Adolescence (ages 12+)

“Now that you have your period, you might think you have to clean your vagina a different way. That is not true. Your vagina does not need soap or water or anything else in it to keep it clean. Keep wiping from front to back and ignore any ads you see about ‘balancing your pH’ or keeping you ‘fresh’—you don’t need any of those products to keep yourself healthy.”

“Please remember that your vagina keeps itself clean—yes, even when you are on your period. You don’t need to do anything special inside your vagina to ‘keep clean.’ All you need to be doing is rinsing your vulva with warm water every day, and wiping from front to back after you go to the bathroom.”

“You might notice that your vulva has an odor, especially if you have exercised a lot or gotten really hot or sweaty. That smell is from the outside of your body—not from your vagina. Clean your body like you usually do, and the smell will go away.”

How Do Periods Work?

Early Childhood (ages 3 to 6)

“Mommy is okay—this blood doesn’t mean I’m hurt. I am having my period. Every month, my uterus—the place where you grew when you were in my body—pretends it’s going to have another baby! It puts tissues on the walls like it’s decorating for a baby that might grow there. But when no baby ends up in my uterus, it takes all the tissues down and they come out of my vagina. Then it does it again the next month, just in case I decide I want to have a baby in there.”

Middle Childhood (ages 7 to 10)

“You are getting closer to the age where you will probably start your period. You remember that a period is when the uterus grows some additional nutrient-rich tissue inside it just in case the person decides they want to have a baby, right? Well, that tissue, along with some blood, is what comes out of the vagina when a person is having their period. Often for your first period, the blood and tissue doesn’t look red like you might expect—they can look brown. Some kids have said that when they wiped during their first period, they thought that their period was poop and that they had wiped incorrectly. But it wasn’t poop—it was just the tissue from their first period, so they got some products to help keep their clothes and body clean, and they went about their day.”

Adolescence (ages 11+)

“We’ve talked before about how having a period or menstrual cycle means your body is preparing itself to potentially become pregnant. It does that roughly every month by changing your hormones, and those hormones signal your ovaries—where your eggs stored—to release an egg and your uterus to make itself ready just in case you get pregnant. The lining of your uterus is called endometrium, and it gets thicker and makes a place for the egg to implant if it’s fertilized in your fallopian tube. If the egg reaches the uterus and it isn’t fertilized (and even sometimes when it is), your body will shed the extra endometrium and the egg—that shedding is your period.”

“The average length of a cycle is anywhere from around 21 to around 35 days, and you are most fertile for pregnancy during ovulation, when the egg releases, roughly in the middle of that cycle. It’s important to know, though, that you can get pregnant at any point in your cycle. A lot of people think that you can only get pregnant when you are ovulating, but since we don’t always know exactly when a person is ovulating, it’s the safest to assume that you are always at least a little bit fertile.”

Discharge

Middle Childhood (ages 8+)

“As you get closer to having your period, you will notice some signs that your body is changing. One of those changes is that your vagina and vulva will start to feel different—there will probably be some fluid that you didn’t have before. That fluid is called discharge, and it is completely normal, and can even tell you some important things about how your body is feeling!”

“I choose to wear panty liners in my underwear because I prefer to have the panty liners catch my discharge instead of my underwear. You can wear panty liners if you want, but you do not have to.”

“You mentioned that you noticed your underwear changing colors—that is from vaginal discharge. Most people have discharge that is somewhat acidic, and when it comes into contact with the fabric of the underwear, it can bleach the fabric a little bit, making it lighter. If you don’t want that to happen to your favorite dark undies, we can get you some panty liners to protect them, if you’d like.”

Puberty Prep

Middle Childhood (ages 8 or 9+)

As your child approaches the age where a period is likely to start (as early as age eight or nine, but generally speaking around age eleven or twelve), it is helpful to discuss what to do if their period starts when they are away from home. Consider assembling a Period Preparedness Pack to keep in their bookbag—a spare pair of underwear, a pad, some wipes, and a pair of comfy leggings/shorts that go with anything (I’m a big fan of black leggings for this purpose). This is one of those situations where humor can go a long way toward making upcoming changes feel much more approachable and less scary. Maybe you can give the pack a special or silly name, like “the go bag,” “Triple P,” “Janitor’s Keys,” both to remove some of the gravitas of having to pack these items, but also to increase your child’s sense of agency and privacy. Only they get to decide if they are going to explain why they are carrying an “aisle 7” (as in “cleanup on aisle seven!”) in their bag—to everyone else, it’s a mystery.

“Alrighty, let’s make sure your school bag is packed and ready! You have your books, pencils, take-home folder … Got your aisle seven? Perfect. Sounds like you’re all set!”

“Hey, kiddo—I noticed that you have been saying you’re extra tired and that your tummy hurts. You are getting closer to the age where puberty starts, and sometimes before a kid gets their first period they can have some signs to let them know it’s coming. Some of those signs include being tired, having cramps, have sore breasts, feeling like your emotions are taking control of your brain, and your hair or skin acting different than you’re used to. Remember where the period stuff is, and if you need anything, you can ask me or any of your other safe adults.”

Body Odor (ages 9+)

Body odor is another topic that is very charged with people’s emotions and morals—we all have thoughts and opinions about how people should or shouldn’t smell and what lengths they should go to to meet those ideals. When discussing body odor with kids, it is helpful to highlight their ability to choose their own path and manage their own goals. While we are trying to maintain neutrality about the body—odor is a fact of life—we also must acknowledge that we live in a society where our location and culture will influence how we feel, and how the people around us feel, about odor. The following conversation applies to a child who lives where I live—in the Midwest of the United States—but attitudes may be different where you are:

“Hey, sunshine—I wanted to let you know that I bought you some deodorant like the stuff I use. I like it because it doesn’t have aluminum in it, since there is some evidence that the aluminum isn’t good for us, and it helps me feel like the odor my underarms make is not as noticeable as it would be if I didn’t use it. You do not have to use it, but most of your peers will be using something similar soon if they’re not already, and choosing not to use it may be something your classmates comment on. If you want a different kind or a different smell, I’m happy to get it for you.”

Emotions (ages 10+)

“As you go through puberty, you might notice that your emotions feel bigger than they used to—you also might find yourself saying things impulsively, reacting really fast to things, and just generally feeling stuff way more than you did before. You also might feel like you’re at odds with me and other grown-ups. Some of that might be due to your amygdala—part of the emotion center of your brain—growing really fast, and when the amygdala is driving the bus, your thinking brain can’t really keep up. I will try my best to remember that this is something you’re going through, and I’d really appreciate it if you can try to remember that your amygdala can be a bit of a jerk. We need to be kind and compassionate with each other and try to keep communicating. I might call your amygdala out when it seems like it’s taken over—I’ll just straight-up say ‘AMYGDALA’ when you’re being a bit much, and that can be our code word for ‘let’s take a breather and talk once emotions have cleared up a bit.’ And you can one thousand percent call me out if I’m chalking things up to your amygdala instead of being a good listener. Sound fair?”

“I also want you to remember that my number one priority is to raise healthy, happy, functional adults. If you are feeling extra down—like you can’t find pleasure in things you used to love, like you can’t enjoy anything, like you don’t want to stick around—or just feel shitty in general, I want you to tell me right away so we can get you the support that you deserve. Sound fair?”

Pick Your Products/Product Options

PREPARING FOR A CHILD to start their period takes way more thought than even I realized. There are all the facts that need to be shared about their changing body, all the dry runs of “what to do when it actually happens,” and then there are the products. Good lord, the products. There are so many options to choose from, and each individual kid is going to have products they like best. The problem, then, is realizing that you have to allow a kid to try multiple things before they settle on what they like best … and that’s freaking expensive. If you have a child who may someday start a period, I recommend setting aside funds for “product experimentation.” Sounds ridiculous to have a savings account just to pay the Pink Tax, but it’s a genuine suggestion, especially since some reusable products, such as some period underwear, can cost in the neighborhood of $50.

I’ve been having my period for over twenty-five years at this point, and and I can still find myself overwhelmed when I walk into the “feminine care aisle.” If this is a dizzying experience for an adult, it must be wildly confusing for kids. Thanks to advertising, pads and tampons are fairly well known, but what about menstrual cups? Discs? Period underwear and washable fabric pads? And each of those products has different subtypes, sizes, and absorbancies! How do you even search for what might work? To help, here is a quick but inexhaustive rundown of the most common products and some things to consider when picking something for your period novice:

Disposable Pads—absorbent and easy to use by sticking to underwear. Special teen-size pads exist for kids who are smaller/newer to having a period. Pads are often the first period product kids will use. Many pads come with wings to prevent shifting and increase coverage. Pads vary in absorbency from light (panty liners, don’t hold much liquid) to overnight (meant to be worn for up to 10 hours and hold a significant amount of liquid). Several different varieties and materials, but all have a limited number of hours that they can be worn before they become unsafe/ineffective and potentially harmful. When they are done being used they should be removed from the underwear and disposed of in the trash. Never flush period products down the toilet, because they can clog the pipes.

Cloth Pads—Very similar to disposable store-bought pads, but washable and reusable. They typically have snaps on the winged parts that help them stay in the underwear. They are made of very absorbent materials like bamboo and have a water-resistant or waterproof backing to protect undergarments and clothes. They can be somewhat expensive and do require special care, but when laundered correctly, they are a cost-effective and eco-friendly alternative to other types of pads.

Tampons—These are typically made of cotton, rayon, or a blend of the two fibers and are made to be inserted into the vagina to absorb menstrual blood. Like pads, they come in many different sizes, absorbencies, and brands. They also come in both nonapplicator types (which must be inserted using your fingers) and varieties with a paper or plastic applicator. Tampons can be particularly helpful during times when the wearer needs to be very active or will be in the water. They can have a steeper learning curve than pads and may require several different tries to find ones that are comfortable and that work. They also must be changed frequently (every 4 to 8 hours), as they carry a risk of complications like toxic shock syndrome (see page 119). Must be disposed of in the trash—never flushed.

Period Underwear—Similar to cloth pads, these are reusable, come in different absorbencies, and require special laundering. Styles vary between brands, and sizing can be tricky. There are usually resources for care and cleaning tips on the manufacturer’s website. These can be particularly helpful for individuals with sensory sensitivity to pads and other products, and can be a more positive experience for individuals whose gender doesn’t align with “feminine products.”

Menstrual Cups—These products are reusable, and come in lots of different sizes and styles, including a wide spectrum of hardness to softness. Menstrual cups are able to hold several hours of menstrual blood, so they’re helpful on active days or days spent in the water. Similar to menstrual discs, these cups can take getting used to. The most common complaint, after difficulty finding the correct size, is that they can be difficult to insert—there are numerous different folds and techniques to try. Applicators do exist, but most cups do not come with an applicator. Unlike menstrual discs, cups create a seal with the cervix so removal is done in a specific way so as not to cause pain. Instructions for insertion and removal are generally available with the product and can also be found online. This option can be costly up front, particularly when trying to find the right fit, but once a fit has been found, the product is long-lasting and can save significant funds over time. Care and maintenance usually include washing the cup and sanitizing it occasionally, as well as using wipes. Like other insertable products, these can be associated with complications like toxic shock syndrome or forgotten insertion, though menstrual cups are somewhat more difficult to forget than tampons.

Menstrual Discs—Reusable or disposable depending on the brand, menstrual discs are an insertable device similar to a menstrual cup but flatter. They can be helpful for people with a shortened vaginal canal. They come in different sizes and can take some getting used to; similar to menstrual cups, it can be costly to find the right one. They can hold several hours’ worth of menstrual blood, so they can be helpful on very active days or days spent in the water.

Breast Discomfort

Middle Childhood (ages 8 to 9+)

“As you get closer to puberty, your breasts and nipples may get sore as they grow and change. They may also get tender on the days around your period. If you are having some of this discomfort, we can help in a few different ways—by trying different types of bras or different support, using cool compresses, and self-massage. Remember, self-massage should only be in private, and if it’s hard to keep yourself comfortable without self-massage, we can find other ways to help you like sweatshirts, camisoles, or bras with some additional padding. You may also notice that your nipples get tender or more sensitive when they get cold. These changes can be really uncomfortable but also really exciting for your body, so we just need to keep checking in and making sure that you are feeling your best.”

Once Periods Have Happened, or Conversations for Adolescents

I was watching a lovely television show—Call the Midwife—recently, and I was reminded how infrequently people in previous generations discussed body functions, particularly menstruation. I then reflected on my own experience as a young person, and realized that the shroud of mystery and shame, while lessened, definitely still exists. This secrecy was part of what prompted me to identify exactly how I propose talking to older teens about menstruation. My approach requires acknowledging that just because someone has had a period doesn’t mean they don’t have questions about menstruation or need support.

“Hey, kiddo, you know a lot about how periods work, but I wanted to remind you that if there’s ever anything you think might be wrong, you really should come to me and let me know. Or go to another one of your safe adults, that’s okay, too. If you get to fourteen or fifteen and you haven’t had your period yet, let me know. Maybe we can get that checked out.”

“Just a reminder—if you have anything that feels weird or off, please tell me. If you’re itchy or sore, let me know. There can be lots of things going on, but also you might have a yeast infection. Having a vulva and vagina can be a lot to figure out, and I don’t expect you to try to navigate all of this all by yourself. I’ve done it, and I’ve been doing it for a lot of years, so I can totally help you understand what might be going on with your body. And I can also help you find help if you need it.”

Body and Product FAQs

I don’t want to wear tampons because they feel weird and/or hurt. Am I doing something wrong?

It’s not a matter of doing something wrong, it’s a matter of practice and fit. You’re right—your tampon shouldn’t hurt. It might be that the angle isn’t quite right—try adjusting the angle that you use to put it in. It may be that you have a shorter vaginal canal and either need to use a smaller product or to adjust the tampon to sit so it’s not poking your cervix. Either way, you can practice putting them in with a little bit of lubricant and see if you can find a way that is consistently comfortable. And if not, we can find you an alternative!

What do I do if I’m not sure if I left a tampon/disc/cup in?

That can be a medical emergency, so it’s important to take a few steps as quickly as you think of it: First, use a finger to see if you can feel the string of your tampon/lip of your disc/stem of your cup. If you can, great! You can pull it out. If you can’t find the string/lip/stem and you’re still worried you left one in, use a hand mirror to check if you can see anything in your vagina or anything you could grasp for removal. If you can’t see anything, then it’s probably a good idea for us to make an appointment with your doctor so we can make sure you don’t end up with an infection or toxic shock syndrome.

Okay, but what is toxic shock syndrome?