Women's Health: Menstruation (periods, menses, 'the curse')

Starting to have periods is probably the most important event of puberty for girls. It is certainly the most identifiable landmark of puberty and periods usually start anywhere between the ages of ten and 16. The average age these days is 13. The age of starting periods (menarche) depends to a small extent on race and genetics and to a much larger extent on body fat and nutrition. The 'Menarche' (the first menstrual period, or first menstrual bleeding in the females of human beings.) usually occurs about two and a half years after the appearance of breast buds and pubic hair and as the growth spurt is slowing. The menarche tends to occur when the body weight is between 42 and 52 kg and when roughly 17 % of this weight is fat. Therefore, very thin girls such as athletes, ballet dancers and malnourished girls tend to have a much later menarche.

At period time, the lining of the womb, along with some blood, is shed through the vagina. This loss usually appears like red or brown blood at the vulva. Fortunately, periods are usually either entirely pain-free or cause a mild, low, crampy discomfort. They usually last from between two and seven days and come on average every 28 days, although a range of 20 to 35 days is perfectly normal.

Periods occur in response to the hormones coming from the ovary. As the ovary starts to become active and produce eggs (ovulation), the main female hormone (oestrogen) increases in the bloodstream and stimulates the growth of the lining of the womb. After the period, the levels of oestrogen in the blood increase up to the time of ovulation and fall off after ovulation. As they decrease, the lining of the womb responds by being shed. If the egg is fertilised, then the oestrogen level does not fall and the period does not start. The first few periods may be irregular and heavy as ovulation is a bit haphazard to start with. Periods usually become regular within two years of the menarche as ovulation becomes properly established. Ovulation tends to occur two weeks before the period starts (i.e. midway between periods if these occur monthly). Many girls notice a watery vaginal discharge at the time of ovulation. This is entirely normal.

Menstrual blood, although clean, may develop an unpleasant smell. It can be absorbed completely by either sanitary towels or tampons. Towels usually have a sticky back to hold them firmly in place, lining the pants. Towels soak up the blood as it leaves the body. Tampons are inserted into the vagina and cannot be felt once correctly positioned. They have the advantage of allowing girls to go swimming and bathing during periods. Towels and tampons should be changed at least every six hours. Do not forget to remove the tampon when the period has finished.