for menstruation

For 19-year-old Ambika (name changed), recalling the time when she was barely 9 years old is a traumatising experience. Her rapidly changing body left her confused, scared and distressed. “Perhaps scarred for life,” she says, recounting her early encounter puberty. She could sense the changes in her body, but she was too scared to ask her mother what was happening. “My mother thought it was too early to talk to me about these things,” she says with sympathy. All of a sudden, in the middle of a school-day, she started bleeding. “I was terrified and ran to my teacher, who called my parents. They were surprised at me having menstruated so early,” she says.

While 12 or 13 years is seen as the ‘usual’ age for girls to attain puberty, biologically it is normal if girls start menstruating when they are between 10 and 15 years of age. However, doctors say that they are seeing girls attain puberty earlier compared to the previous generations. “When it happens before 10 years of age, we are really worried and wonder why it is happening,” says Dr Radha Rajagopalan, Senior Consultant in Paediatrics at Apollo Hospitals in Chennai.

Early periods

While research is ongoing on why girls are starting to hit puberty early, doctors believe that change in diet patterns and obesity could be one of main causes. “Increase in body weight can cause the hormones to kick in early,” says Dr Radha. Research has shown that the age of menarche is a function of interplay among genetics, overall health and hormonal changes, nutritional status and several other environmental influences. While it is not clear if anything can, or should, be done to stop girls from hitting puberty early, girls can be prepared for it.

“Around the age they are expected to start having periods, mothers have to sit their daughters down and talk to them, tell them that sometimes they may have blood discharge, and that if they do, they have to tell the mothers,” says Dr Radha, “We have to tell them that there is nothing to be worried about. This is physiological, this is normal for all girls.”

The focus of the mother’s advice to the girl must be on reassuring her and helping her maintain personal hygiene, and not stigmatise the experience. “We need to tell the girls that they have to maintain hygiene. We can teach them how to avoid staining their clothes. But if it does happen, it is ok and they don’t have to be ashamed of it,” explains Dr Radha. She adds, “Some families say they should not take a bath for three days. All that is wrong, they should keep themselves clean.”

“Mother should develop confidence in their daughters so that they share everything happening with their body and nothing is considered too embarrassing to be shared,” Dr Radha adds.

Initially, children are worried and scared, so parents don’t send them to school. “If the child doesn’t feel comfortable, then she can skip school, but it is not necessary. If they can take care of themselves, then they can go to school,” Dr Radha assures.

Bumpy start

Girls who hit puberty early might have irregular periods because all their endocrine organs might not be fully functional. “This is nothing to be worried about, but the girl and the mother should monitor the cycle. One should know what the pattern is like for the girl. So, they should maintain a diary where they can note down the period dates, so we know how often the period comes,” Dr Radha explains.

Bleeding can also be excessive in the first few years. If there are abnormalities, like they are bleeding for 15 days or longer, then they must consult a doctor. A usual cycle can last between 21 to 30 days, but it may vary for each child. “We have to teach them what is normal, and if the body deviates from it, then they should communicate this and seek help.”

The pain tolerance can be really low for kids, and they need all the support they can get from parents. “There are tablets to ameliorate the pain, but they should be active. They should avoid physical exertion, like sports, but they should not be in bed all day. For some children the pain may be more than others, and we can deal with it accordingly,” Dr Radha says.  

There are a lot more options available now for parents to help their child deal with periods and pain. Medicines can be prescribed for pain, if required. To deal with the bleeding, parents should teach girls about the different products available, and girls must be taught how to use pads, tampons and menstrual cups so they can use what is comfortable for them. Parents should explore all new options and enable the child to be comfortable with their body.

This article has been produced by TNM Marquee in association with Apollo Hospitals.