WHAT YOU NEED TO KNOW:

What do I need to know about menstruation?

• Menstruation is also called your monthly period. Menstruation usually starts at about 12 years old. Some girls may have their first period as early as 9 years of age or as late as 16 years or older. Menopause is the time when menstruations stops. This usually happens around 50 years of age.
  
  
• Menstruation is part of a cycle that helps prepare your body for pregnancy. During your menstrual cycle each month, your hormone levels increase. The lining of your uterus becomes thicker, and ovulation happens. Ovulation is when your ovaries release an egg. If the egg does not get fertilized, the lining of your uterus sheds and menstruation happens. Menstruation usually happens every 21 to 28 days.

What happens each month? Each period may last for 2 to 7 days and can be light, moderate, or heavy. The total amount of blood loss may be 1 to 4 tablespoons (20 to 60 milliliters) for the whole menstrual period. This amount may be different among women and it may be different for you from one period to another.

What symptoms may I have before my period starts? These symptoms are part of premenstrual syndrome (PMS) and usually go away when your period starts. Ask your healthcare provider for more information about any of the following:

• Mood changes such as feeling irritated, sad, or emotional
  
  
• Breast swelling or soreness
  
  
• Feeling bloated
  
  
• Tiredness
  
  
• Headache
  
  
• Problems with sleep
  
  
• Dizziness
  
  
• Nausea

How can I care for myself during menstruation?

• NSAIDs, such as ibuprofen, help decrease PMS symptoms. This medicine is available with or without a doctor's order. Take them as directed. NSAIDs can cause stomach bleeding or kidney problems in certain people. If you take blood thinner medicine, always ask your healthcare provider if NSAIDs are safe for you. Always read the medicine label and follow directions.
  
  
• Use tampons or sanitary pads. Read the instructions carefully or ask how to use tampons or sanitary pads.
  • Always wash your hands before you put in a new tampon to prevent infection. Wash your hands after you change pads or tampons.
    
    
  • Change your pad or tampon about every 3 to 4 hours to keep the blood from soaking through your clothes. Change your tampon often to help prevent toxic shock syndrome (TSS). This rare condition is caused by a bacteria and may be related to leaving a tampon in for a long time. Alternate tampons and pads during the day. Use sanitary pads at night. This may help prevent TSS.
    
    
  • Wrap toilet paper around the pad or tampon and throw it in the trash. Do not flush the pad or tampon down the toilet. It can block up sewer lines.

What is toxic shock syndrome (TSS)? TSS is a rare condition caused by a bacteria and may be related to leaving a tampon in for a long time. Alternate tampons and pads during the day. Use sanitary pads at night. This may help prevent TSS.

When should I seek immediate care?

• You have severe abdominal cramps.
  
  
• You have any of the following during or after you use tampons:
  • Fever and chills
    
    
  • Diarrhea
    
    
  • Vomiting
    
    
  • Lightheadedness or confusion
    
    
  • A rash
    
    
  • Muscle aches

When should I contact my healthcare provider?

• You change pads or tampons every 1 hour or more often.
  
  
• You skip periods or they are irregular.
  
  
• Your periods last longer than 7 days.
  
  
• You periods occur more often than every 21 days or less often than every 45 days.
  
  
• You have questions or concerns about your condition or care.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.