Your menstrual questions answered

Your first period is an important part of growing up. It is a normal, healthy action of your body, but doesn't mean you shouldn't have questions about what is happening. Educating yourself about the facts of puberty is the best way for you to become comfortable with the many changes that will come with it.

The medical term for it is menstruation, and it is the end of a month-long cycle of hormonal changes in your body. At the beginning of the cycle, the hormone levels in your body are increasing, as an egg is being prepared to be released for possible fertilization. At the same time, a build-up of blood and cells occurs in the lining of the uterus, the organ where a fertilized egg grows into a fetus. If, at the end of this cycle, the egg is not fertilized and you do not become pregnant, the hormone levels drop and the lining of your uterus is shed through the vagina. This shedding of the lining is called the menstrual flow, and it can take as long as two to six days.

Most women lose roughly 4 tablespoons of blood during menstruation. The flow can sometimes appear dark and lumpy, but this is perfectly normal. It is important to realize that what you are discharging is blood and tissue, and that you are not actually bleeding from an internal cut.

Most cycles take around 28 days to complete, but a normal cycle can be anywhere from 21 days to as long as 35 days. Irregular menstrual cycles are not uncommon in teenage girls, particularly in the two years following your first period. Stress and sudden changes in diet or environment can also affect your cycle.

There is no one 'right' time or age to get your first period. Most girls begin menstruating between their 10th and 16th birthdays, and even this wide range won't be true for everyone. There are signs that your period is approaching—such as developing breasts and hair growing around your genitals and in your armpits. You should talk to your mom, as many girls get their periods around the same time as their mothers did.

Your doctor or school nurse can help answer some of your questions. You can also read many books on puberty and menstruation at your public library or local bookstore. You can get ready by learning how to use tampons and sanitary napkins, the things that absorb the menstrual flow. But most of all, talk to your parents—they can help you understand menstruation, and make you feel comfortable about it.

Yes, many women experience some physical or emotional changes just before or during each menstrual period. Some of the physical effects are: temporary weight gain from retaining water, swollen legs and breasts, pelvic ache, and headache. The emotional changes can include: depression, irritability and loss of concentration, as well as cravings for specific foods. When these symptoms occur before menstruation they are termed 'premenstrual syndrome' or PMS, and are probably the result of the high levels of hormones present at that time.

About 60% of American teenage girls do report some pain with their periods, usually just before and during the first few days of the period. The pain is usually the result of substances in the body called prostaglandins, which cause contractions of the uterus. These contractions cause an achy, crampy feeling, sometimes accompanied by nausea, vomiting, diarrhea and headache. To relieve some of this pain, try the following:

1. Exercise—the more in shape you are, the less likely you are to have painful periods.
2. Use a heating pad to assist with the blood flow.
3. Lie on your back with a pillow under your knees to keep your legs elevated while you sleep.
4. Take a non-prescription pain reliever such as Advil®, which contains ibuprofen. Ibuprofen is especially helpful in relieving cramps, because it reduces the level of prostaglandins in the body.

No. You should, however, consult with a doctor if you have:

• Irregular bleeding between periods
• Menstrual flow for more than seven days
• Abdominal pain and cramps when you do not have your period
• Severe cramps during your period