Talking About Periods: The Facts I Want My Kids to Know

As mothers, we have our own reproductive health to manage, but also the responsibility to teach our daughters AND sons about how bodies work, what is and isn’t normal, and when to seek help. As a fertility specialist, I see women shocked by new reproductive health diagnoses in their 30s and 40s. I also have men who will tell me straight up that difficulty conceiving was the catalyst for them to finally think about, and try to understand, anything related to women’s health.

mother and daughter sit on bed with laptopWe can change that for our families, and for ourselves. I found myself thinking about this topic as March is Endometriosis Awareness Month. Endometriosis is a condition often associated with heavy, painful periods, and delayed diagnoses after years of suffering, but also because of some of my own recent experiences.

I’ve brainstormed some useful period tidbits. These are the things I plan to teach my daughter at points along the way, sometime between now (age 2.5!) and middle school:

  • A “period” is the catch-all phrase for uterine bleeding. If someone is not on any hormonal medications like birth control, and they have regular menstrual cycles, they will typically get a period every 24-38 days. That bleeding will last 3-8 days, and on the heaviest days may be associated with cramping.
  • In the first year or two after the first period, a teen may not have established a regular ovulation pattern yet, and so a 21-45 day interval would be considered normal.
  • Experiences for which I would recommend seeking medical care from a pediatrician or gynecologist include: severe pain resulting in a need for regular pain medication or time off from school or work, bleeding so heavy that one is soaking through a pad or tampon in less than an hour especially if repeatedly, cycles coming routinely outside of the normal interval for one’s age, or notable changes from a previously stable menstrual pattern. These can suggest conditions like endometriosis, polycystic ovary syndrome, fibroids, uterine polyps, or more!
  • If someone is on birth control, that controls the period, make it lighter and more predictable. Typically, hormonal contraception eliminates ovulation, so this is no longer a reflection of the hormones the body is producing. Therefore, it can mask changes that may be happening underneath. When women take birth control for decades and then come off, they are often surprised at changes to their cycle. These changes are not caused by birth control, but rather have been hidden all this time by being on hormones.
  • Birth control is incredibly safe, and much safer than pregnancy. Some women don’t tolerate it well, in which case another pill might work better, or other methods of contraception like rings, or implantable or intrauterine devices. Abstinence-only education has never been scientifically demonstrated to be effective at preventing teen pregnancy, so being realistic about what my child might need is definitely my goal, even if her choices don’t line up with my preferences. Birth control does not impact future fertility.
  • There are so many more options for managing period bleeding than when I was a teenager! I love period underwear myself, and as someone increasingly conscious of unnecessary chemical exposures to myself and global issues around plastics and waste, I try to use as few disposable products as possible. My impression is that young women often love using menstrual cups with period underwear as the most environmentally-friendly, non-toxic method of dealing with bleeding. But to each her own! No period product, including cups or tampons, is unusable for virginal girls, but having mom teach you how to use teen-appropriate products is probably preferable to trying to figure it out by reading the package insert {my experience when I tried to “borrow” one of my mom’s super tampons as a teen}.
  • Many kids express a non-binary gender identity these days. If that’s relevant to any discussions you might have, using terms like “those with ovaries”, “people who menstruate”, they/them pronouns, and so on can make the conversation more friendly.

mother sits on steps outside home with daughtersIn my own personal history, I was a long-time birth control user. But in the times that I have experienced my own natural menstrual cycle, I’ve had issues with not ovulating when I was at my skinniest, difficulty pinpointing my fertile window without detailed ovulation tracking, heavier bleeding, especially after a miscarriage that I was not used to managing, and more. I can only imagine how in the dark I might have felt about some of these experiences if I didn’t have my medical training to fall back on.

My husband was definitely unaware of how most of this stuff works, and remains somewhat content to remain blissfully ignorant since anything related to reproduction is my particular jam. So, I know it’s definitely going to be on me to be the sex educator for however many kids we have. I’m honestly looking forward to it, though I’m sure the kids may think it’s horribly awkward and weird. I have a running list of some of the books that have come recommended to me to use when the time is right {this one, and this entire series are good starts}.

So, in the name of diagnoses like endometriosis that often worsen because of a lingering stigma or taboo around talking about periods, I encourage everyone to figure out what period facts might help themselves or their loved ones along the way. Good luck!

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Rashmi Kudesia, MD MSc is a board-certified OB/GYN and Reproductive Endocrinology & Infertility specialist who is passionate about improving women's access to evidence-based, honest reproductive health information and care. Aside from her clinical practice seeing patients in Houston and Sugar Land, Rashmi frequently speaks at conferences and community events, and advocates for women's health via media interviews and social media. Originally a Midwesterner, she moved around the East Coast for school and training, including nearly a decade in NYC, where she met her husband, Ashish, a Houston native. After moving to Houston in 2018, she's continued searching for that perfect work-life balance as the family grew quickly, adding their first pup, Bowser {2018}, their first home, and now their first kiddo, Amara {2019}! Right now, she's learning the ropes of being a working mama, but still loves exploring Houston's amazing food scene, checking out the newest museum exhibits, or planning the family's next trip. She's always on the hunt for the city's best iced latte or glass of wine to be savored with a good book. Find her on Facebook and Instagram {@rkudesia}.

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