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Most girls get their first period between the ages of 10 and 15.

A girl’s monthly cycle, in terms of duration, is the number of days from the start of one period to the start of the next. You often hear that this is a 28-day cycle. But 28 is just an average number used by doctors. The range of monthly cycles is between 24 and 34 days. These cycles are considered normal. The amount of blood and pain experienced by each girl can also vary.

The onset of puberty is a process of maturation of the adolescent’s body. It takes time for hormonal fluctuations to stabilize each month, and it is expected that the first two years of the period will be unstable in the days it comes, but also in the amount of blood, bleeding or just a drop (very frequent or very infrequent intervals).

So when should I worry?

Painful period

Pain during periods is a common symptom. It is attributed to uterine contractions. However, any pain that is not relieved by simple analgesia (ibuprofen) and causes the adolescent to change her daily routine because of this, should be checked. An ultrasound of the lower abdomen in order to visualize the uterus, ovaries and to rule out any anatomical abnormality that may be causing the pain. If the examination is normal, then the reason may be hormonal and among those suggested are: Exercise, taking analgesic painkillers, hormonal contraception (such as the contraceptive pill)

“Heavy” period 

The word “menorrhagia” means excessive blood during a period. A period is considered “heavy” if it causes one or more of the following:

• Frequent pad changes (every 2 hours or more often)
• The teen soiles her clothes or sheets
• Needs “double” protection, i.e. pad and tampon
• Sees pieces of blood clots on the pad

When daily activities e.g. school, sports, etc. are affected by the period

What causes “heavy” periods?
The cause is not known in most cases
It is most commonly observed when menstruation has recently started for the first time. Rarer causes are: clotting disorders and/or infections (in the case of sexually active teens).

“Heavy” bleeding does not cause any medical problems other than lifestyle disorders and anemia, iron deficiency with the corresponding supplements, dizziness, shortness of breath and fatigue, inability to concentrate, etc.

It is important to monitor the rhythm of menstruation. Keep a diary of your periods for a few months and show it to your doctor. He will direct you if you need treatment. Note the amount of bleeding and the number of pads you need.

Do I need to do any tests?

Your doctor may ask you to do a complete blood count to see if you are anemic or have low iron stores. You do not need other blood tests regularly. Rarely, the bleeding may not be of a gynecological nature.

This requires specialized testing and will be checked by your doctor if you have any unusual symptoms such as:

• Easy bruising
• Frequent nosebleeds
• History of significant bleeding during minor surgery
• Family history of bleeding disorders

Is there a cure?

Of course there are solutions.

Options for managing heavy periods are:

1. Non-hormonal pills (Mefenamic acid with or without Tranexamic acid)
2. Combined contraceptives

Interrupted or missed periods

There are many reasons why a teenager may miss her period.

Some common reasons are:

• Expected cycle instability in the first two years after the start of menstruation
• Pregnancy (if the teenager is sexually active)
• Stress
• Sudden weight loss or, conversely, morbid obesity