How to Help Her Get Ready

If your child is biologically female, she’s almost sure to eventually menstruate as she grows up. And the sooner you start talking about it, the better, says OB/GYN Melisa Holmes, MD, co-founder of Girlology, an on-demand wellness program that supports girls and their caregivers through puberty and adolescence.

“It’s never too young to start these conversations,” she says. Early on, you can keep it general. For instance, you might mention that she’ll have a period when she gets older. As your child gets older or asks more questions, you can add more details, perhaps explaining that the blood doesn’t mean anything bad and that periods happen roughly once a month, give or take, if a woman isn’t pregnant or in menopause.

The overall goal, Holmes says, is to stick to the facts and make it clear that periods are absolutely normal and a sign of good health. “We’ve been passed down the embarrassment and stigma, but our young children know none of that,” she says.

Be Clear and Straightforward

Girls typically start puberty between ages 8 and 13, though it can happen earlier or later. While there’s no way to pinpoint exactly when it’ll happen, this milestone usually happens 6 months after a girl’s fastest growth spurt.

A good way to bring up the topic is to simply to ask your child if they’ve noticed any changes with their body that they’d like to discuss, says Melissa Dundas, MD, an adolescent medicine doctor at Hassenfeld Children’s Hospital at NYU Langone. “This allows the child to invite parents into that safe space to facilitate a conversation.”

Whether your child asks questions or not, you should consider that they might be stressed, scared, or confused about what’s going to happen – and that good information can help a lot.

Start with the basics. You should explain that some bloody fluid will trickle out of the vagina slowly over the course of 3 to 7 days, and that she’ll use pads or tampons to collect it so it doesn’t get on her clothes.

You should also explain that some women get premenstrual symptoms like bloating, cramping, headaches, and breast tenderness. These aren’t very common when a girl gets her first few periods, but they are possible, so she shouldn’t be totally caught off-guard.

Equip Her With Must-Have Supplies and Good Instructions

Your daughter might not be at home when she gets her first period. So it’s wise to set her up with a period kit that she can keep in her backpack or purse. Fill a bag or cosmetics case with:

• A few pads and/or tampons
• A clean pair of underwear
• A zip-close bag for dirty underwear
• Some hypoallergenic wipes

Next, you’ll need to make sure that your daughter knows how to use her product(s) of choice.

Many girls prefer to start with pads, because they’re easy to use, but they still require some basic know-how.

“Some girls put the pad on with the adhesive side to their skin, like a Band-Aid,” which is not correct, Holmes says. You should show your daughter how to stick the pad to her underwear and where to position it to best avoid leaks. You should also explain that a pad needs to be changed every 4-6 hours, or whenever it feels damp.

If your daughter is interested in using tampons, you should be sure she knows how to use them. Unwrap one and show her how to properly hold it and release it from the applicator, and review the package insert instructions or show her some YouTube videos aimed at teens that go over the process. Explain that she can sit or stand, use a hand-held mirror if she’d like to, and that the wrapper and applicator go in the trash, not the toilet.

She should also know that a tampon isn’t supposed to hurt; if it does, she should take it out and try again. It’s also important that your daughter knows to change a tampon at least every 6-8 hours; she might have to change it more often depending on her flow.

If she does decide to use tampons, make sure she knows the signs of toxic shock syndrome, which include a rash and flu-like symptoms. This problem is very rare and it’s easy to treat, but it’s important to catch and treat it right away.

This might also be a good time to discuss other period products, such as period underwear and menstrual cups, though neither is ideal for a very first period, Holmes says. “The challenge of period underwear is that if it gets full, you have to change your entire underwear,” she points out. So it’s best to hold off until your daughter understands her flow a little, though there’s nothing wrong with trying it out if she’s interested.

Menstrual cups are getting popular with older teens, especially those who are concerned about the environment. But your daughter should be comfortable using tampons before trying a menstrual cup, Holmes says.

Ultimately, though, the choice is hers: “Youth who have started menstruating can benefit from any period product on the market,” Dundas says. “It comes down to them knowing what their options are and what they feel most comfortable with.”

Teach Her What’s Normal – and What’s Not

Your daughter might have heard in health class that a typical cycle is 28 days. But she should expect her first three periods to be pretty irregular before falling into a vague pattern.

“She might have one and then not have another for 2-3 months,” Holmes says. “By the time she has had three periods, they should start happening within 21-45 days of each other.”

When she does have her period, she shouldn’t need more than six to eight pads per day. If she’s filling up more than that, she should see her pediatrician or a gynecologist. And while she might get some cramping, severe pain – the kind that keeps her home from school and other activities – isn’t normal, either, so it’s also worth a checkup.

What if My Child Is Nonbinary or Transgender?

If your child is going through puberty and is biologically female, then they’re on track to start menstruating. Although some nonbinary and transgender kids might take it in stride, many find the disconnect between their identity and what’s happening to their body to be distressing.

Your best move is to ask your child how they feel about the fact that periods are on the horizon, Dundas says. “Once that has been established, the goal should be to support them however they would like to manage their periods.”

Some might prefer pads because they don’t need to touch their genitals. Others might opt for tampons because they aren’t as visible. Or they might like menstrual cups, because they don’t have to be changed as frequently.

If your child is having gender dysphoria, meaning they are severely distressed by the conflict between their gender and the sex they were assigned at birth, be sure to discuss that with their doctor and a mental health care provider. On the physical side, pubertal blockers (hormones that suppress puberty) might be worth exploring. There are pros and cons to this treatment, so discuss it thoroughly with your child’s doctor and mental health provider.