How doctors want you to change the “period talk”

How doctors want you to change the “period talk”


I don’t know about you, but the period talk I got from my mother in the early ’80s was as bare bones as it gets. I’m pretty sure a TV commercial lasted longer than her talk with me. And it didn’t get any easier once I got my period. My mother was so uncomfortable discussing anything menstruation-related that when I needed a refill on pads, I had to use code, asking her to “Pick up more cereal” from the store. And hope she didn’t actually bring back more cereal.

My health teacher didn’t do much to fill me in on the details either. If I remember correctly, there was one 40-minute lecture that encompassed the birds, the bees and periods–with not much time to dwell on any of it for too long. Which was probably exactly what a room full of embarrassed seventh graders were hoping for.

I like to think that nowadays, many mothers, fathers and other caretakers are comfortable going into more detail about periods with adolescent girls–and using the actual names of body parts and menstrual products, not code words. And I’m hoping that health class teachers spend a bit more time on the particulars regardless of how squirmy their tween charges get.

Here’s the thing though: Whether you’ve ever given the period talk as a parent, caretaker or teacher or one day will, it’s possible that you’re missing key details that could turn out to be critical for a girl with a new menstrual cycle.

That’s the word from doctors with the American College of Obstetricians and Gynecologists (ACOG) who recently wrote about their concerns that many young girls aren’t being taught about what to expect from a normal period, for example, the amount of blood that’s shed, how many days you bleed and how long is typical between periods.

Without this kind of information, girls who are new to menstrual cycles won’t be able to detect when periods are abnormal, which can be an indicator of a serious condition, such as a bleeding disorder, thyroid disease, polycystic ovarian syndrome or tumor. And, they won’t know to alert their parent, guardian or doctor, which can have devastating consequences if the condition is left untreated.

Alternatively, girls who are experiencing a normal period, but are unaware of just what constitutes “normal”, might get unnecessarily worried because they didn’t expect to bleed as much as they do or for as many days.

So, today I’d like to ask you do something: Make a plan to talk with a girl who’s about to get her period or has recently started to menstruate–for instance, your daughter or, with her parent’s or guardian’s permission, your niece, little cousin or student–and let them know what a normal period is like. The doctors from ACOG have included details about normal periods in their report here. I’ve summarized them below:

Normal menstrual cycles in adolescent girls:

  • Typically start between the ages of 12 and 13
  • May be irregular at first, averaging about 32 days (from the first period day to the day before the next period) for the initial cycle year
  • Range from 21 to 45 days (from the first period day to the day before the next period)
  • Have a menstrual flow that lasts 7 days or less (bleeding may be as short as two days for the first period)
  • Require 3 to 6 pads or tampons per day

Menstrual abnormalities that should be discussed with a doctor:

  • A girl has not had her first period within three years of breast growth
  • A girl has not started a period by 14 years of age with signs of hirsutism (abnormal hair growth), excessive exercise or an eating disorder
  • A girl has not had her first period by 15 years of age under any condition
  • Menstruation occurs more frequently than every 21 days or less frequently than every 45 days
  • A menstrual cycle (from the first period day to the day before the next period) stretches to 90 days at any time
  • Bleeding lasts longer than 7 days
  • Bleeding is so heavy, it requires frequent pad or tampon changes (soaking every one to two hours)
  • Periods are heavy and associated with excessive bruising or bleeding or has a family history of a bleeding disorder

The doctors in this report also recommend that parents and guardians chart a girl’s first cycles so you’ll be able to spot abnormalities and have this information in case you need it for your next doctor’s visit. You can use a journal or menstrual cycle tracking app.

This report didn’t go into menstrual cramp pain, but personally I recommend also including information in your period talk about what kind of cramp pain is normal and abnormal, since severe pain can be a symptom of certain conditions, such as endometriosis and cysts. Normal cramp pain typically starts after menstruation begins and is worse at the beginning, then tapers off. It can usually be managed with pain relievers, such as an adhesive heat patch or over-the-counter pain medication. Abnormal menstrual cramp pain can begin before menstruation begins and last after it ends. It may also be so severe that it doesn’t lessen with pain relievers and interferes with everyday tasks.

I hope this helps you fill in the details of your next period talk–and that the girl you share it with passes on the knowledge when it’s her turn to give it.


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