Frequently Asked Questions (FAQs)
• My periods are not regular. Why?
Periods in the first few years after menarche may be irregular. This does not indicate any abnormality. The adolescent girl needs reassurance to be able to adjust to the periodicity. She needs to be told that it will normalize in the course of a few years. Emotional strees because of the cycles itself or otherwise needs to be addressed. The cycles are more likely to be longer than a month but in a few cases they may even be shorter or with no fixed patter.

• What if there is excessive or prolonged bleeding?
Sometimes adolescent girls may experience heavy bleeding (need to use 3-4 pads/day. This is likely to normalize as the cycles become regular and are accompanied by maturation of the egg. Excessive loss of blood may lead to anaemia which can be prevented or treated by dietary counseling and if required, iron supplementation. Treating worm infestation (if a common problem in the area) can help in preventing aggravation of anaemia. This may need referral for medical checkup by gynecologist.

• Is scanty menstruation a matter of concern?
The amount of bleeding varies and is different from girl to girl. Even a lesser menstrual flow is normal especially if it is regular in occurrence and is not associated with any other problem. Reassuring the girl about her fertility is important.

• How do I handle discomfort?
Young adolescent girls any face a few discomforts during menstruation. The usual discomforts are:
• Severe / incapacitating pain or cramps in lower abdomen
• Swelling of feet, breast, face
• Weakness and exhausted feeling
• Backache
• Breast Discomfort
• Itching in genital area
Weakness, feeling of exertion, tiredness and headache may be due to lack of proper nutrition. Since adolescent girls are growing they need a nourishing diet, especially rich in iron, to make up for blood loss during menstruation. Lack or iron intake / absorption leads to anaemia. A commercial preparation of the drug Mefenemic Acid, aspirin or paracetamol, can be given 2-3 times for pain during periods and the girl can be told the name of the drug so that the can procure it. Itching may be due to lack of cleanliness. Daily bath and maintaining hygiene and use of clean cloth should be encouraged. Explanation of menstrual process, correction of constipation, physical exercise and reassurance are important aspects of management.

If the pain interferes with the daily routine of the girl and is not improving with the above mentioned measures she should be referred to a doctor.

• Why do I feel so low?
Seven to ten days before menstruation girls may experience:
• Irritability, restlessness
• Gastro intestinal tract upset – constipation, colon spasm
• Feeling of fullness in breasts, abdomen, face and feet
• Some weight gain of 1 to 1.5 kg

Most girls will benefit by reduction of slat intake, regular exercise and emotional support. Severe cases may need treatment and should be referred to a doctor.
• An adolescent girl can become pregnant anytime after she starts having her periods. As fully mature egg is not released in the first few years after menarche the likelihood of their conceiving is very less. However, adolescent girls must know that even a single act of sexual intercourse can lead to pregnancy. It is important for all adolescents to know that sexual activity without the use of a contraceptive carries with it the risk of getting pregnant.

In some parts of our country, girls are married before menarche and as soon as they attain menarche, the marriage is consummated and they are expected to bear a child. This may not happen, as the earlier cycles are not producing a mature egg. The family of the married adolescent and she herself will need reassurance and counseling to tackle the related social pressures of proving her fertility.

• Is it normal to have discharge from the genital tract?
A certain among of discharge is normal during the middle of the cycle at the time of the resale of the egg and a few days before the beginning of the periods. This discharge is clear and not foul smelling. It could be profuse and accompanied by itching if it is due to poor personal or menstrual hygiene. Care should be taken to exclude sexually transmitted infections, if there is history of sexual activity.

The Male genital tract is designed to
• Produce and store sperm
• Release sperm as required
• Add regulatory components and fluid to sperm
• Produce testosterone (male sex hormone)