Talking to your daughter about periods

Why early? Many girls get their first period with no idea what it is. Some think they are hurt or ill. Some hide it for days. One calm talk before it happens can save her that fear.

The signs that her body is starting to change

• Her breasts begin to grow, often with a small, tender lump under the nipple. This usually starts between 8 and 13 years.
• Hair grows under the arms and between the legs.
• She grows taller quickly.
• She may get pimples, or sweat more.
• A white or clear discharge may show in her underwear. This is normal, and often starts a few months before the first period.

When does the first period come? For most girls, between 10 and 15 years. It usually comes about two years after her breasts start to grow. Every girl is different, and her age is not a race with her friends.

You do not need one big talk. Small talks work better. Start when she asks about a pad in the bathroom, sees an advertisement, or a cousin gets her period. Keep it short, keep it calm, and tell her she can ask you anything, any time.

If you feel shy, that is normal too. Many of us were never told by our own mothers. You can start with: 'Nobody told me when I was your age. I want you to know.'

To begin

• 'Your body will start to change soon. That means you are growing up. Can I tell you about it?'
• 'Soon, maybe in a year or two, you will get something called a period. Every girl and woman gets it. I get it too.'

To explain what a period is

• 'Every month, the body gets ready in case, one day when you are grown up, you want a baby. A soft lining grows inside the womb (बच्चेदानी).'
• 'When there is no baby, the body does not need that lining. So it comes out slowly through the vagina, as some blood, for a few days. That is a period.'
• 'It is not dirty blood, and it does not mean you are hurt. It is a sign that your body is healthy.'
• 'It usually lasts from 2 to 7 days, and comes back about once a month. In the first year or two it may not come on time. That is normal.'

To make her feel safe

• 'If it starts at school or anywhere, it is okay. Tell your teacher, or call me.'
• 'You can always ask me anything. No question is silly.'
• 'This is private, but it is not a secret and it is not shameful.'

Words to avoid

• 'Dirty', 'impure', 'that problem', 'you have become unclean'. These words stay with a girl for years.
• Frightening her: 'now be careful of boys'. She needs facts and trust first.

If she does not want to talk, do not force it. Leave a small book or this page where she can find it, and say, 'Read this when you like. Then ask me anything.'

If she comes to you

1. Smile, and give her a hug if she likes. Say: 'This is your first period. It is normal. You are growing up.'
2. Show her how to use a pad (Guide 4). Let her do it herself, with you nearby.
3. Give her clean underwear. Stains come out with cold water and soap.
4. Tell her how long it may last, and that she will need to change the pad every 4 to 6 hours, or sooner if it feels full.
5. Ask how she feels. Some girls feel tired, or have a dull pain in the lower tummy or back.

If she has some pain

• A hot water bottle or a warm cloth on the lower tummy can help.
• Rest, warm drinks, and a gentle walk often help too.
• Before giving her any medicine, ask a doctor.
• Pain so bad that she cannot go to school, or faints, is not something she has to bear. See Guide 5.

If it starts at school

• Tell her before it happens: go to the teacher, the school nurse or a trusted friend. Many schools keep pads.
• Keep a small kit in her school bag (Guide 4), so she is never caught without one.

What she should know she CAN do

• Bathe and wash her hair. This is good for her, not harmful.
• Go to school, play, eat normal food, and sleep normally.

A small celebration, if your family likes it. Some families mark the day with a sweet or a small gift. It tells her this is good news, not a burden. Keep it simple and private if she is shy.

What goes in the pouch

• 2 or 3 sanitary pads (or clean cloth pads, if your family uses cloth)
• 1 pair of clean underwear
• A few small paper bags or old newspaper, to wrap the used pad
• Tissues or a small towel
• A small note: 'If you need help, tell your teacher, or call Mummy'

How to use a pad

1. Wash your hands.
2. Take off the wrapper and the strip on the back.
3. Stick the pad to the inside of the underwear, in the middle. If it has wings, fold them under.
4. Change it every 4 to 6 hours, or sooner if it feels full or wet. Change it before sleeping, and when you wake up.
5. Wash your hands again.

How to throw away a used pad

• Roll it up, wrap it in its wrapper, paper or newspaper, and put it in the dustbin.
• Never flush a pad down the toilet. It blocks the pipes.

If your family uses cloth

• Cloth is a good choice when it is kept clean.
• Use soft cotton cloth. Change it every 4 to 6 hours.
• Wash it in cold water first, then with soap.
• Dry it in the sun, not hidden in a dark corner. Sunlight helps keep it clean.
• Keep the dry cloth in a clean bag or box until next time.

Other products Menstrual cups and tampons are used inside the body. They are for when she is older. When she is ready to think about them, she can ask you or a doctor.

Keep a calendar. Mark the first day of each period with a red dot. Over the months, it helps her know when the next one may come, and it helps a doctor if she ever needs one.

In the first one or two years, these are normal

• Periods that do not come on time, or skip a month.
• Some months heavier, some lighter.
• Small clots, smaller than a one-rupee coin.
• Mild pain on the first day or two.

See a doctor if

• She shows signs of puberty (breasts, hair) before 8 years.
• Her period has not started by 15 years.
• Her period has not started within three years of her breasts starting to grow.
• Bleeding lasts more than 7 days.
• She has to change a pad every one or two hours because it is soaked.
• Clots are often bigger than a one-rupee coin.
• Periods come closer than 21 days apart, or more than 45 days apart, after the first two years.
• Her periods were coming regularly and then stop for three months.
• Pain is so bad that she misses school, vomits or faints, or pain does not get better with rest and warmth.
• She feels very tired, dizzy, or looks pale.
• She has a fever with bad pain in the lower tummy, or a discharge that smells bad, is green or grey, or itches a lot.

Where to go

• A gynaecologist (a women's doctor) at a government hospital or a private clinic.
• Your local health centre, or the ASHA didi in your village, can tell you where to go.

Before the visit

• Bring her period calendar (the red dots from Guide 4).
• Tell her what will happen. Most first visits are only a talk and a check of her tummy, weight and blood pressure. Stay with her if she wants.

Customs you may meet at home Many families have old rules: do not enter the kitchen, do not touch the pickle, do not go to the temple, sleep separately, do not bathe or wash your hair. These rules came from a time when people did not understand the body. Most were never about health.

What the body needs

• Bathing and washing hair during periods is good for her. It keeps her clean and comfortable.
• She can cook, eat any healthy food, play and go to school.
• Touching food or a plant during a period does not spoil it.

Talking to elders, gently

• Start with respect: 'Amma, in your time nobody explained this. Now doctors have told us more.'
• Choose your battles. Faith is personal, and every family decides for itself what it does at a place of worship. But rules that keep her out of school, away from water and soap, or make her feel ashamed, are worth a gentle conversation.
• Ask a teacher, an ASHA didi or a doctor to say it too. Elders often listen to them.

What fathers can do

• Know the basics. Read Guide 2 yourself.
• Keep pads at home without being asked, and buy them without embarrassment.
• If she has pain, offer a hot water bottle, and do not make her feel she is making a fuss.
• Never tease, and do not let brothers tease. Tell your son what periods are (see 'For boys').
• Say it once, simply: 'If you ever need anything, you can tell me too.'

A girl who sees her father treat periods as normal grows up believing she is normal.