First Period - Menarche

The first period of a woman's life is called menarche and usually occurs between 10 and 14 years old. At age 15, over 95% of girls have already had their first menstrual period, which is why this is considered the age limit for the onset of menarche. Girls who complete 16 years without ever having menstruated should be evaluated by a (a) gynecologist, so he (a) to investigate the reasons for the delay.

The menarche is a manifestation of puberty, but is not the only nor the earliest. Several changes in the body of the girls can be noticed before the onset of menarche and serve notice to the arrival of the first period.

First period
First period

In this article we will explain what menarche, when it arises, what are the signs and symptoms and what it might mean when at 16 years of age menstruation has not yet appeared.

What is menarche?

As explained in the introduction of the text, menarche is the name we give to the first period of a woman, which is a landmark event in the child's life, both cultural and physiological point of view.

The menarche arises because women's ovaries begin to produce hormones from the onset of puberty. The first period is just one of many changes that the woman's body undergoes a hormonal influence through adolescence.

The onset of menstruation marks the beginning of fertile life of the woman, despite the first period itself not necessarily be associated with ovulation. The first period can occur exclusively by the action of the estrogen on the endometrium, which is the tissue that covers the inner wall of the uterus. After menarche, however, the trend is that the girl begin to ovulate, initially erratically, which also translates as irregular menstrual cycles, and then over the years, more regular and predictable basis.

So after menarche, any sexual activity without contraception can result in pregnancy. The emergence of the first period is a great opportunity for parents to talk about contraceptive methods and take the girl to a first assessment of gynecologist.

When comes the first period?

Interestingly, over the last 150 years, the age of menarche has been declining steadily. Reports of the nineteenth century show us that the first menstruation occurred on average between 16 and 17 years old. Around 1920, the average age of menarche had dropped to 14 to 15 years, and since the second half of the twentieth century lies around 12 and 13 years.

Several factors can explain this trend of lowering the age of menarche, including, dietary changes over the generations, percentage of fat girls, physical inactivity, exposure to smoking, alcohol consumption, socioeconomic factors, stress, etc. The single largest factor, however, is still the family history. Girls whose mothers had a late menarche tend to menstruate later also.

Currently, menarche usually occurs between 10 and 14 years, and the average between 12 and 13.

What are the signs that suggest that menarche is next?

As mentioned above, the menarche is one of the milestones of puberty, but it is not the first one. Years before menarche, the girl's body starts to go through several transformations induced by the start of production of sex hormones by the ovaries. In general, menarche usually appear 2 to 2.5 years after the onset of puberty.

The first sign of the onset of puberty is usually the acceleration of growth, called pubertal growth spurt. However, in the early years of puberty, this acceleration is not as sharp, and, in most cases, the first noticeable sign is the appearance of the breast bud, called thelarche. 15% of girls, the appearances of the first pubic hair, event called pubarche occurs before thelarche and turns out to be the most noticeable early sign of puberty. Therefore, the first period is usually about 2 years after thelarche or pubarche.

Between 6 and 12 months before menarche, increased estrogen production by the ovaries generates changes in the mucosa of the vagina, which gives rise to a physiological vaginal discharge. This discharge that arises early in puberty is usually thin, whitish, has no odor and does not cause itching or burning. It is a benign discharge and has no clinical significance.

About 6 months before menarche, the girl goes through the final phase of the pubertal growth spurt, which is the stage of adolescence with higher growth rate. Months prior to menstruation, the child gets to have a growth rate of 8 to 10 cm per year. When menstruation comes, the girl has reached about 96% of its final height, and the growth rate falls, announcing the end of the pubertal growth spurt. So after menarche, the girl continues to grow, it just makes it less intense and more slowly. A girl who has 1.60 meters tall during menarche can still grow up to 1.66 or 1.67 meters in the next 2 or 3 years.

What if the first period did not show up until 16 years?

The absence of menstruation is called amenorrhea. The amenorrhea is divided into two forms: primary and secondary. When menstruation to descend in women who have menstruated ever in life, we called secondary amenorrhea. When a woman reaches the age of 16 * without ever having menstruated, we say it has primary amenorrhea.

* Some doctors consider 15 years instead of 16, the age limit to say that the girl has primary amenorrhea.

So if a girl has normal growth and already shows signs of puberty, but the 15-16 years not yet submitted menarche, she should make a visit to the gynecologist to investigate the cause. This visit to the gynecologist should be anticipated if the 13-year-old girl had not had their menarche and also does not show any signs of the onset of puberty. The absence of menstruation, thelarche and pubarche to 13 years is a late sign of puberty and needs to be investigated.

It is important to know the age of the mother of menarche. If the mother had her menarche only 15 or 16 years, we can be more relaxed because it is more likely that the daughter has her first period with more or less the same age. On the other hand, if the mother had her menarche at age 12 and daughter at 15 not yet menstruated, this is an indication that there may be a problem.

What are the signs and symptoms of menarche?

Days before the first period descent, the woman can start, for the first time, the symptoms of famous premenstrual syndrome (PMS). Mood swings, fluid retention, increased breast tenderness, abdominal cramps and cramps are common signs and symptoms.

When the first period down, the usual note is that girl initially a blur of blood in her underwear or toilet.

How appear first menstruation?

The appearance of the first period varies from case to case, but the most common is that the flow is weak. There are girls, however, that since the first period already have large menstrual flow.

The color of menses varies with the bleeding time and the flow. The menstrual blood is usually dark red half, almost wine. But when it gets too long in contact with air, blood oxidizes and becomes darker. So at the beginning of menstruation, the blood tends to be more alive, but with each passing day it is getting darker. If the flow is large, the blood is eliminated more rapidly and has less time to be oxidized. On the other hand, if from the start the menstrual flow is small, the blood takes longer to be eliminated and just getting dark.

The existence of "balls" in menstruation is normal and only indicates the presence of clots. Menstruation is no active bleeding, such as that which occurs when we get hurt; menstruation is the peeling of the inner wall of the uterus. So what is expelled through the vagina is a mixture of tissues, glands, mucus secretions, clotted blood, blood vessels and other structures that were part of the endometrial wall.

What happens after the first period?

The first period usually lasts between 3 to 8 days and then disappears. Do not expect any sharp change in appearance immediately after menarche. If you do not tell, no one will know you have menstruated.

The day the second period will come is anybody's guess. As the hormonal cycle of the girl is still very immature, ovulation occurs unpredictably. The next period may come in the next month or only two months later. In the first two years, the main feature of the menstrual cycle is irregular and be somewhat predictable.

It is not unusual that the girl present some vaginal bleeding in the middle of the cycle. In many cases, this bleeding is even more massive than the menses. This vaginal blood loss is called dysfunctional anovulatory bleeding. The difference this bleeding to menstruation is the fact that it occurs less than 24 or more than 38 days apart, does not cause symptoms such as cramping or fluid retention, usually have large volume and is not associated with ovulation.

Can virgin girls use tampons?

Yes, normal hymen is a membrane ring-shaped, with a hole in its center. For this hole out the blood of menstruation and it is where the tampon settles. The choice between internal or external absorber is personal and depends on factors such as comfort and volume of menstruation.
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