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Ask Dr Marla: What to expect with the first period

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Doc marla - ask dr marla: what to expect with the first periodQuestion

My 10-year-old is starting to get moody and sometimes complains of
abdominal cramps. Is she too young to be getting her first period? What
should I expect?


While you might think 10 is young, in fact research shows us that puberty is happening earlier than in previous years. We do know that the timing of puberty can vary but the so-called normal range of puberty, which includes both breast and pubic hair development, as well as the onset of the menstrual cycle, can range from as young as eight to about 13.

In the last century, the age of menstrual cycles was closer to age 17. That no longer is the case. There is also a difference in the age of onset by ethnic background. For example, African American girls may menstruate at a younger age than Caucasian girls.

While we are not completely sure why the age has drifted downwards, there are a number of factors that have encouraged younger age of onset. As our rates of disease have decreased and nutrition has gotten better, our bodies have adapted and matured earlier.

There are physical changes that mark the onset of puberty. These changes as mentioned include changes in breasts and their development, called thelarche, as well as growing pubic hair that is called pubarche. Breast development starts with a breast bud that is the elevation of the nipple area. There is hair growth in the pubic area. Many parents will notice a growth spurt and often this is the case. Hair development under the armpit or axillae is next. Somewhere along this continuum of these changes, the menstrual cycle will start.

You note that your area of concern about early periods stems from mood changes. Mood may change with hormonal variation and the onset of menstruation is a vulnerable emotional period. Typically these body changes as outlined are the clues that puberty has started.

It is important to understand if there are any underlying changes in your daughter’s mood. Relationships at school and peers may be a source of emotional strain leading to changes. Have an open conversation with your daughter discussing what you are noting in language that is clear, easy to understand and age appropriate.

In addition, you have noted complaints of cramping. There are many possible reasons for cramping, ranging from primary bowel issues as well as gynecological issues. Note if there are changes in appetite, weight or bowel habits to help gain a more complete picture of these cramps. As always, your primary care giver is a good place to seek help in answering your concerns.

Originally published in ParentsCanada magazine, June 2015.

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