Why Am I Bleeding? Understanding Periods
Puberty can be an overwhelming milestone in an adolescents life. It is a time where hair grows everywhere, voices change and sometimes, one starts to bleed.
For an uninformed child, the first period can be particularly dis-tressing. In our society, we often pass over topics relating to sexual and reproductive health (SRH). There is an assumption that children will magically accumulate this information when they’ve reached an ‘appropriate’ adult age and act accordingly.
However, this unwillingness to tackle such discussions, can lead to unfortunate situations that could have otherwise been avoided through proper SRH education. Therefore, it is up to parents and trusted guardians to take the initiative of educat-ing their children, and empowering them to make informed de-cisions.
Before taking on the task of discussing SRH, it is just as im-portant for the adult in charge to brush up on their own SRH knowledge.
Therefore, today’s article is a quick brush-up on periods. Though this article is intended as a basic revision for those who are wanting to educate a child on SRH education, it can be used as a resource for all ages.
Right, so what is a period?
Above is an image of the internal reproductive organ in which the menstrual cycle takes place. It shows the vagina, uterus, fallopian tubes and ovaries. The menstrual cycle is the process by which the uterus prepares for a potential pregnancy. Different phases of the menstrual cycle are controlled by hormones released by the pituitary (a gland in the brain) and within the reproductive organ itself. Two vital components of this system which are involved in the menstrual cycle, are:
- The Ovaries: the word ‘ovary’ is derived from a latin word that essentially means ‘egg nut’. This summarizes the role of the ovary in the menstrual cycle quite well – the organ where ‘eggs’ develop. The events that take place in the ovaries are called the ovarian cycle. The ovaries consist of fluid-filled sacs, called follicles. One of these follicles matures into an egg, which is then released into the fallopian tubes during a phase called ovulation. The egg then travels to the uterus, where it is either fertilized (leading to pregnancy) or breaks apart (leading to a period).
- The Endometrium: this is the lining of the uterus. The endometrium is involved in the uterine cycle which describes the events that take place in the uterus, during the menstrual cycle. This lining thickens to create an ideal environment for a fertilized egg to ‘implant’ on, therefore resulting in pregnancy. However, when an egg is not fertilized, this lining breaks and sheds through the vagina, resulting in a period and bleeding. After the period, this lining begins to build up again, in preparation for the next ovulation. sheds through the vagina, resulting in a period and bleeding. After the period, this lining begins to build up again, in preparation for the next ovulation.
How long does a period last?
On average, the menstrual cycle lasts about 28-days. However, it can range from 21-45 days, especially to begin with in young teens. This is why periods are usually described as a monthly occurrence. The start of the period is considered as the 1st day of the menstrual cycle. Bleeding typically lasts for up to 5 days, but may range from 2-7 days.
Ovulation usually occurs around day 14 of the cycle.
The length of the menstrual cycle varies between individuals and also month to month for the same individual. ‘Regular’ cycles can vary up to 9 days for a given individual.
Periods usually stop around the ages of 45-50. This is called menopause.
When does a child get their first period?
Menarche is the word used to describe the first period. This process usually occurs between ages 9-16. Menstruation is usually accompanied by other signs of puberty, such as development of hair and breast buds. A child may also complain of cramps leading up to their period.
Periods initially may not occur regularly every month. It is normal for cycles to fluctuate for the first 2-3 years, before settling down into a pattern.
What are cramps?
Periods are often accompanied with pain in the lower back or abdomen – these are known as cramps. Other symptoms may be: tender breasts, headache and nausea. These symptoms usually only last a few days.
Light exercise, hot water bottles and over the counter pain medications can help relieve discomfort.
What is PMS?
Premenstrual Syndrome. Apart from the physical changes that occur around the time of a period, there are certain emotional changes as well. Mood swings and irritability are commonly felt before the start of a period. In such cases, resting and eating well can help. It is important to listen to one’s body and it’s needs.
What about pregnancy?
Once an individual begins menstruation, they can become pregnant. In some cases, reproductive hormones may be active before the first period, meaning, some individuals can get pregnant in the days leading up to their first period as well. This is partly why menstruation needs to be included in SRH education – so that children are aware of the pubertal changes happening and their significance.
What are the ‘red flags’ to look out for?
In the following situations, a doctor’s appointment may be necessary:
- A child is beyond 16 or developed breasts 3 years ago, and has still not had their period
- 3 years after menarche, if periods still do not come regularly and cycles are missed
- Severe cramps and heavy bleeding
- PMS that affects daily life