With sharp decline in the menarche age, it’s become critically important for parents to mentally prepare girl children for the onset of menstruation and its associated physical changes, writes Ramiya Saktivel

Menarche or the onset of menstruation is a time of anxiety and apprehension for girl children. More so, since the age of menarche has been steadily declining over the past decades for several reasons including global warming, rising incidence of obesity, and lifestyle changes. It’s not uncommon for girl children today to attain puberty between nine-11 years of age.

According to a 2014 research study published in the National Library of Medicine online journal, the mean age of menarche of Indian women was 13.76 years in 2005. A more recent study (2020) published in the Journal of Preventive Medicine and Holistic Health estimates the average age of menarche to have declined to 12.77 years.

Against this backdrop of sharp decline in the menarche age, it’s become critically important for parents to mentally prepare girl children for the onset of menstruation and its associated physical changes.

Menarche signs
Dr. Anu Sridhar, senior consultant, obstetrics and gynaecology, Fortis Hospital, Bengaluru, advises parents to look out for bodily changes/signs indicating onset of the first menstrual period. “A girl’s menstrual cycle usually begins around two years after she grows breasts. Another sign is vaginal discharge fluid, which can be noticed on the underwear. This discharge typically begins six months to a year before menarche,” says Dr. Sridhar.

Preparing the child
These signs are indicators that it’s time to start conversations about puberty. If she is nine years old and/or mentions a friend experiencing menarche, explain that menstruation is a normal physical process experienced by all girl children worldwide. In particular, prepare her for the physical changes she will experience. Answer all questions honestly including queries about child birth.

Discussion guidelines

• Stress that menstruation is normal and experienced by every woman
• Use age-appropriate language to explain the ovulation process which will make childbirth possible in later years.
• Reassure her that blood discharge is heavier for some girls and lighter for others.
• Teach her to use sanitary pads the right way, to maintain vaginal hygiene.
• Emphasise that normal activities including sports can be continued during menstrual periods.

Menstrual products
Sanitary pads are available in a variety of shapes and sizes, and should be chosen according to the severity of the blood discharge. Although synthetic material pads are readily available, the trend is towards using natural pads made with plant fibres and reusable cloth. Tampons are another option but since they need to be inserted internally, all girl children are not comfortable using them. Usually tampons and menstrual cups are used by girls who participate in sports such as swimming.

“Whatever sanitary product you use, it’s most important to maintain proper hygiene. Parents must teach girl children how to use pads, change them frequently, and wash hands before and after adding or changing them. This is necessary to prevent vaginal infections. Moreover, some girls may experience menstrual cramps in the lower abdomen just before or during their periods. Usually, it is light and subsides on its own. If not, consult your gynaecologist,” advises Dr. Sridhar.