Premature menstruation can cause discomfort and social discomfort for girls, and increase the risk of depression and cardiovascular disease later in life. Hormonal birth control and counseling may help manage symptoms, while treatments are available to delay puberty in cases of precocious puberty.
Early menstruation is the onset of menstrual periods at an earlier than normal age. The average age at menarche, the first menstrual cycle, varies across cultures and time periods; in the early 2000s, for example, it was about 11.5 for girls worldwide, but 100 years earlier it was closer to 17. A doctor can determine whether a patient is menstruating prematurely based on information from patients with a history similar medical and profile.
During puberty in girls, hormones trigger the development of breast buds and the slow maturation of breast tissue. Two to three years after the breast buds appear, girls usually experience menarche. Breast buds can appear as early as age eight, with menstruation following by age 10 to 11. Menstruation before age 10 may be premature, the result of precocious puberty, in which girls develop sex hormones too rapidly.
For patients, this can cause immediate discomfort and social discomfort. Girls may not be prepared for menstruation and in some cases have not been given adequate information about what to expect because parents and caregivers assume they do not need this information yet. They can also become targets of attention among their peers, who may take note of the differences associated with puberty.
In the long term, premature menstruation can increase the risk of developing depression later in life and is also associated with cardiovascular disease. Patients who develop early periods may need to be aware of these higher risks, especially if they have other risk factors. A patient with a family history of depression, for example, may need close monitoring for early signs of depressive behaviors.
A patient with premature periods might consider options such as hormonal birth control to manage the timing and intensity of periods if they become a problem. These patients may also need sex education and other interventions to protect them from risks such as pregnancy that might not otherwise be a problem for girls of the same age. Some also benefit from counseling and support to help them adjust to their maturing bodies and to develop coping strategies for teasing and other attention from their peers.
In cases of precocious puberty where a doctor can predict that a patient will have premature periods, treatments are available to delay the onset of puberty. The patient may take drugs to suppress sex hormones until she reaches a more appropriate age, at which point she may be allowed to develop naturally. A doctor can discuss this option with patients and their parents if early onset puberty is identified.
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