You are not my daughters OBGYN
August 12, 2018 12:11 PM   Subscribe

My daughter will be turning 10 in October. Today it would seem she had her first period. This came as a surprise to us considering she has shown no other signs of hitting puberty. Is this unusual, should we be concerned, and what should we expect moving forward with subsequent doctor's visits?

After closer inspection, my wife did discover my daughter now has some pubic hair. That was also a surprise as we were always told that she would first develop breasts / buds well before pubic hair / first period.

I understand it is not unusual for girls to get their periods as early as 8 but our instincts where that we wouldn't be seeing this for at least a few years because......Her mom didn't get her period until she was 13. She has zero breast development. She is tall and skinny. She eats a rather healthy diet. She has only lost 6 baby teeth. She was born one month premature. Adding all that up in my mind, I thought she would be hitting puberty later rather than earlier.

A few other random facts: Her mother has PCOS. When my daughter was born she had a few hemangiomas ( still has one on her lip ). Also she is multi ethnic ( western european, chinese, black, indian ). All of that may be completely irrelevant but I thought I would just state some facts.

Question 1: Is it very unusual that menarche ( first period ) would come before thelarche ( breast development )? If so, what is happening here?

Question 2: Should we be in any way concerned with further risks in her development / health long term based on question 1? I know sometimes early puberty can make girls very self-conscious but in this case she is literally showing no public signs of maturation. As well, I have read there are linkages to long term health risks like development of PCOS / breast cancer.

Obviously we are going to go see a doctor about this, but was hoping we might get some insight from the site that literally saved the same daughter an invasive surgery 8 years ago.
posted by jasondigitized to Health & Fitness (24 answers total) 4 users marked this as a favorite
Best answer: It's fine. She's fine. I was the same age and I would guess she won't get another for another year or two. Her ped is still fine, and you can call for a chat if *you* need to be reassured.

Do not traumatise your child with a pelvic exam.
posted by DarlingBri at 12:27 PM on August 12, 2018 [63 favorites]

Best answer: This is totally normal.
posted by Hermione Granger at 12:29 PM on August 12, 2018 [9 favorites]

I think this is one of those things where yes, "usually" menarche comes after other puberty symptoms, but there is a wide range of normal. I can't find the source of the statistic, but for example wikipedia says that for 60% of girls, breast development is the first sign of puberty. That would mean that for 40% of girls, breast development is *not* the first sign of puberty. Your daughter is well within the range of normal.

(I am not a doctor.)
posted by mskyle at 12:34 PM on August 12, 2018 [1 favorite]

I got my period a few months before my 11th birthday, so almost exactly the same age as your daughter. If you’d like to hear about my experience in some detail, feel free to MeMail me.
posted by holborne at 12:35 PM on August 12, 2018

Not unusual. Also, there might be no association between preterm birth and timing of puberty. (source)

With regards to self-conciousness, one lesson I learned the hard way is that just because I was a pre-teen did not mean that the "teen" branded supplies (tampons especially) were robust enough. I went off to summer camp with a box of tampons that lasted such a short time each that I was constantly in the washroom. It wouldn't have been an issue otherwise!

"I have read there are linkages to long term health risks like development of PCOS / breast cancer. Obviously we are going to go see a doctor about this...."

Also, I'd be careful of accidentally treating this like a choice that your daughter (should not have) made. Increased statistical likelihood of a health condition is not relevant to her right now! If she's going for a check up anyway, that's one thing, but to worry like this, or to specially take her to the doctor like something is wrong (!)... please don't create thoughts in the back of her mind that she's done something wrong or bad or that she's sick!
posted by delezzo at 12:50 PM on August 12, 2018 [21 favorites]

There’s a lot of “cultural knowledge” that says periods happen according to a schedule, they start at age X after an orderly progress of other development and then they proceed to show up every 28 days thereafter. In reality they just show up when they show up. For some people it’s predictable but it’s not a requirement. Bodies aren’t clocks. I’m only telling you this because you sound concerned that if her body isn’t doing everything on the same schedule as everyone else that it’s a sign of something wrong. But really how you MIGHT know something is wrong is if it starts messing up its own schedule, and even that doesn’t necessarily mean anything on its own.
posted by bleep at 12:58 PM on August 12, 2018 [4 favorites]

Response by poster: To be clear......

1) We are positioning this as a good / beautiful thing for her. She has no idea we have questions / are concerned. If this is normal than awesome. I just want to make sure we aren't misdiagnosing what just occurred. We just got back from Costa Rica less than 12 hours ago where she was climbing trees / going on natural rock waterslides where she took some damage so just being careful.

2) Inspected was probably the wrong word, but when your daughter is bleeding, and you didn't see any previous signs that she should be bleeding ( outside of getting bang up climbing a tree / sliding down rocks ), you are gonna have a peek.

This is all great advice btw.
posted by jasondigitized at 1:01 PM on August 12, 2018 [1 favorite]

Honestly, when I first got my period, I thought I had cut myself, or something. I knew about periods, sort of, but wasn't expecting mine any time soon. I did think that I had done something wrong, to 'cause' it. Puberty is enough to deal with as it is. Please don't 'closely inspect' your daughter. She's fine.
posted by delezzo at 1:03 PM on August 12, 2018 [9 favorites]

Best answer: Totally normal. I got periods long before my boobs or any hips showed up. The rest will follow in their own time, specially if her pubic hair is starting to arrive. If YOU have any questions call your pediatrician. You & your wife, need to take a deep breath & calm down, your daughter is growing up & it's scary & things are changing & it's a wonderful thing, but shifting that perception from kid to pre adult in the parents can be harder than it is for the kids. This is not a problem to be fixed. You got this. She's fine. When you or your wife feels ready make sure to have a calm talk to her about menstrual products & their uses and what these changes can mean. About the only thing I'd suggest is now is probably a good time to start bringing in deodorant use if she doesn't already, once hormones & body hair hit bodies get smellier.

I got pancakes for dinner to celebrate when my periods started with my Mum & her women friends. I'd recommend pancake dinners as the best response.
posted by wwax at 1:29 PM on August 12, 2018 [9 favorites]

Best answer:
As well, I have read there are linkages to long term health risks like development of PCOS / breast cancer.
My understanding, as someone who also got my period early and has some other risk factors for breast cancer, is that early menarche increases a woman's risk for breast cancer, but not by that much. It's not like she tested positive for BRCA or something. And your kid is 9. In 40 years, which is really the earliest she would need to worry about this, there will probably be much, much better treatments for breast cancer than there are now. The world is a scary enough place without stressing out over a very mildly elevated risk that your kid could have health issues in late middle age.

Early puberty messed me up emotionally, because I got hit on by older guys when I was much too young to process it. If your daughter does start to develop an adult body soon, you are going to need to address that. But getting her period young is not a big deal, unless she somehow picks up on your anxiety over it. She's fine. You're fine. Take a deep breath!
posted by ArbitraryAndCapricious at 1:39 PM on August 12, 2018 [7 favorites]

You know how people are always saying everyone develops at their own pace? Well, this is exactly what they mean. I got my period before any other development. (As it happened, I didn’t really develop either breasts or hips until my mid-teens.)

By the way, I know you say you are not letting your daughter know you think anything concerning is happening, but the whole tone of your post is pretty alarmist and girls can be really sensitive about this stuff, because it’s a big deal and there’s lot of cultural baggage around it. I had really supportive parents who were not weird about bodies and I was still MORTIFIED when I told my mom. It’s just the age. So please relax about this. I guarantee you she’s picking up on more than you think she is.
posted by lunasol at 1:42 PM on August 12, 2018 [18 favorites]

Chill out! I got my period when I was 10 and I got a pad from my mom and she just told me to watch out and how to track my periods. No drama. My elementary school was already grueling enough on a day to day basis, I didn't need more to deal with. I later read a Dear America book where the protagonist got it at 15 and I was flabbergasted.
posted by yueliang at 1:52 PM on August 12, 2018

Best answer: This is perfectly normal. Every body develops in its own way, and mother's onset of menarche doesn't correlate to daughter's, usually.

If you feel there is something to worry about (we found that our daughter, who got her period early, also ended up getting ovarian cysts when the rest of the cycle kicked in) there are pediatric gynecologists.

We took our daughter to one because of aforementioned cysts, and we were SO relieved when she said, "We don't do pelvic exams this young anymore."

So if you do feel like she needs to be seen at some point, look for a pediatric gynecologist, and go on and ask them if they do pelvics on girls your daughter's age.

(Also! Make sure she knows that the period stops, and then comes back. Somehow, I failed to get that across with my daughter. She thought it was supposed to last forever, and was anxious when it stopped!)
posted by headspace at 2:03 PM on August 12, 2018

Best answer: We just got back from Costa Rica less than 12 hours ago

I didn't start this early, but throughout my teens, things like travel and stress had a much more noticeable impact on my cycle than they do now in my 30s. These things might be related... not in a way that I'd expect to be dangerous or anything? But just in terms of maybe it would have been a little while longer otherwise, and it's good to be aware that things don't start out super regular and bodies are great at doing this "surprise, you just had this big anxious thing happen, do you think cramps will help" thing.
posted by Sequence at 2:15 PM on August 12, 2018 [7 favorites]

I think you've had some great advice here. But since you mention that she's just back from an active vacation, I want to add the anecdata that I broke my hymen(!) riding a mountain bike on a school trip at about the same age. There was a surprising amount of blood, and everyone assumed it was the start of my period. It wasn't. I realised what had happened a long time later.
posted by featherboa at 2:38 PM on August 12, 2018 [5 favorites]

Toe in Norma Klein's Tomboy gets her period when she's 10.
posted by brujita at 2:54 PM on August 12, 2018

Well, so, this isn't *abnormal* but just because it happened to a lot of us and went unremarked doesn't mean it's not indicative of a physical or endocrinological problem, it's just that nobody gave a shit or wanted to talk about it when we were kids so we just suffered until our 20s or 30s or 40s. Ping her ped and see if their inclination is that it's NBD or maybe it's time for a young menstruating person's First Routine Bloodwork, which isn't a rite of passage but probably should be. Agreed that there's no need for a pelvic exam until much later or additional cause to believe it is necessary, but almost anything that might feasibly be wrong can be preliminarily assessed via external imaging and bloodwork anyway, and there's no reason to see anyone but her regular physician until referred elsewhere.
posted by Lyn Never at 3:35 PM on August 12, 2018

I did develop breasts/hips/hair before I started my period at 9ish, but it did come basically out of nowhere in the middle of the summer while we were moving - hard work, stress, lots of sweating, lots of just pushing forward. i had cramps and was moody during the 3 day period of moving but everyone assumed it was the moving process itself. my first 4 or so periods were weird (too far apart and too close together) but then it normalized. I personally had a lot more pain and flow than others around my age (or older) and I wish adults around me took that more seriously.

This is obviously not science, but all my puberty stuff followed my dad's side in timing not my mom's side, and likewise my brother's hairline is far more based on my mom's side than my dad's.
posted by I'm Not Even Supposed To Be Here Today! at 4:07 PM on August 12, 2018

Mrs. 4ster is a third grade teacher and says she has seen girls reach puberty at this age more than most people might think. This is over the course of 22 years.
posted by 4ster at 4:15 PM on August 12, 2018 [2 favorites]

Best answer: I well remember a notice that was sent home prior to sleep away camp that it was very common for girls to have a period due to travel /stress / elevation changes. That was a long time ago and there's probably a better scientific description or explanation but all in all rest assured that it is a common occurrence. I did in fact get a period at 11 while at sleep away camp, but no one took me to any doctor, they just let nature take its course and everything worked out as expected.

I say let it go unless your daughter starts getting heavy or frequent periods. She very likely won't be regular for a few years so I'd treat it as nbd and don't let it get into her head that there's something wrong with her.
posted by vignettist at 5:00 PM on August 12, 2018 [1 favorite]

We are positioning this as a good / beautiful thing for her.

god bless you but like..she's 10. she is many years away from intentional childbearing and probably a couple years from even wanting to have sex. so what is she supposed to think is good or beautiful about it?

this is normal, not a big deal, and not a hardship once you're used to it. maybe cool in the way that mildly gross things are cool to 10-year-olds sometimes. but the thing to remember about girls with early menarche is she is not entering womanhood early just because she's menstruating, and this has no connection to beauty, either literal or metaphorical. this part of puberty is just like early acne or suddenly going up a couple of shoe sizes, don't nudge her towards mystic rites of passage or maturity just cause she got her period. it's really a very mundane thing and unless there is pain or medical complication, entirely value neutral. nothing to be embarrassed about but no more good than bad.
posted by queenofbithynia at 9:32 PM on August 12, 2018 [13 favorites]

If you/your wife haven't already, please explain to her what menstruation actually is. I was totally unprepared for my first period at age 9 (despite the fact that my mom and apparently all my female family members started around that age), and I thought I was dying and that's why my belly was on fire and my mom was being so gentle around me. The only explanation I got was that this was my body's way of preparing me for having kids one day -- which is confusing as hell to a 9-year-old!
posted by basalganglia at 4:05 AM on August 13, 2018 [3 favorites]

Is she around 105 lbs? I heard years ago that that's sort of the magic weight to trigger periods in girls and that girls have been getting periods sooner because they are reaching that weight sooner (on average).

Anyway, this is all normal.
posted by WeekendJen at 11:50 AM on August 13, 2018

Seconding that this all sounds normal to me. I can't recall whether I had/needed a bra when my period started. I had some stretch marks from my hips starting to grow--they looked like giant red claw marks on my lower back/upper butt. Even though my mom had had stretch marks during her pregnancies, she didn't explain to me what these were. I figured it out years later.

Please provide her with any and all forms of menstrual products that she wants, along with all the advil, heating pads and comfort food she desires during her period.

I mean this gently: there is a definite vibe of freaked out parent in your question and your follow-up. For some reason "bleeding" is bothering me--it might help you to think of it as "menstruating" even when you talk to yourself about it. That might just be me though. It might also help to read some teen girl perspectives on it? I'm recommending this link for YOU btw, not necessarily for your daughter.

It's funny the things that you remember and don't about puberty. I don't recall when I got my first bra. I do remember my mom telling me I needed to start wearing deodorant, but it didn't hurt my feelings--she was very matter of fact about it. I do remember not knowing how to use a tampon because she wouldn't talk to me about it and I do remember throwing an epic fit to finally be allowed to shave my legs. I wanted to fit in and none of the girls in my class had hairy legs like mine. I'd been menstruating for over a year at that point. Puberty is difficult for everyone!

She's gonna be fine.
posted by purple_bird at 3:17 PM on August 13, 2018

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