First menstrual periods in adolescent girls.

The appearance of the first menstrual period means that you are healthy and have started the next stage of puberty -  becoming a woman. At this important moment of your life you are certainly looking for answers to many questions troubling you.

In the second part of the article the following issues will be discussed in details:

  •  The first menstrual period (menarche) in a young girl’s life is preceded by the appearance of whitish mucus in the vestibule area. This is not a symptom of a disease but the evidence of the ovaries starting their function.
  • Often, before the menstruation you can observed a collection of physical and psychological symptoms, known as PMS (premenstrual syndrome). The awareness of the cyclical changes will help you to understand better and deal more effectively with these problems.
  • Menstruation which marks the beginning of each cycle is a natural symptom of the cyclical shedding of the uterus lining. It prepares the lining of the uterus for re-rising and transformation in order to create a favorable environment for the possible implantation of a fertilized egg.
  • Menstrual cycle is a series of repetitive cyclical changes, individual for each woman, initiated by the relevant areas of the brain (the hypothalamus - pituitary). These include: menstruation, the gradual lining recovery, growth and maturation of ovarian follicles, the release of a mature egg from the Graafian follicle (ovulation), secretory transformation of the endometrium and corpus luteum activity resulting from a burst Graafian follicle, and eventually death of the corpus luteum causing mucosal ischemia and another menstruation.
  • The first menstrual cycles are usually irregular and they are often anovulatory, single phase ones. Gradually both phases of the cycle appear, the preovulatory and postovulatory, and their length becomes more regular. Note, however, that the individual course of the menstrual cycle forms up to the age of 25.
  • Conducting self-observations, and saving them on your cycle card helps you to  understand better the functioning of your body, facilitates the acceptance of changes and allows you to identify any abnormalities or disorders of the cycle.

The first bleeding in adolescent girls is usually between 12 and 13 years of age. Before the onset you can often see the appearance of whitish mucus, which is not a symptom of disease, and you should not worry. It shows the correct functioning of the ovaries. This is a symptom of the first menstruation (menarche) in the near future. Just before the occurrence of the first and probably all the next periods you may feel a slight pain in the  abdomen or in the lower part of your back.

The first menses may have different intensity (from mild bleeding and spotting to heavy in flow) and vary in length (usually 3-5 days). In order not be surprised by menstruation, after experiencing the first symptoms, keep your pad with you.

Remember that menstruation is the culmination of the sexual maturation process, it appears only when your body has undergone the physical transformation from a young girl to a young woman.

What is menstruation?

Menstrual bleeding is caused by shedding of the uterus lining and its excretion through the vagina to the outside. Menstruation prepares the uterus for the next cycle when the lining grows again and transform to create the conditions for a possible implantation of a human embryo. During menstruation, particularly during the first two days, the strong contractions of the uterus cause detachment of the lining layer (endometrium), which can cause severe pain sensation in the lower parts of the abdomen and back. You can mitigate them by taking preparations with magnesium or diastolic medicaments. In the case of particularly intense pain you should consult your doctor to eliminate diseases such as endometriosis, uterine fibroids, abnormal genital structure or inflammation.

The common symptoms are: headaches and migraines, nausea, edema, general irritability and anxiety; and these are called PMS (Premenstrual Syndrome). Natural and effective preparations alleviating these problems are magnesium and evening primrose oil. What can also help is a light diet with restriction of sodium, salt and fat; as well as the physical activity.

Menstrual cycle

Menstrual cycle begins on the first day of menstrual bleeding and it ends the day before the next bleeding. The number of days with menstruation is not relevant.

Shortly after the end of menstruation, that is shedding of the uterus lining grown in the previous cycle due to estrogens, the process of the lining reconstruction begins in the uterus. It lasts until the moment of an ovulation.

While the endometrium is growing again one can observe the process of growth and maturation of ovarian follicles and only one of these, called the Graafian follicle, will eventually mature. The essential moment of the cycle is always the ovulation when the egg released from the mature Graafian follicle is taken up by the hyphae of the fallopian tube and directed into the internal part of the fallopian tube. The remains of the cracked Graafian follicle form the corpus luteum which produces the hormone - progesterone, responsible for the conversion of the endometrium. The uterus lining changes, the glands secrete the large amounts of mucus and glycogen, preparing it for the possible implantation of the fertilized egg.

If there is no fertilization and implantation of the egg in the uterus, the corpus luteum disappears (progesterone level decreases) causing endometrial ischemia and next menstrual bleeding. Thus another menstrual cycle begins.

It is worth noting that the whole body of a woman experiences menstrual cycle: in the first, preovulatory phase you can feel the power regeneration, health and energy improvement; and the second, postovulatory phase,  is the time of experiencing some physical weakness. The menstruation is a kind of tidying up your body, recovering and getting ready to start everything again.

Read more: What kind of physiological changes accompany the particular phases of the menstrual cycle?

Irregular cycles and the development of the menstrual cycle of young women

First menstrual cycles are usually single phase ones, i.e. there is only one phase dominated by the estrogens activity, we do not observe an increase in temperature and the ovulation does not occur, but there is some bleeding. The majority of girls at puberty experience so called  shed bleeding caused by lowering the level of estrogen only, without changing the progesterone level.

In the case of young girls the level of estrogen is usually small, so it may cause only a slight growth of the endometrium, insufficient to bleeding. As a result, it may delay the time of the next bleeding or it can cause a light shedding of the endometrium only in the form of spotting.

Later, there are already biphasic cycles, but the first postovulatory phases (higher temperatures, dominated by the activity of progesterone) are usually shortened. Bleeding preceded by at least a 3-days of  high temperatures phase is considered a proper menstruation. Gradually this phase becomes more regular being 11-16 days long.

Irregular menstrual cycles for young girls are completely natural phenomenon. The intervals between the particular bleedings during puberty may be both very short and very long (more than 3 months). Individual course of the menstrual cycle is formed up to 25 years of age and irregular menstruation are quite normal then, so one should not bother (and what is more, one should not “regulate” them with hormonal pills!).

In troublesome situations, in case of any doubt, it is helpful to conduct self-observation (mucus and temperature) and save them on your cycle card. This will help to determine whether you have single or biphasic cycles, whether you have ovulation or not, if you have mid cycle bleeding, if there are any other alarming bleedings or if you have proper  hormonal balance.

Read more: How to conduct self-observation and how to interpret the fertility changes in your menstrual cycle?


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