CONTRIBUTORS
Caroline Kabiru
Head of Sexual, Reproductive, Maternal, Newborn, Child and Adolescent Health (SRMNCAH)
Caroline Wainaina
Research Officer
Michelle Mbuthia
Senior Communications Officer
Menarche—the first menstrual period— and subsequent menstruation mark a significant milestone in a girl’s life, signaling the transition into reproductive age. But what does this mean? A woman of reproductive age refers to anyone with the biological capability to conceive and bear children. Menstruation typically begins during puberty and continues until menopause.
The age at which menstruation begins varies among individuals, with most girls having their first period between the ages of 12 and 15 and for some, as early as ten years. Several factors influence the timing of menarche, including:
- Genetics –if one’s female relatives start their periods early or late, a girl may follow a similar pattern.
- Nutrition – Well-nourished girls tend to start menstruating earlier than those who are undernourished or underweight.
- Physical Activity – Intense exercises can delay the onset of menstruation.
- Body Weight – Girls with higher body fat percentages will likely experience earlier menarche than those with lower body fat.
Menarche as an experience and, to a great extent, menstruation/period varies greatly among pre-teens and adolescent girls, while some navigate it with little to no discomfort, others endure excruciating pain that significantly disrupts their daily lives. Many adolescents who experience painful periods (dysmenorrhea) rely on medication to manage their symptoms. For some, this distressing situation becomes a monthly trauma, impacting their academic performance, social interactions, and overall well-being. One of the most significant educational impacts is school absenteeism, with one in ten girls missing school in sub-Saharan Africa. Girls may miss school due to severe menstrual pain or because they lack access to sanitary products. Some experience shame or embarrassment, leading to social isolation and withdrawal from activities.
Beyond the physical pain, menstrual distress can adversely affect mental health and emotional well-being. According to the World Health Organization, mental health is a state of well-being that enables individuals to cope with life’s stresses, learn effectively, and contribute to their communities. During the menstrual period, adolescents may encounter emotional challenges such as embarrassment, discomfort, and social exclusion from school and home activities, heightening the risk of poor mental health outcomes. Given these challenges, families, schools, and peers should be vigilant for signs of distress and offer emotional, social, and practical support to adolescents facing menstrual-related difficulties.
Supporting girls during early menstruation
It is essential to acknowledge what preteen girls experience during early menstruation and offer both emotional and practical support. No longer the young girl but not quite an adolescent, the preteen phase is a period of significant physical and emotional changes. For some girls, it is a period during which they start receiving their monthly period. Just like other teenagers, pre-teens experience a range of emotions and mood swings, and a supportive environment assists them in managing these changes in a healthy manner. However, there are some things families, schools, and the wider community can do to make the experience more bearable, which may include:
- Adjusting responsibilities– Flexibility in daily responsibilities can ease the transition. Parents, guardians, and educators can delegate tasks to others when needed, allow flexibility in school and home duties, and encourage self-care without guilt or pressure.
- Providing a safe, private, and comfortable environment– Girls should have comfortable environments, such as school and home, where they can manage their periods with dignity. This includes providing essential menstrual hygiene products, ensuring access to clean restrooms and private spaces, and encouraging self-care and rest when needed. A personal space where individuals can relax, reflect, and recharge is essential for mental well-being. This environment enables them to process emotions effectively, communicate openly about their experiences with a trusted person, build resilience, and cultivate healthy coping mechanisms.
- Encouraging open conversations– Breaking the stigma around menstruation helps normalize the experience. Supportive discussions, with boys and girls, can reduce misinformation, anxiety and fear associated with periods, and promote a culture of openness and acceptance. This can be in formal and informal settings, as part of regular curriculum-based learning and forums such as period Menstrual education is also essential in providing accurate, age-appropriate menstrual education is essential to prepare girls physically and emotionally for menstruation, teach proper menstrual hygiene management and available sanitary options, and, in the process, dispel myths and misconceptions about menstruation.
- Youth-friendly healthcare support– Healthcare support that is cognizant of the changes and challenges young people go through is a critical part of the support systems necessary for their transition to adulthood. This includes effective pain management and related complications such as heavy bleeding, which can lead to anaemia, loss of appetite, vomiting, and fatigue. Access to menstrual products, like sanitary pads, is essential for managing periods and allowing girls to transition with dignity.
- Policy action on menstruation– In many countries across the world, governments have acknowledged the need for support during menses by subsidizing or abolishing taxes on menstrual products and ensuring the availability of these products and sanitation facilities in schools and other learning institutions.
In conclusion, communities should foster an understanding and supportive environment to help young girls navigate menarche and subsequent menstruation with confidence and resilience, ultimately improving their overall well-being and a smoother transition to womanhood.