Why haven’t my periods started?
If you have a teenage daughter who hasn't got her periods yet, this could very well be a question that she is frequently thinking about. Indeed it is common for teenage girls to worry about this, and think they are somehow abnormal if they are one of the last in their peer group to start their periods.
There are many possible explanations for why a girl's period might not have started, and this article will explore each one so that you can have a reassuring (biologically correct!) conversation with her, answer any questions and know where to turn if you still have concerns.
Starting with the basics
Most girls start their periods (menarche) when they're about 12, but they can start as early as 8, so it's important to talk to girls from an early age to make sure they're prepared. Periods usually come around 2 years after the first signs of puberty ( breasts starting to grow ) and around 1 year after you start to get white or clear vaginal discharge. If you are growing underarm and pubic hair this is often a sign you will get your period soon. It is important to understand that periods will start when the body is ready which is different from person to person, however if your child is 16 and has not yet got her period or 14 and showing no signs of puberty then please don't hesitate to book an appointment with us where we can see if there are any underlying causes.
Pregnancy
Often the first situation minds can jump to when periods haven't started is pregnancy. Whilst it is very uncommon, it is technically possible to get pregnant before you have had your first period if you have sex in the (approximately) 28 days before your period starts. It is important to be aware of this if your child is sexually active, in which case it could be helpful to weave a chat about contraception and safe sex into this conversation about periods. If any person under 16 years is sexually active, it is also vitally important to consider issues around the age of consent and we recommend you start with this link.
Body weight and exercise
Another possible reason that your child might not have her period yet is if she is very active or underweight. Sports such as gymnastics, dance and athletics which are very physically demanding can cause a delay in periods starting due to rising the metabolism. Being underweight can affect hormone production which also delays periods. N.B. If you suspect that your daughter has eating or body image issues of any kind, it is important to approach these sensitively and with expert support. Try here as a start point.
Stress
When you are stressed, the body produces cortisol which can cause the starting of periods to be delayed. If you suspect this could be a reason for your child not having her period then definitely talk to her about the reasons she's feeling stressed and ways to cope with this.
How to start the conversation
A good way to open up the conversation about periods with your child could be putting together a small kit with the essentials eg. pads, tampons, spare pair of underwear. This could be kept in her school bag to avoid any DIY-pad-made-of-toilet-paper situations! Whilst making this kit with her you could also briefly explain how to use each product and the do's and don'ts (flushing down the toilet etc.) It could also be worth making her aware of the symptoms that come with a period such as abdominal cramps, mood swings and bloating. Reassure her that these are normal and nothing to be afraid of, and can be relieved by using painkillers, exercising and managing stress.
Irregular periods
When periods first start, it is completely normal for them to be irregular to begin with, before settling in to a more predictable pattern. For some people, their second period can take a year to come whereas for others it comes around a month after the first- again showing how everyone's experience is different. Irregular periods aren't something to worry about, but they can also be caused by the same things that delay the first period which are listed above.
To summarise, in the vast majority of cases, a girl's period will come without any medical intervention when her body is ready. You can reassure your child to remind your child that there's no reason to be embarrassed if theirs takes longer to come than some of their friends- and that you are there to listen and help if she is ever concerned. Once periods have started, there will almost definitely be times when they miss not having one!
One final thought- don't forget the boys!
Whilst the conversation will obviously be pitched quite differently, it's important to make sure that any teenage boys you care for have a good knowledge of the menstrual cycle also. This isn't just so that they can understand fertility and contraception. We think it will stand them in good stead for healthy and empathetic relationships with the women in their life.