New parents are sometimes shocked to find blood coming from the vagina of their week-old infant. This bleeding is caused by hormonal stimulation of the baby’s uterus by the mother’s hormones after pregnancy. When a baby is born, she is no longer exposed to these hormones and a small menstrual flow occurs. This is the same situation that will occur in adolescence when she enters her puberty. Do not be concerned if you see a small amount of vaginal bleeding in the first two weeks of life.
The normal time for your daughter’s first menstrual period is quite variable. Nine to 16 years of age is the range I consider the normal. I encourage you to contact our office if a period begins earlier. After periods begin, cycles are seldom regular for the first two years. The amount of flow may vary widely. These variations usually last for several years after menarche or the beginning of menstruation. Medical help may be needed if the periods are very heavy, painful, prolonged, frequent or have stopped for more than 4 months.
Young women who have had regular periods for several years may have occasional missed periods. An emotionally upsetting experience, severe exercise or pregnancy are frequently the cause. Severe dieting may also affect the regularity of menstrual periods.
Approximately 15% of all women experience some premenstrual symptoms. These symptoms can include headache, irritability, abdominal bloating, breast tenderness, and thirst. Five percent of women can have severe pain during menstruation. Crampy, lower abdominal or back pains begin shortly before the cycle and last about 24 hours. Over-the-counter medications including Tylenol™ or Advil™ work well in most cases.
Sexually active adolescents should have yearly physical exams which include a vaginal and Pap exam. Because I do these infrequently I would advise a visit with a gynecologist.