Going through puberty can be a confusing time for many young people. The changes your child’s body will go through can happen at different stages. During puberty, teens and tweens with the potential to menstruate will start getting their period. Menstruation, or getting your period, is one part of the menstrual cycle, and your child’s first few periods may be irregular or vary in flow. Since everyone’s body is a little bit different, your child may start having their period earlier or later than their peers.  

This section of Next Step provides important information for parents, caregivers, preteens, and teens about periods for young people with a bleeding disorder. This information includes an overview of periods, period protection, bleeding disorders and periods, and how to manage periods at school.  

This section of Next Step covers: 

Periods

Period Protection

Bleeding Disorders and Periods

What About Periods and School?

Periods

Experiencing a period, also called menstruation, for the first time can be exciting and confusing. For tweens and teens with the potential to menstruate, getting a period is one of the big changes in the body that happens during puberty. Puberty is the life stage when physical and emotional changes transform a child's body into an adult body. 

Tweens and teens with the potential to menstruate typically have their first period between the ages of 11 and 14 years. Some people start as early as age 8 and others as late as age 16. A period is one stage of the menstrual cycle, the monthly cycle a body goes through to prepare for pregnancy. During a period, the body is getting rid of the blood and tissue that built up in the uterus. Everyone’s period is a little different. A normal period usually lasts about two to seven days. The first day of your child’s period is the beginning of a new cycle. It ends when the bleeding of your child’s next period starts. 

Diagram of a menstrual cycle:

Chart, sunburst chart Description automatically generated

Period Protection

There are many options for managing a period, including pads, tampons, menstrual cups, and period underwear. Your child may want to use different period supplies depending on their flow. Some people may use tampons on heavy flow days and pads on lighter days, or only use menstrual cups during their periods. Everyone’s needs are different, and you can encourage your child to find what works for them. 

Pads
A pad is an oval shaped material that sticks to the inside of the underwear to soak up period blood. Some pads have extra material folds on the sides, called wings, that are folded over the sides of the underwear to help keep the pad in place and prevent leaks. Most pads are thrown out after each use, but there are washable, reusable ones too.
Liners
Liners are similar in shape to pads, but they do not absorb as much blood because they are a lot thinner. Some people use them as protection on lighter menstrual flow days or as a backup protection with tampons.
Tampons
A tampon is made of absorbent material in a tube-like shape that can be inserted into the vagina to soak up blood. Usually, tampons are thrown away after each use. Tampons should not be used for more than eight hours. Your child may need to change tampons more often if they are saturated.
Menstrual Cups
A menstrual cup is a small, flexible cup that is inserted into the vagina to catch and collect blood. It doesn’t absorb the blood like a pad or tampon. Instead, it forms a seal so no blood will leak out. When the cup is removed, the blood is placed in the toilet, and the cup is washed and reinserted. Once the period is over, sterilize the cup in boiling water so it’s ready to be used next month.
Period Underwear
Period underwear is made of special absorbent material that can be worn like regular underwear. Depending on how heavy the flow is on a given day, it can last most or all day or can be a backup for a tampon. At the end of the day rinse them out, usually by hand, and then throw them in the wash. It is likely your child may need to have more than one pair, but they are reusable month after month.

Bleeding Disorders and Periods

Some people might first notice the signs and symptoms of a bleeding disorder because of heavy or irregular bleeding during their periods. Teens and tweens with the potential to menstruate with bleeding disorders often have longer and heavier periods. If your child has a bleeding disorder, their period might last longer than seven days. Finding out your child has a bleeding disorder and getting access to care can improve your child’s quality of life and reduce stress.

Heavy Menstrual Bleeding

Bleeding for longer than seven days is heavy menstrual bleeding. Other possible signs and symptoms of heavy menstrual bleeding include: 

  • Need to use more than one pad or tampon every hour 
  • Need to double up by wearing one pad and a tampon because of heavy bleeding 
  • Need to change pads or tampons more than once during the night 
  • Experiencing flooding or gushing blood 
  • Have a menstrual flow that repeatedly contains blood clots the size of a quarter or larger 
  • Have a menstrual flow so heavy that it keeps your child from doing the things they would do normally, such as going to work, school, or other activities 

You may need to watch your child for signs of anemia due to heavy periods. Signs of anemia include:  

  • Weakness 
  • Tiredness (called lethargy) 
  • Paleness (called pallor) 

If you see signs of anemia, talk with your child’s health care provider about possible care and treatment. 

If you want more information about periods, please go to Normal and Abnormal Periods. 

Ways to Manage Heavy Menstrual Bleeding

Heavy menstrual bleeding can be emotional and affect quality of life. For young people, heavy menstrual bleeding may lead to feelings of stress, isolation, or exclusion. Talking openly about periods and how they affect a young person’s life is important and can help teens and tweens who menstruate feel independent and confident.

 

Tips on how to manage heavy menstrual bleeding: 

  • Keep an emergency bag of period protection supplies, extra underwear, and clothing at school, work, or carried with your child. 
  • Have a long-sleeved sweater or jacket in your child’s locker to tie around their waist. 
  • Put a doubled-up, dark-colored towel underneath your child when they sleep or consider using a backup form of period protection.  
  • Don't give your child aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs), including ibuprofen and naproxen, because they interfere with clotting. 
  • Discuss alternative pain relief options with your child’s health care provider. Simple measures, such as taking a warm bath or placing a hot water bottle or heating pad on the abdomen, often help to relieve discomfort. 
  • Encourage your child to exercise. Periods shouldn't get in the way of being active and exercise has been shown to relieve cramps. 
  • Lower or avoid salt and caffeine in your child’s diet.  
  • Have your child drink plenty of water.  
  • Encourage your child to get the proper amount of sleep.  
  • Eating a low-fat, high-fiber diet may help with cramps. 
  • Talk with your child’s health care provider about how to care for heavy menstrual bleeding 
Resources for Managing Heavy Bleeding
  • Period Tracking Apps: Helping your child start to track their period can help them feel in control of their cycle. Keeping a record of menstruation can also help a health care provider understand what your child is going through. Some examples of apps that track menstruation cycles, ovulation, and any patterns include: 
  • HTC Resources: Check with your local Hemophilia Treatment Center (HTC) to learn about special programs. Some chapters offer opportunities to learn more about bleeding disorders, networking, and tips on managing periods.  
  • Better You Know:  At Betteryouknow.org you can find useful materials including the BYK Menstrual Chart and Scoring System, BYK Healthcare Diary, and the BYK Teen Girls Brochure.  

What About Periods and School?

Heavy menstrual bleeding can often affect daily life, such as getting through the school day. Talking with the school staff about bleeding disorders and heavy menstrual bleeding can help those working at the school understand the needs of a young person with a bleeding disorder. 

Creating a plan for bleeding accidents or changing period supplies will help tweens and teens with the potential to menstruate feel prepared to go to school. Think about walking through the school day and what supplies will be needed at what time. Is there a trusted teacher or school staff member that can help? Having a plan and knowing who to go to for help can make your child feel comfortable during school.  

Schools should be able to meet any needs that arise from heavy menstrual bleeding. Schools should also be able to help with needed bathroom breaks and keeping an extra change of clothes stored. You can request a permanent pass from school staff to help your child go from the classroom to the bathroom quickly.  

If you want more information about accommodations in schools, please go to Your Rights: Legislation and School Accommodations.    

Remember: Heavy periods can be managed! 

 

For more information about periods, school, self-esteem, and ways to manage heavy menstrual bleeding check out Time to Talk Puberty