Understanding Periods in the Teenage Years
For the first two years after a girl's first period, cycles are often irregular, and that in itself is not a cause for concern. What does need attention is bleeding heavy enough to affect school attendance or cause anaemia, pain that does not respond to simple painkillers, cycles that remain unpredictable well beyond two years, or periods that stop altogether.
Our approach with adolescents is deliberately conservative. We investigate carefully, explain findings to both the girl and her parents, and treat only where there is a clear reason. Many girls need reassurance and simple measures rather than medication.
When to Bring Your Daughter In
A consultation is worthwhile if you notice any of the following.
- Very heavy bleeding - soaking through protection every hour or two, passing large clots, or bleeding for more than seven days.
- Severe period pain - cramps that mean missed school, vomiting, or pain not relieved by ordinary painkillers.
- No periods by age fifteen - or by age thirteen if there are no other signs of puberty.
- Periods that stop - three or more missed cycles after they had become regular.
- Cycles shorter than 21 days or longer than 45 - once two years have passed since the first period.
- Bleeding between periods - or bleeding that follows no recognisable pattern at all.
- Tiredness and pallor - which often point to iron deficiency from heavy loss.
Heavy periods from the very first cycle can occasionally signal an underlying bleeding disorder. This is easy to test for and important not to overlook, so mention it if it applies.
