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When (and how) to talk to your daughter about periods

Posted by Dr. Claire McCarthy  March 1, 2013 09:16 AM

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talking w tash.jpgIn that list of awkward-parenting-moments-we-wish-we-could-avoid-but-can't, talking to daughters about periods is way up there. It's just hard to talk about. It's hard to know what to say, and it's tough because it has to do with sex--my experience is that most parents get a bit squirmy talking to their kids about anything related to sex.  

So when a reader asked if I would write about this, I thought: what a great idea.
Here's some advice from both my experience as a pediatrician and as a mom who has talked about periods with three daughters...
When to Talk
When you start talking is going to depend a lot on your child and the culture of your family. But at some point you really have to--and in figuring that out, there are three things to consider:
1. When she is going to get her period. There's really no way to know exactly, but when your daughter has both breasts and pubic hair (not just a couple of wisps of hair, but a reasonable amount), you need to get talking if you haven't already.
2. When someone else is going to tell her about it. My opinion is that she should hear it first from you, not the health teacher or her best friend. Most schools do have some education about puberty; find out when (in our district, it's the end of fifth grade), so you can plan (and have some time to get up your nerve).
3. When she starts asking questions. That's what happened with my eldest: when she was 10 she noticed the tampon dispenser in a public bathroom and would not give up until I explained what they were for.
What to Say
Give the actual facts. I remember that all my mother said was something along the lines of "You're a woman now." Which was remarkably unhelpful. And really made being a woman seem uncomfortable and unfair. 
You should explain why girls have periods and what is going on. You can figure out what explanation works best for you. In case it's useful, here's what I do in the office when I'm explaining it to girls (when their parents want me to):
I draw a picture of two ovaries connected to the uterus, with a vagina below (very abstractly, no artistic ability required). I explain that the ovaries have eggs, and that in women who have their periods, once a month one of the ovaries sends an egg down toward the uterus. I say that it to make a baby, the egg has to meet up with a sperm. How you want to handle the issue of how the sperm gets there is up to you--I talk with parents ahead of time about what they want me to say (I recommend giving the facts there too, but it's important to imbue those facts with values, advice, and an open door for further communication). When I'm giving this talk, I always say that for a while, the egg isn't going to be meeting any sperm. 
I explain that babies need a sort of nest in the uterus to grow (the top layer of the endometrium). I scribble some lines on the inside of the uterus to look like a nest. I say that every month the uterus makes a nest just in case. But when the egg doesn't find a sperm and make a baby, the nest comes out because it isn't needed--and that nest coming out is the period. That's why, I explain, women who are pregnant don't get their period: the nest is being used.
How to say it
Refrain from using words like "curse." Please don't be negative about something your daughter is likely already a bit nervous about--and that is inevitable. Actually, for the first couple of years she's unlikely to have any cramping, so it shouldn't hurt. Be positive. It's part of womanhood and motherhood, and these are both good things.
Allay any fears you can. I reassure girls that it isn't likely to come gushing out the first time, that some toilet paper in the underwear can temporize until they can get a pad. Talk together about packing some pads for her school backpack. Have her practice putting one in her underwear.
A note about tampons: I have found this to be a very sensitive topic in some families. It doesn't take a girl's virginity away to use one, and if your daughter swims regularly or needs to wear a tight leotard for dance or sports, tampons can be helpful. There are some very slender ones with applicators that are easy to use--talk to your doctor if you have any questions.
Sometimes we all need help with figuring out what to say. The Center for Young Women's Health has good information about menstruation. There are lots of great books out there, too. The Care and Keeping of You series by the American Girl company is very nice, and now has books for both younger and older girls. I also like Growing Up--It's a Girl Thing by Mavis Jukes. But there truly are so many. I recommend going to a bookstore without your daughter and looking at the various choices--and choosing one (or more than one--I bought three!) that fits with your daughter, your family and your values. 
Because talking about periods isn't just making sure your daughter has the facts she needs; it's also about encouraging and empowering her to make the best choices for her health and her life.  
That's our job as parents, after all. 

Is there something you'd like me to write about? Leave me a message on my Facebook page.

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About MD Mama

Claire McCarthy, M.D., is a pediatrician and Medical Communications Editor at Boston Children's Hospital . An assistant professor of pediatrics at Harvard Medical School and a senior editor for Harvard More »

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