Premature menstruation is the onset of menstrual periods at an age earlier than normal. The average age at menarche, the first menstrual cycle, varies between cultures and time periods; in the early 2000s, for instance, it was around 11.5 for girls worldwide, but 100 years earlier, it was closer to 17. A doctor can determine if a patient has premature menstruation on the basis of information about patients with a similar medical history and profile.
Over the course of puberty in girls, hormones trigger the development of breast buds and the slow maturation of breast tissue. Two to three years after the breast buds appear, girls usually experience menarche. Breast buds may appear as early as age eight, with menstruation following by age 10 to 11. Menstruating before age 10 may be premature, the result of precocious puberty, where girls develop sex hormones too quickly.
For patients, this can cause some immediate distress and social discomfort. Young girls may not be prepared for menstruation and in some cases have not received adequate information about what to expect because parents and care providers assume they do not need this information yet. They can also become targets for attention among their peers, who may take note of the differences associated with puberty.
In the long term, premature menstruation can increase the risk of developing depression later in life, and it is also associated with cardiovascular disease. Patients who develop early periods may need to be aware of these higher risks, especially if they have other risk factors. A patient with a family history of depression, for instance, might need careful monitoring for the early signs of depressive behaviors.
A patient with premature menstruation might consider options like hormonal birth control to manage the timing and intensity of periods if they become a problem. These patients may also need some sexual education and other interventions to protect them from risks like pregnancy that might not otherwise be a concern for girls at the same age. Some also benefit from counseling and support to help them adjust to their maturing bodies and to develop coping strategies for teasing and other attention from their peers.
In cases of precocious puberty where a doctor can predict that a patient will experience premature menstruation, treatments are available to delay the onset of puberty. The patient can take medications to suppress the sex hormones until she reaches a more appropriate age, at which point she can be allowed to develop naturally. A doctor may discuss this option with patients and their parents if early onset puberty is identified.