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Menarche – The First Occurrence of Menstruation

Exploring the physical, social, and emotional impact in today’s world.

What we’ll be deep diving into:

  • What is menarche?
  • What is the impact? – physical, social, and emotional
  • How to care for self
  • Guidance for caregivers

How is menarche defined?

Menarche, pronounced ‘muh-naa-kee’, is the first occurrence of the menstrual cycle in an individual. It marks the first time the body sheds the endometrial lining of the uterus. This shedding is also known as period or menstrual blood.

Today, the NHS reports that most young people experience menarche between the ages of 11-14, with the average age being 12.

It often signifies the beginning of reproductive years, meaning an individual can become pregnant and have a baby, unless there are health conditions that prevent this.

According to research there are several factors that can influence the beginning of menarche, such as: genetics, race, environmental factors, health, body composition, and psychological factors.

What is the impact?

Leading up to and during menarche, a time known as puberty, presents a unique and equally immeasurable change. It impacts a young person physically, emotionally, and socially in an array of different ways.


Menarche is a memorable event, often viewed as a ‘rite of passage’, symbolising an ending and new beginning. It also arrives at a time when young people seek to belong and be accepted by others. Unexpected or extreme changes in their physicality often present a challenge.

As hormone levels increase, with oestrogen and progesterone cycling through the body, many physical changes are observed such as chest development, widening hips, growth spurts, changes to skin, and hair growth on underarms and the pubic region. Changes continue after menarche, but most of the physical changes will have occurred before the first menstruation.

The 5 stages of puberty, termed the Tanner Stages, are an objective way of tracking bodily changes that occur throughout puberty, including approaching menarche.

Some physical symptoms to look out for that would indicate the beginning of menarche, as described by the Cleveland Clinic are:

  • Cramping (pain or achiness in your belly, back or legs)
  • Bloating (your belly feels full or swollen)
  • Tender or sore chest
  • A flare up of acne / pimples
  • Fluctuating moods
  • Tiredness

The physical changes are not the only thing shifting in the young person’s world.

Fascinating Fact:

The scientific journal The Lancet reports that the average menstruator has more than 400 periods in their lifetime.


Menstrual stigma is embedded within our culture. We find ourselves warping the language we use to describe a natural bodily process, using euphemisms such as our ‘time of the month’ or a ‘visit from aunt flo’. Indirectly discussing menstruation in this way creates secrecy and a sense of embarrassment.

Eye-opening Fact: There are more than 5,000 euphemisms for periods around the world according to a 2016 Clue research study.

This stigmatization of the menstrual cycle is often introduced at a very early stage for young people, sometimes even before menarche. As they curiously seek answers, which can be met openly and sensitively, for others it may quickly become apparent that conversations about menstruation are off-limits, further shrouding the topic in mystery and taboo.

In these instances, questions may quickly arise as to who is ‘safe’ to ask or tell, creating confusion around the use of sanitary products, becoming increasingly self-conscious about their changing body, and questioning how they will be received by others. This creates further isolation as the unknown is often anxiety provoking.

Since the updated publication of the Relationships Education, Relationships and Sex Education (RSE) and Health Education statutory guidance for England in 2021, education settings have begun actively teaching young people about puberty and the changing adolescent body in schools.

Schools in the UK are also addressing the global issue of Period Poverty, defined by the Royal College of Nursing as ‘lack of access to sanitary products due to financial constraints.

Research conducted by the Bloody Big Brunch found that one quarter of girls in the UK have been forced to miss employment or education because they cannot afford menstrual products.

To address this issue in the UK, the Period Product Scheme, launch by the government in early 2020, provides free period products to menstruators in their place of study.


The emotional impact can be far-reaching. Throughout history, menstruation has been used to disempower and oppress those who bleed. The physical and mood-related changes that occur have been used to mock and belittle, labelling individuals as overly sensitive and emotional. These perceptions, that still exist today, serve to disempower rather than uplift.

For some, menarche is welcomed with a sense of pride and identity, and more so if the young person felt prepared for the change. On the other hand, an individual may feel embarrassed, fearful, and even experience low mood stemming from the powerlessness of the overall experience.

To understand the emotional extremes, it is important to recognise that it is the mind and body’s reaction to multiple apprehensions through such a transition. It can be helpful to know these feelings stabilise as they transition through menarche and adjust to their new ‘normal’.

Naturally, we fear what we do not understand. The more information that can be provided, over time, in age-appropriate ways, the more a young person will feel equipped to embrace this stage of their lives.

Young people should feel that they can embrace this stage of their lives and understand that these feelings are normal. 


Menstruation is a health matter, with menarche and menstrual management being integral to our wellbeing.

Timing and access to quality information varies from person-to-person which often means that when this milestone is reached, there can be gaps in a young person’s knowledge and understanding.

Learning about menstrual health and hygiene during the premenstrual stage (before menarche) can serve to equip and empower, whilst also reducing anxieties and giving permission for young people to begin building a nurturing relationship with their body and cycle. The more awareness the young person has, the more able they are to advocate for themselves and ultimately recognise if something isn’t right.

To begin forming this connection to self, there are several self-care strategies that could be employed. For example:

  • Tracking their cycle (noticing the emotional and physical changes each month).
  • Understanding which sanitary products maybe suitable for them to manage blood flow.
  • Becoming aware how individual influencing factors such as stress and overwhelm can impact their monthly cycle.

Focusing on self-care creates a foundation that allows young people to take responsibility for their body’s natural rhythm, without feeling the need to hide or separate parts of themselves through fear of being accepted.

Below are examples of practical tips for managing physical symptoms: 

  • Take a warm bath or shower
  • Exercise and stretch
  • Place a heat pad, hot water bottle or warm washcloth on your belly

Fascinating Fact:

You probably bleed a lot less than you think. According to PubMed Health a menstruator loses roughly 60 millilitres of blood during each period.

Guidance for caregivers

Families can play a huge role when normalising menarche and menstruation. However, as a parent or caregiver supporting an adolescent, it can feel like a daunting task.

This life stage provides an opportunity for families to reflect and bring awareness to their own personal, often programmed responses and reactions to menstruation and how this could influence the young person’s experience.

Understanding the values and beliefs that have shaped adults allows them to be stable and present when supporting our youth. The accelerated physical maturation often means there is misalignment with the young person’s emotional maturity. Young people are expected to ‘grow up’ in many ways, but do not yet have the resilience and wisdom to support themselves independently through this stage, experiencing the same levels of uncertainty and insecurities as children.

Cultivating an honest, open, and supportive environment for period-positive communication at home, particularly leading up to and during these years, is crucial. Providing regular opportunities to talk freely – in age-appropriate ways – whilst sharing factual information, reliable resources, and useful coping strategies may afford the young person a sense of comfort and lead them to feel prepared during this transitory stage.

It may also be helpful to include those within the family who do not menstruate, as education on this topic should not just be for those with female anatomy. In doing so it challenges the social norm and allows us to address the age-old narrative that menstruation solely concerns women.

Don’t let talking about sensitive subjects seem like a daunting task. Create a supportive and open environment for period-positive communication at home.

In summary:

  • Address misinformation:
    • Fact-check, what do they already know?
    • Use the correct terminology for the anatomy.
    • Do they have any questions and ensure you are honest when providing answers?
    • Research together if you are both unsure.
  • Provide support:
    • Offer reassurance if your child is struggling with the changes to their bodies or emotional states.
    • Try not to compare to other young people.
    • Recognise the developmental stage they are at.
  • Become a role model for the young person:
    • Adults can help to model healthy and calm communication.
    • Gain an understanding as to how your young person can be best supported and meet them where they are at.
  • Respect the young person’s privacy:
    • They may have increased sensitivity about their physical changes and personal space may become very important to them.
    • As they become more independent, they may choose not to share everything with you. Ensure they know no topic is off limits, listen when they talk, avoid telling them how they should feel – they are becoming the experts of themselves.
  • Prioritise health and fitness:
    • Encourage making healthy choices which include sleep hygiene, eating a healthy diet, and engaging in regular movement.

Inclusivity Statement:

At Kari Health, we recognise the importance of using inclusive language throughout these conversations. It provides a respectful and considered approach to people’s identities.

Individuals with a reproductive anatomy associated with being assigned female at birth (AFAB) – a vagina, uterus, fallopian tubes, ovaries – can menstruate.

Meaning cisgender girls, transgender boys, and nonbinary people with an AFAB anatomy can experience many of the physical and mood-related symptoms associated with menarche and menstruation.

Equally, we recognise that not all those with a female anatomy do menstruate / experience menarche.

This article is intended to provide awareness and to support peoples understanding. In providing information that is accurate and inclusive means that every person can apply it to their lives.

Evidence Based
This article has been reviewed by our Kari Health Experts and Editorial Board to ensure accuracy and reliability of the information presented. However, please note that the content provided is for informational purposes only and should not replace advice from your medical professional.

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