Between the ages of 11 (9) and 14 (15), girls show the first signs of puberty, which serve as signals that menarche is coming soon. These features include:
- a sharp rise in growth, and in some also in weight,
- breast development
- hair growth of armpits and pubis,
- possible deterioration of the skin, acne and acne.
The culmination of all these changes is menarche - the first periods. Menarche is the line between childhood and youth, it began a new stage in the girl's life. She becomes a girlfriend.
Menarche - the first menstruation
In different cultures, this event is treated differently. For example, in Muslim countries, menarche is celebrated with the whole family. Little girls from a very early age know what menarche is, that this is a very important day in their lives, and they are waiting for this momentous day. In Eastern culture, for any girl since childhood, priority is given to happy marriage, the birth of children, and service to her husband. In Western civilization, it is not customary to advertise this. However, the other extreme is undesirable, when the girl does not know anything about menarche at all - that this is absolutely normal and happens to all women. Sometimes the lack of information about such an important aspect can lead to undesirable consequences: the girl, having found blood on her underwear, is horrified, thinks that something is wrong with her, and shyness does not allow her to share with adults. Therefore, doctors and psychologists advise mothers to tell their daughter about the physiological features of the female body, about what should happen to her in the near future, about menarche, about the beginning of a new stage in her life, about treat this and prepare. It is also important because for several months before the first menstruation periodical abdominal pains, more abundant leucorrhoea (discharge from the genitals), and the appearance of acne can be observed in girls. Nevertheless, with the beginning of the first menstrual period, the girl’s sexual development does not end there: it takes years for her to become a full-fledged woman and to have children without problems.
Initially, for many girls, the duration of the menstrual cycle ranges from 28-30 days, and the regulations (menstruation days) generally last from 3 to 5 days. However, only 50% of girls immediately established a normal cycle, the rest of it normalizes within a few months, even a year after menarche. What is it? Pathology? Most likely - no, although there may be exceptions. Of course, if it continues like this after a year, then this should be a cause for concern, and parents should consult a doctor. Scanty or, on the contrary, too abundant menstruation is also a reason for a medical examination. As already noted above, the period of menarche is a segment from 9 to 15 years, therefore, an earlier or, on the contrary, late first menstruation is an alarm signal. Do not be afraid of trips to the gynecologist. Perhaps the girl has no problems, but for her own good, you need to establish the true cause of premature or late menstruation.
Stages of puberty
In girls already at the age of 8, the first changes in physiological development occur, indicating the beginning of puberty or the so-called puberty period. This process ends by an average of 16 years. Throughout this time, the reproductive system of the future woman is being formed. The girl is rapidly growing in height, while there is a closure of growth zones in the tubular bones, the female type of the figure is formed, due to the specific location of the muscles and body fat.
Changes in the structure and function of the ovaries and the pituitary-hypothalamus system, which is responsible for the release of female sex hormones, occur in 3 stages:
- Preparatory or prepubertal. It starts at 8-9 years. In the body without a system, and from time to time sex hormones are synthesized, but their level is rather low. There may be a sharp increase in growth, rounding of the hips and the formation of a "female" pelvis. At this time, the epithelium in the vagina is modified, there is a greater number of layers due to the appearance of intermediate cells. In the future, a new epithelial structure will be formed from these cells.
- Puberty or puberty. Phase 1 of the pubertal phase accounts for 10-13 years. At this time, daily cyclic fluctuations in the level of hormones occur, the pituitary gland produces more follicle-stimulating and luteinizing hormones, which stimulates the work of the appendages that synthesize at this time intensively sex hormones. The breast begins to grow and pubic hair grows, the bacterial composition of the vagina changes, and lactobacilli appear in it. This stage ends with the onset of menarche.
- The final stage of puberty or 2nd phase of puberty falls on 14-16 years. The cyclical nature of hormone production by the ovaries is established, which begin to work in accordance with the phases of the menstruation cycle. The increased level of follicle-stimulating and luteinizing hormones creates prerequisites for the onset of ovulation. Growth intensity is already decreasing, and the figure finally acquires female forms. At this time, despite the inconstancy of the ovulatory cycle, the girl may well become pregnant. The period of puberty ends when not only the reproductive organs, but also all systems are prepared to perform the main function of the female body, to bear offspring. From about 16 years and up to 40, until the onset of menopause in women, there is a period of puberty.
When menarche comes
Most often, the arrival of menarche should be expected 2 years after the girl had a manifestation of the first physiological changes: the chest begins to increase, the hips get wider, the genitals increase, and body hair appears. This means that the body increases the secretion of female sex hormones, preparing the body for pregnancy.
The time of occurrence of menarche is individual for each girl and depends on many factors, including physical development, nutrition, living conditions, and illness in childhood. Normally, the appearance of the first menstrual period is 12-14 years. Since the first menstruation is stressful for a child, a girl already 10-11 years old should be mentally prepared for the arrival of critical days.
Initially, the intervals between menstruations can be one and a half to three months, but during the first year after the first menstrual periods, 80% of girls cycle back to normal. After the normalization of the condition, the girls' menstrual cycle is 29-30 days, and menstruation lasts 3-5 days, up to a week. At this time, the girl may feel weakness, pain in the lower abdomen and dizziness, these symptoms disappear 2-3 days after the start of the regula. The intensity and duration of discharge from each girl is individual, as well as the period of arrival of the first menstruation.
The first periods are a visible sign of physical maturation and the beginning of the full functioning of the genitals. The following changes also occur in the body:
- ovaries begin to produce female hormones estrogen, at first their amount is insignificant,
- grow, lengthen and take the sinuous form of the fallopian tubes,
- the volume of the uterus and the thickness of the endometrium increases,
- the vaginal microflora is formed, the amount of vaginal secretion increases,
- increases the fatty layer of the genital lips.
The appearance of vaginal discharge light color and odorless, hair growth on the external genital organs are regarded as symptoms of menarche. The forthcoming changes are evidenced by changes in the girl's psychoemotional state. Shortly before the first menstruation, many of them complain of increased fatigue, headaches, dizziness, irritability, minor pains in the lower abdomen. This period requires special attention from parents.
Age of menarche is not the only indicator of proper physical and sexual development. Should be taken into account the regularity and timeliness of the menstrual cycle.
In adult women, the irregular cycle indicates hormonal imbalance and lack of ovulation. At a young age, only every fifth girl forms a regular cycle in the first months after the menarche. Most adolescent girls throughout the year and more monthly come with interruptions. Menstruation can "disappear" for two or three months, but its absence does not mean the presence of the disease. The delay should be a concern if the monthly do not come for more than six months. Finally, the regular menstrual cycle is formed within two years.
To assess normal puberty, the abundance of secretions is taken into account, which may also be an unstable indicator.
Time of occurrence
At the time of the onset of menarche is influenced by various factors. Heredity plays a key role. If the girl's mother or grandmother had an early menarche, the repetition of the situation is not considered as pathology. At the time of occurrence of the latter also affect the living conditions, food, transferred early illness. According to statistics, the inhabitants of northern latitudes monthly occur a little later than the southerners. Later menarche is also observed in girls with a thin physique, and earlier in women in high-mountainous areas.
Premature menarche in children is the beginning of menstruation at the age of less than 10 years. It is not always possible to consider it as a pathology. In some cases, hormonal disorders that cause early development of the mammary glands and the appearance of hair on the body can occur due to malfunctions of the pituitary-hypothalamus system. Among the predisposing factors are the presence of hormone-induced tumors, birth injuries, diseases of the central nervous system (for example, epilepsy).
Often, the onset of menstruation (up to 10 years) may cause an unprepared child to anxiety about his health and even psychological shock. Of great importance are informing and preparing the girl for a future event, which parents (often mother) should hold in advance and with the maximum amount of tact.
In adulthood, these women have a slightly higher risk of developing cardiovascular diseases, diabetes, breast cancer, and osteoporosis.
Later, menarche is diagnosed significantly more often than early. The reasons may be different, but as a rule, this results in a low body weight of a teenage girl. Monthly in a woman is possible only when the body produces the hormone estrogen. With a shortage of body weight and low body fat, the amount of estrogen produced falls to a critical point or stops altogether.
According to medical data for the arrival of monthly adipose tissue should be at least 17%. Critical body weight required for the onset of menstruation is 45 kg. Low mass - the most characteristic reason for their delay.
Unfortunately, many modern girls are influenced by dubious canons of beauty from glossy magazines and see non-existent extra kilos in their bodies. Passion for exhausting diets, unhealthy diet causes the absence of menarche and the development of disease.
Predisposing factors for the delay in the appearance of the first menstruation can be:
- poor living conditions
- endocrine gland diseases,
- intense physical exertion (for example, during professional occupations in some sports),
- constant psychological stress, depression,
- underdevelopment of internal genital organs.
Girls who have reached the age of 15-16, who have not yet begun their monthly periods, should be examined by a gynecologist and an endocrinologist. Although in many cases delayed menarche does not indicate a disease, ignoring the problem can lead to the development of genital infantilism. Its signs in adult women are an underdeveloped vagina, an irregularly shaped uterus with an underdeveloped neck, and small ovaries. Often, physical infantilism is accompanied by a delay in mental development, when a girl looks much younger than her age and performs actions adequate to a younger age.
In adulthood, these women are often diagnosed with miscarriages, infertility, childbirth, complicated by bleeding and weakness of labor.
The first task of the doctor is to establish the cause of the violations. In the absence of evidence that indicates the presence of pathologies, the girl is recommended to regularly monitor the pediatric gynecologist and observe the rules of hygiene. In other cases, prescribe treatment. In early menarche, medication is shown to suppress the production of hormones by the pituitary gland. If early menstruation is caused by tumors, they are treated promptly.
For the treatment of genital infantilism prescribed hormone therapy and drugs that normalize metabolic processes in the body. Useful sessions of psychotherapy and physiotherapy. Of great importance is the correction of nutrition and the normalization of weight with excessive thinness.
How to accelerate the arrival of menarche?
In most cases, it is enough to revise the regime of the day and the nature of food of the girl or, improve living conditions and the level of psychological comfort in the family. If there are serious pathologies, it is necessary to convince the girl that the prescribed treatment will help her to be healthy in the future and have children. However, it is not recommended to excessively focus on the absence of menstruation and even more so to intimidate possible diseases.
Features of the course of the first menstruation
Usually with menarche, there are moderate or scanty discharge. Often they are brown. Normally, the volume of blood lost should not exceed 150 ml.
How long do menarche?
Duration ranges from 3 to 5-6 days. The most abundant discharge during the first two days, then their intensity gradually declines. Sometimes menarche are scarce and last no more than two days, this also refers to the norm.
The ability to conceive is formed only six to eight months after menarche, when the formation of hormonal levels is completed. The first periods are usually painless, but, like in adult women, the girl may experience nagging abdominal pain, nausea, indigestion, engorgement of the mammary glands, and general weakness. Some girls become emotionally impressionable, irritable, or whiny. As a rule, these symptoms disappear without treatment on the first day.
It is very important to form a positive attitude of the girl to her critical days. A prerequisite for the mother will be to teach her daughter to calculate her menstruation time and keep a special calendar. During menstruation, the girl can not disturb the usual way of life, paying increased attention to the hygiene of the genitals and avoiding increased physical exertion and hypothermia. Prior to sexual activity, the use of sanitary napkins instead of tampons is recommended. During menstruation, a shower is required at least twice a day. Visiting a bath or sauna, swimming in the river or the sea is prohibited.
Menarche is a natural physiological process that does not require a visit to the doctor. However, some factors may be grounds for visiting a pediatric gynecologist:
- duration less than 3 days or more than a week
- discharges are very abundant, have a bright scarlet color and an unpleasant smell, come with large clots,
- after the establishment of a regular cycle, there are delays of more than 36 days,
- the interval between the monthly exceeds half a year,
- menstruation is accompanied by severe pain, vomiting, fever.
Even in the absence of complaints, the first visit to the gynecologist is recommended at the end of puberty, aged no later than 16 years.
Abundant menarche - exceeding the normal blood flow (150 ml). In this case, the monthly last more than a week, the blood comes out with clots. A large loss of blood (menorrhagia) is quite common in adolescents and amounts to 37% of the total number of pathological bleeding.
The main causes of pathology:
- previously suffered acute infectious diseases
- intense physical exertion or psychological stress
- insufficient production of progesterone by the body,
- underdevelopment of the uterus and other internal genital organs.
A large amount of blood lost leads to a sharp development of anemia, which in turn causes increased fatigue, dizziness, and a decrease in the level of platelets. In order to normalize the cycle and stop excessive bleeding, prescribing drugs that reduce the uterus (Oxytocin), hemostatic drugs (Vikasol, Ditsinon, extract of water pepper, calcium gluconate).
Поскольку сильное кровотечение неизбежно ведет к анемии, в обязательном порядке девочка должна принимать препараты железа (Мальтофер, Феррокаль, Ферроплекс). Также показаны общеукрепляющая терапия, витамины, физиотерапия, иглорефлексотерапия.
Для профилактик кровотечений рекомендованы следующие меры:
- соблюдать режим дня и правила питания,
- своевременно лечить хронические и инфекционные заболевания,
- normalize body weight
- regularly visit the gynecologist and endocrinologist,
- take folic acid prophylactically, vitamins E and C,
- avoid during the month of intense physical exertion and hypothermia.
Symptoms of menarche
In order for the onset of menstruation to not become an unpleasant shock for the girl, you need to prepare her for this, tell you exactly what signs mean the onset of a new period in her life. It should be understood that the average age at the onset of menstruation is average and that deviations from it are possible and normal. Therefore, it is better to begin familiarization conversations as early as 9–10 years old.
The fact that the onset of menarche soon, indicates an increased amount of vaginal discharge. Their color, transparency and density vary depending on the phase of the cycle, so the very fact of the appearance of such secretions suggests that the organs of the reproductive system begin to work. The first spotting will not necessarily be scarlet and abundant, rather, on the contrary, at the beginning of menstruation they are weak, smearing, brown in color.
The onset of menstruation may be accompanied by a slight increase in temperature, back pain, weakness. These are all variants of the norm, as well as abundant discharge for 7–10 days. However, it is necessary to control both the duration and the volume of discharge, since this is a very important indicator of women's health.
Period of menarche
According to statistics, on average, the onset of menarche is noted at the age of 12.5 years. However, this indicator is influenced by so many factors that you should not rely on this figure. A small and thin girl is likely to notice the first signs of maturation later, while she is tall and developed earlier. Orientation is better not on age, and not on external changes that are hard to miss. However, if within 2-3 years after the telarche or at the onset of 15 years of age, the periods have not begun, it is better to be examined by specialists. And do not try to figure out how to speed up or provoke the appearance of menstruation. Looking for reasons for the delay is the task of the doctor.
Many parents are trying for some reasons to understand: when will the first periods begin? To answer this question, you need to understand what changes occur in different phases of the cycle. Menstruation is the detachment and rejection of the endometrial layer lining the walls of the uterus. In order for this to happen, the quantitative and qualitative indicators of the hormonal background must change, that is, some hormones become less, others, on the contrary, more. Such changes can not affect the mental and physical well-being, therefore, 7-10 days before the first discharge are noted:
- hypersensitivity of the mammary glands,
- mood swings
- lethargy, drowsiness,
- pulling pains in lower abdomen.
All these signs precede the onset of menarche, but this is unlikely to help with the maximum probability to predict the event. The fact is that the hormonal background of a teenager is already unstable, and the jumps of progesterone and estrogen do not particularly affect the overall picture. In addition, an adult woman who is familiar with PMS can unmistakably guess when her tearfulness is related to the phase of the cycle, and when the reason is different. The girl is still not able to analyze her condition in such a way, therefore she is unlikely to have any suspicions.
Features of the course of the first monthly
The main thing you need to know about menarche is that it is completely different and should not be like the menstruation of an adult woman. This is only the beginning, the “launching” of the normal functioning of the reproductive system and the stabilization of all processes will take years. The first periods can be:
- Short. Even 2 days is a variant of the norm, therefore, if the monthly began and immediately ended, do not panic.
- Long The opposite situation, the allocation lasts 7-10 days, and maybe two weeks, which frightens both the girl and her parents. However, this is also a variant of the norm, although on the 15th day of bleeding it is worthwhile to consult with a doctor.
- Scanty. Throughout the menstruation, discharge may be smearing, it is also not scary.
- Abundant. Normally, a woman loses up to 80 ml of menstrual blood, but to an adolescent girl this amount may seem excessive. It is important to explain that discharge is considered abnormally abundant when it is necessary to change the largest sanitary napkin more than 4 times a day. Everything else is normal.
- Painful. Most (about 90%) of girls complain of abdominal pain, weakness and poor health. The best option would be to rest a day or two at home, avoiding physical exertion, calm down and do your favorite thing. In many ways, pain is associated with stress, so the right attitude is better than any painkillers.
Menarche as part of sexual development Edit
Menarche is the culmination of a number of physiological and anatomical processes in the female body.
- The ovaries produce hormone estrogen under the influence of pituitary hormones.
- During the interval of 2-3 years, estrogen stimulates the growth of the uterus (in addition, the mammary glands increase, the pelvis expands, the subcutaneous fatty tissue increases in the pubic region and the labia majora).
- Estrogen stimulates the growth and improvement of blood supply to the mucous membrane of the uterus lining its cavity (lat. Endometrium).
- Endometrium is a target organ for sex hormones due to the presence of specific receptors in it. A balanced hormonal effect through cytoplasmic and nuclear receptors provides physiological cyclic transformations of the uterine mucosa.
- Due to changes in the level of hormones, the functional layer of the uterine mucous membrane is rejected, which peels off and goes through the vagina with blood.
The specific hormonal signal for menarche is unknown.
Signs of the first menstruation
Menarche in girls is different, but the symptoms of its approximation are about the same for everyone. The girl may feel the approach of the first regul a couple of months before their arrival, with the following signs:
- bad or, conversely, excessive desire to eat,
- deterioration of the skin.
Pain before menstruation
In the lower abdomen, pulling pains may occur in the lumbar region. Headache and dizziness may also occur. The girl feels general fatigue and weakness. Parents can be struck by the often unreasonable change in the mood of their daughter, as well as increased emotional excitability. The behavior and well-being of the child is similar to the female ICP.
At the first monthly discharge, they are quite scarce, and ovulation does not occur in every cycle. At this time, the probability of becoming pregnant is very small, although it is. The intensity of the excretions will fluctuate until the work of the reproductive system is improved.
The first menstruation should not last less than three days, normally it lasts 4 days and has an average intensity of discharge. During the first two days, the girl may feel nagging pain in the lower abdomen, this is normal, but if they continue for the entire period of menstruation, you should consult a doctor. Perhaps a child has dysmenorrhea, requiring mandatory treatment.
This disease is diagnosed with an increased amount of prostaglandins in the blood, substances under the influence of which the uterus is strongly reduced, thereby causing spasmodic pain in the lower abdomen. Dysmenorrhea may indicate the presence of pathological changes in the reproductive organs or the wrong location of the uterus. To treat this disease is necessary to prevent the development of more serious health problems, including infertility.
Causes of menarche disorders
Each girl puberty occurs at different times. In many ways, the period of menarche depends on heredity, and if the grandmother's first menstruation came very early, then her early appearance in her granddaughter should not be considered pathology. The timing is also influenced by living conditions, diet and diseases carried at an early age.
Statistics show that for women living in the northern regions, the first periods come later compared to Southerners. Menarche delay is also observed in thin, thin girls, and early puberty occurs in girls from the highland regions.
Early is considered menarche, when the first menstrual flow appears in a girl under 10 years old. But far from always critical days at such a young age are considered pathology. There are cases when hormonal disorders, leading to the earlier development of secondary sexual characteristics, occur due to a malfunction of the pituitary-hypothalamus system. Predisposing factors are hormonal tumors, injuries sustained at birth, CNS disease (epilepsy).
If puberty begins before the age of ten, very often the child may not be psychologically prepared for this, which may cause not only severe anxiety, but also a state of shock. It is very important that the mother prepares her daughter in advance for the possible arrival of menstruation, especially if there were cases of premature menarche in other generations in the family.
In adulthood, women who mature earlier than their peers have an increased chance of developing heart disease, osteoporosis, diabetes, and breast cancer.
The delay of the first critical days is much more often than their premature offensive. This is due to too low body mass of modern teenage girls, because critical days are possible only with the normal production of the female sex hormone estrogen. If there is a lack of body weight and too thin fat layer, then the production of estrogen can not only decrease, but also stop altogether.
Medical reference books claim that for the onset of critical days it is necessary that adipose tissue should be at least 17% of body weight, and the girl's weight should reach 45 kg. The most common cause of the late onset of menarche is just low body weight, and because of the modern questionable canons of beauty, the number of girls exhausting themselves with diets is constantly growing. The pursuit of "glossy" beauty can not only delay the onset of menstruation, but also contribute to the development of various diseases.
In addition to excessive thinness, there are other reasons for the delay of menstruation:
- poor living conditions
- endocrine system diseases
- excessive exercise
- constant stress and depression,
- insufficient development of reproductive organs.
If at the age of 15-16 the girl did not have her period, this is a reason to visit the gynecologist and endocrinologist. Diseases during menarche delay are extremely rare, but ignoring the problem, you can wait for the development of genital infantilism. Its main features in adult women are:
- underdevelopment of the vagina,
- irregular uterus and underdeveloped cervix,
- changes in the ovaries, they may be too small
- a delay in physical development can be accompanied by a delay in mental development, while the girl not only looks younger, but does things that are appropriate for external age, and not actual.
In adult women who have late first menstruation, spontaneous abortions, childbirths complicated by hemorrhage, and later labor and even infertility occur more often.
After the onset of menarche, the girl should take the issue of personal hygiene very seriously, because the critical days from now on will disturb her throughout the reproductive age. First, personal hygiene will prevent the spread of an unpleasant smell from the girl, which can repel others and cause dislike to the child. Secondly, poor hygiene can cause the development of serious diseases, because leaving the genital tract, menstrual blood combines with oxygen and becomes an excellent breeding ground for bacteria and infections.
To prevent all negative consequences from critical days, you should wash at least 2 times a day with warm water and soap. It is better for the child to take the usual baby soap, although a huge amount of intimate hygiene products is now being produced, which gently clean the intimate area, moisturize the skin, eliminate odor and prevent bacteria from reproducing.
As for sanitary pads or tampons, today there are many brands offering similar products for critical days with varying intensity of discharge. A girl can choose the right tool for her at her discretion. Before the start of sexual activity, the use of tampons is not recommended, since the virgin membrane can be an obstacle to the insertion or removal of the tampon, and if misused, it can be damaged.
To choose a suitable sanitary pad, you should look at the label on the package, which indicates the number of "drops". This method is determined by the intensity of discharge, which is able to absorb the gasket. At night, underwear is better to attach pads with an elongated and extended back, which will not allow the flow of menstrual blood to the panties and bed.
At this time, girls are not recommended to take a bath, go to the swimming pool or sauna, excessive physical exertion should also be avoided. It is better to wash during menstruation just under the shower.
Since menarche is a new stage in the life of every girl, parents should be very sensitive and prepare their child in advance for entry into reproductive age. If the girl does not have complete information about the changes in her body, then with the arrival of the first menstruation she can get a lot of stress, which can later turn into serious complexes. It is better that such information reach the child in a family atmosphere, and not from friends in possibly distorted form. All parents are advised to talk in advance with their daughters about puberty and the characteristics of the female body.
Stages of growth of the female body
The laying of the female genital organs begins in the sixth or seventh week of fetal development. Gradually, the girl's ovaries form, in which by the 40th week several million eggs are formed. They did not go through all stages of division. And after the birth of the baby, some of them die, and by the time of puberty they remain 250-300 thousand. These eggs will form the ovarian reserve of the female body and will come out during each ovulation.
Normally, sexual development starts at the age of nine. By this time, mechanisms are launched that lead to changes in the genitals and mammary glands. There is an order of growing up.
- Pubarche. Beginning pubic hair growth. In more than 50% of girls, this symptom appears first.
- Thelarch It usually appears after pubarche, but sometimes it can be the other way around. On average, between the beginning of the growth of pubic hair and the mammary gland are one to two years.
- Menarche. This is the time when the first periods come. Most often they begin two years after the start of breast growth.
Effect of hormones
In childhood, the concentration of sex hormones is minimal. But by the time of puberty, the first changes appear at the hormonal level. Two years before the increase in the secretion of female hormones in the blood gradually increases the level of androgens. They provide a sharp jump in the growth of the girl. Only after this increase in the concentration of luteinizing (LH) and follicle-stimulating (FSH) hormones, which lead to the activation of the synthesis of estrogen. Further changes, step by step, begin to correspond to the adult female body, occur in a strict order.
- The maturation of the follicle. The pituitary gland increases the secretion of FSH and some LH. Under the influence of FSH, several follicles are distinguished in the ovaries, among which only one will pass to the stage of final maturation. The cells in the follicle enhance the synthesis of estrogen, which leads to an increase in the thickness of the endometrium. On the 12th day, the amount of estrogen reaches its maximum, this stimulates a peak release of LH from the pituitary.
- Ovulation. 12-24 hours after the estrogen peak, ovulation occurs. The follicle bursts, and the egg leaves the abdominal cavity.
- Education yellow body. Under the influence of LH, the formation of the yellow body occurs at the place of follicle residues. His cells begin to synthesize progesterone. It leads to an increase in the number of vessels and glands in the endometrium. The ovum descends through the fallopian tube into the uterine cavity, but does not attach there.
- Regression of the corpus luteum. No organs are created that are capable of supporting the work of the corpus luteum. It gradually regresses.
- Menstruation. The endometrium does not receive the necessary hormonal replenishment, it also atrophies. Flaking of uterine mucosa with blood leads to menstrual bleeding.
Then everything repeats again. But in the first year, some cycles can take place without ovulation, and the rhythm of hormone secretion will be irregular.
Norms of menarche
Накануне появляются выделения, которые обычно усиливаются у взрослой женщины в дни овуляции (примерно за 10-14 дней до менструации). Могут появиться симптомы, напоминающие предменструальный синдром (ПМС):
Затем на белье появятся первые кровянистые выделения. Это может быть мазня или всего несколько капель крови. The intensity of bleeding is individual. Sometimes they are immediately abundant. Color is variable:
This is not pure blood, but endometrial remnants mixed with blood and vaginal secretions. The duration of such bleeding can be different, but most often the period is not more than three to five days, sometimes a week.
The normal sign of menstruation is pain in the lower abdomen, which appears in the first days and gradually decreases. Some girls feel weak and dizzy. Signs of irritability, tearfulness with the appearance of bleeding should pass.
After the first bleeding, the cycle may be irregular. Sometimes for its formation it takes about a year.
Sometimes girls 15-16 years old appear harbingers of early menstruation. The stomach hurts, the mood changes, but bleeding does not occur. If this is repeated for several months, then you need to contact a pediatric gynecologist. There are cases of abnormal development of the genital organs:
- full fusion of the hymen,
- vaginal atresia,
- fusion of the cervix.
In such cases, with a normally formed uterus and ovaries, cyclic changes occur in them, but the blood has no way out. It is collected first in the uterine cavity, and then, with a large volume, it can enter the abdominal cavity and mimic the symptoms of acute surgical pathology. This condition requires surgical treatment.
You should also look for the causes of deviations in the following situations.
- Volume Abundant first discharge when you need to change the gasket every two hours. This is usually a sign of bleeding. Scanty menstruation, which recurs monthly in the form of daub, should also alert.
- Duration If the bleeding continues for more than a week, then an urgent need to consult a doctor. This may be due to both the pathology of the reproductive organs and the blood coagulation system.
- Sensations . Menstruation should not be accompanied by acute abdominal pain, marked fever. Fever - a sign of an infectious process.
- Periodicity. If during the year menstruation is constantly changing the duration, between them are not set equal periods of time, then you need to consult a doctor. It is considered invalid if the cycle lasts less than 21 days or more than 35 days.
- PMS. This is a consequence of the effect of progesterone. The syndrome should not be pronounced and disrupt the rhythm of the girl's life. But sometimes it is able to take critical forms, accompanied by pressure surges, autonomic symptoms, and depression. In such cases, the need correction hormonal drugs.
In some, the first menstruation is associated with the disease. But it is not. Monthly should not affect the rhythm of life. It is only necessary to adhere to certain recommendations.
- Hygiene Lingerie must be breathable, made of cotton. It must be selected in size. Menstrual blood is an excellent nutrient for microorganisms. If you neglect the shower, then there will be not only an unpleasant smell - products of the metabolism of bacteria are toxic to the human body.
- Gaskets. Need to use those that correspond to the amount of bleeding. They change as they are filled, but at least once every four hours.
- Tampons Developed special tampons for teens. They are not capable of damaging the hymen. In the days of menstruation under the action of estrogen, it becomes elastic and folded, therefore it is not an obstacle. It is impossible to use tampons only with the anatomical features of the development of the genital organs. Swab replacement in the first days of bleeding should be done every four hours. In the following days - less often, up to eight to ten hours. If you change very often, the vaginal mucosa will be overdried, will not allow you to enter a new or irritation.
- Physical Education . Sports and attending physical education classes are not prohibited. Only with pronounced poor health in the first days can you refuse to exercise. In other cases, exercise will benefit. They help reduce unpleasant symptoms, abdominal pain, and keep the body in good shape. But you should refuse to lift weights, work on the press, so as not to increase the bleeding.
- Sex After the appearance of menstruation, some girls begin sexual intercourse. If you follow the rules of contraception and hygiene, they will not bring harm. But do not use the days of menstruation for unprotected intercourse to avoid pregnancy. At this time, the risk of contracting a genital infection increases, because the cervix opens slightly and there is no acidic environment in the vagina to protect against bacteria.
Sometimes during menstruation, the girl experiences severe pain in the lower abdomen. In this case, you can use painkillers from the group of nonsteroidal anti-inflammatory drugs. For example, "Ibuprofen", "Paracetamol". They will help not only get rid of the pain, but also reduce the intensity of bleeding.
My older one started at 14, she was crying hard, although most of the girls in her class already had them. I explained to my children that nothing changes from menstruation, except that they can become mothers. But still there were difficulties, Elinka did not want to grow up. For the first six months they did not go all the time, for 7 days The discharge was strong. With clots. I was scared, led to the doctor. It turned out the reproductive organs are underdeveloped. Now she is 17, the cycle returned to normal about a year after it arrived.
I also have a younger daughter. Which is now-14. But she has no signs of puberty. Probably because she is premature.
My friend's daughter, her period began at 9 years old. Now she is 17 and she is 34 weeks pregnant. And do not say that she is already adult.
Olga Gladkikh, https://www.baby.ru/community/view/126569/forum/post/85347609/
My doctors all doctors promised monthly almost in 9-10 years. Southern origin, the smell of sweat appeared in incomplete 9. As a result, she is already almost 12, so far nothing. Weight 39, height 147. Recently I was with her at the gynecologist, so she says that no earlier than six months or a year, because weight is too small. I don’t know how true this is) My daughter in the class has only one girl started her period.
Signs of menarche
It should be noted that the age of the onset of menarche is not considered to be a unique criterion of sexual development. It is important that menstruations not only come on time, but also comply with accepted physiological norms. The menstrual function after menarche at first has its own characteristics, therefore, some deviations from the norm are permissible.
Only in 20% of girls, periods immediately after menrache become regular. As a rule, in the first 1-1.5 years they come with delays and have a different duration. Also, menstruation may be unevenly abundant. If the girl is healthy, and the process of the formation of hormonal function proceeds normally, the periods are settled independently after the period of adaptation.
In order to navigate the changes that are taking place, with the appearance of menarche, the girl must learn to keep an individual menstrual calendar and mark the first day of the next menstruation in it, as well as all the accompanying unusual symptoms. Thus, she recognizes her menstrual cycle (it is equal to the number of days from one to another marked date) and its important characteristics: duration, volume of blood loss.
Most women have monthly periods every 28 days. The intermenstrual period of 25-35 days is not considered pathology. The number of "abundant" days does not exceed three days, and the menstruation itself should not last less than three and longer than seven days. A daily change of four or less pads indicates normal blood loss.
If after menarche menstruation has not been established within one and a half years, the hormonal function of the ovaries should be investigated.
Normal age to start menstruation
The process of puberty depends on many factors. Most girls have menarche at 11-13 years. But it is generally considered normal when the first bleeding from the genital tract occurred in the period from 10 to 15 years. It signals that the ovaries begin to perform new functions, namely, to synthesize sex hormones.
The puberty period in girls begins at 8 years old and, with the correct course, from a physiological point of view, it should be completed by the age of 16 years. For 8 years, the reproductive system is formed, and the children's organism is transformed. The girl is actively growing, her body is overgrown with muscle and fatty tissue and a certain type of figure is formed.
During the process of puberty are the ovaries, pituitary and hypothalamus. Thanks to their well-coordinated work, maturation occurs gradually, in three stages:
- Prepuberty (preparatory) period. In the body of an 8–9-year-old girl, sex hormones with a low level of estrogen begin to be produced unsystematically. Externally, the changes are manifested by the body growth rate in length and rounding of the body in the thigh area. The vagina also undergoes changes. It becomes multi-layered due to the formation of intermediate cells. Subsequently, new structures will be formed from them.
- Puberty (the beginning of puberty). The period takes several years and passes through two phases. The first is inherent in the age of 10 - 13 years, when daily cyclic hormonal fluctuations begin in the body. At the same time, the work of the pituitary gland, which actively produces FSH and LH and affects the appendages, is increasing. Hair growth is observed in the pubic and axillary areas. The mammary glands are gradually increasing. Lactobacilli appear in the vaginal microflora. The second phase of puberty accounts for 14 - 16 years. The ovaries function in phases of the standard menstrual cycle, hormones provide ovulation. The formation of the pelvis and mammary glands is completed.
- The first full ovulation. It should not be identified with puberty, because the girl's body should not only change outwardly and declare growing up to menstruation, but also be prepared for the continuation of the race. Real puberty comes only after 16 years.
For puberty the inconstancy of ovulatory cycles is characteristic. If the girl begins to have sex, irregular periods will not save her from pregnancy. During this crucial period, it is important to build a relationship of trust with the child and explain what kind of trouble can bring intimate relationships at a young age. Despite the presence of menstruation, the body until the age of 16 is not ready for bearing a normal pregnancy and childbirth.
Feelings girls under menarche
Menstruation in girls is different. The symptoms of their approximation are about the same and expressed during the first two months before the menarche:
- Deterioration or increased appetite.
- Blanching of the skin.
Painful sensations occur in the lower abdomen and in the lumbar region. It may hurt or dizzy, there is a general weakness. The girl may feel tired, overwhelmed. Parents notice an irrational change of mood and emotional excitability of the child. Health and behavior is reminiscent of PMS in women.
Discharge from the genital tract
With the onset of the menstrual cycle, discharge may be minor. Ovulation does not always occur, and the risks of pregnancy are small, although they exist. The intensity of discharge varies to complete adjustment of the reproductive system.
The first menstruation in girls lasts an average of 4 days, and the discharge has an average intensity. At first, the child will experience pain in the lower abdomen, but for 2 - 3 days they will disappear. If painful sensations persist on all menstrual days, the daughter must be shown to a doctor and examined for dysmenorrhea.
The appearance of abdominal pain is due to contractions of the uterus, which is affected by prostaglandin substances. With a significant concentration in the blood, prostaglandins increase the contractile function of the uterus and cause spasms in the vessels. Dysmenorrhea signals the wrong location of the uterus or pathological changes in its structure.
Do not treat dysmenorrhea can not. Launched disease provokes the development of serious pathologies of the sexual sphere and infertility.
In some cases, girls first sexual signs appear up to eight years. This is considered an early menarche. It is very important to immediately visit with the child a specialist who will determine why the first menstrual cycle began so early.
As a rule, early menarche occurs due to malfunctioning of the ovaries, adrenal glands or pituitary gland. In this case, too much testosterone and estrogen are secreted in the child’s body. In some cases, the causes may be:
- Features of ecology.
- Stressful situations in the life of a teenager.
If we talk about more serious causes of early menarche, then here are some serious illnesses:
- Tumors in the spinal cord or brain, or their severe injuries.
- The transfer of meningitis or encephalitis.
- Abnormal activity of the adrenal glands.
- Genetic diseases (including McCune – Albright Syndrome).
- Incorrect operation of the thyroid gland.
It is possible to talk about late menarche if the first menstruation does not begin in a teenager after 16 years. But do not immediately worry if menarche is delayed. This may be due to an inadequate diet, individual characteristics of the body, stressful situations, dieting, unfavorable ecology, exhausting physical exertion or nervous irritations.
The most common cause of late menarche is considered an excessively low body weight of a girl. If the body does not have enough fatty tissues, this may cause an insufficient amount of estrogen. Remember that 17% of adipose tissue is considered normal.
Late onset of menarche can also talk about serious diseases:
- Pathology in the functional and anatomical development of the uterus.
- Malfunction of the ovaries.
- Disorder of the endocrine glands.
- Violation of the pituitary gland.
That is why it is necessary to visit a pediatric gynecologist, who will determine what could be the problem.
The first menarche is a stressful situation for a girl, if you do not prepare her for it in advance. The menstrual cycle is always formed gradually, so parents usually have time to talk with their daughter about menarche. Do not expect that immediately after the first menstruation, the girl’s cycle will always be even and equal. The body is still developing, so a delay of several days should not cause concern.
An isolated delay of the first menstrual cycle is a disease in which the girl has all the signs of puberty, but her monthly periods do not come about four to five years.
There are many reasons for this delay:
- Hypergonadotropic hypogonadism: a pathology that means that the sex glands do not function correctly.
- Deficiency of certain hormones in the body (including gonadotropic ones).
- The outflow of blood from the vagina is impossible due to too dense hymen.
- Malformations of the internal genital organs (agenesis of the uterus or vagina).
Remember that only a professional can make an accurate diagnosis, so with a strong delay in the first menstrual period in a teenager, be sure to visit the pediatric gynecologist.
Menarche delay can cause infertility.
Monthly after menarche
After the onset of menarche, menstruation occurs again in 25-28 days. This is the standard interval, but in some cases it may be larger or smaller. It happens that the cyclicity after menarche is not set immediately, so the start of a new menstruation can be expected even two or three months. This is normal and not worth worrying about.
The first year after menarche is considered special in the life of a girl. It is not recommended to perform any surgical operations during this period. Also try to protect your child from stress, as they may then cause serious female problems in the future.
In many girls, premenstrual syndrome begins before menstruation (change of mood, abdominal pain, breast swelling).
Delay after menarche
After the first menstruation, cycle oscillations are the norm and should not frighten either the child or his parents. Some factors are very important here, namely the physical health of the adolescent, his diet, sports, stress. For those who eat right and have no bad habits, the cycle almost immediately becomes the same.
In adolescents with delayed physical development, a weak immune system, and chronic diseases, the stability of the menstrual cycle after menarche may fluctuate. At the same time, menstruation itself can bring a lot of unpleasant sensations: fever, headaches, shortness of breath, sweating, pain in the chest and lower abdomen.
The main reasons for the delay after menarche are:
- Improper nutrition - try to ensure that the child does not sit on exhausting diets, and also does not overeat.
- Excessive physical exertion - if a child exercises too much in sports, this can lead to monthly delays.
- Acclimatization - sometimes a cold snap or warming can cause delays.
- Стрессы – нервные напряжения нередко негативно сказываются на женском здоровье, особенно после первого менархе.
Как вызвать менархе?
Если нет причин для задержки менархе, необходимо сразу же обратиться к специалисту. Дело в том, что первые месячные могут не приходить из-за гормонального сбоя, который необходимо правильно лечить. Remember that only a professional gynecologist can give advice on how to cause menarche without harming the adolescent's health.
But there are general guidelines that can be used without a doctor:
- Eat regularly and properly.
- Stabilize the emotional background of the child.
- Adhere to a healthy lifestyle.
Very often, if the delay in menarche is not a consequence of serious diseases, doctors prescribe "Duphaston." This drug helps cause the first menstruation. The drug contains the active ingredient didrogesterone. Dosage prescribed by a doctor.