(Photo by S.E.R.G.O/ thinkstock.com)
There’s no doubt about it: Periods aren’t fun. From pesky PMS to tampon woes, getting your period every month can make you feel more like curling up in bed than taking ballet class. But the more you know, the more pain- and mess-free your period can be. Whether you’re waiting to get it or have had it for years, you probably have some questions—and we have the answers.
TIMING IS EVERYTHING.
All my friends have gotten their periods, but I’m still waiting for mine. Why?
Don’t assume there’s something wrong. The average age to get a first period in the U.S. is 12.3 years old, and anywhere from 10 to 15 years old is perfectly normal. For a good prediction, ask your mom when she got hers. Besides genetics, another good indicator is weight: Since body fat secretes estrogen, heavier girls may get their periods earlier. For thin dancers under 13 who haven’t gotten their periods yet, other indicators of puberty—like breast development and pubic hair—are signs everything is most likely A-OK.
Dancers who are too thin could see a delay in menstruation that’s not healthy. “If you’re not getting enough calories, you could have hypothalamic hypogonadism or hypothalamic amenorrhea, which a lot of dancers get when they’re underweight,” says obstetrician/gyne-
cologist Dr. Leah Millheiser, clinical assistant professor at Stanford University Medical Center. These conditions could lead to further complications in your future, including osteoporosis and infertility. Millheiser adds that there are also certain chromosomal abnormalities that can cause a lack of menstruation. If you’re 15 and haven’t had a period, it’s worth seeing a doctor to get evaluated, just in case something is wrong.
Keep track of your periods. Ideally, they should begin 24 to 38 days apart and last between three and seven days. (Photo by Otto Kalman/thinkstock.com)
I know periods should come once a month, but mine seem totally random. Is that normal?
It’s not unusual to be irregular for the first couple years after starting your period. “Once you start menstruating, if you’re getting a period at least every three months, there’s nothing you need to worry about besides the inconvenience factor,” says Dr. Lauren Streicher, a gynecologist and associate professor at Northwestern University’s Feinberg School of Medicine. “But if you’re going longer than three months without a period, get an evaluation to make sure there isn’t anything serious going on.” Once you’ve been menstruating for a few years, your periods should even out. At that point, anywhere from 24 to 38 days between the first days of each period is considered normal.
How long should a period last?
“In general, a period should range from three to seven days, but some people’s periods are shorter, and some are longer,” says Dr. Diana Wang, an obstetrician/gynecologist at Austin Area OB/GYN in Austin, TX. “Remember, we’re not robots, so there’s a range that’s within normal.” If your period lasts more than eight days, mention it to your doctor.
I’ve heard that friends will “sync up” and get their periods at the same time. Is that true?
“Misery loves company” actually does apply when it comes to your period. “There are pheromones women give off that can cause them to cycle together,” Millheiser says. “For example, if two girls are roommates in college and neither of them are on hormonal birth control, over the course of the first year, you often see those girls getting their periods at the same time.”
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How can I keep from acting like a brat in the days leading up to my period?
Your hormones may go a little haywire the week before your period. You may cry more easily or snap at the tiniest things. For most people, simple fixes like getting extra exercise can relieve these symptoms. It helps to realize what’s happening and to take a second to breathe when you feel yourself getting worked up. If your premenstrual moodiness goes beyond a little irritability, there may be something else going on. “There’s a difference between premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD), which can cause women to become clinically depressed for the two weeks prior to their periods,” Millheiser says. “The important distinction is that those with PMDD will have significant symptoms that affect their jobs, schoolwork and relationships, but then feel fine after their periods. If you feel your life is being disrupted, talk to a doctor about hormone treatment, like birth control pills.”
Cramps are making me miserable! How can I cope?
Most people only cramp for the first couple days of their periods. When this happens, take ibuprofen or acetaminophen and use a heating pad, and you should feel some relief. “If you have to stay home from school, can’t dance or can’t function, talk to your doctor for other solutions,” says Streicher. “The worst-case scenario is endometriosis, a condition in which the glands that normally line the uterus are other places in the pelvis. That can cause very painful periods.”
I get so bloated during my period that I’m embarrassed to put on a leotard. What can I do?
Often, girls’ bodies retain extra salt during their periods, making them gain noticeable bulk around the middle. “It won’t help to stop drinking water,” Millheiser says. “Bloating is going to happen regardless, and it’s important for dancers to keep hydrating even if they’ve gained a little water weight.” Instead, limit the amount of salt you eat.
During my period, I have to go to the bathroom a lot (number 1 and number 2). Is that normal?
A side effect of all that bloating may be having to run to the bathroom to get rid of excess fluid. “Some women also experience mild diarrhea, which isn’t unusual,” Streicher says. “If you’re having terrible diarrhea with horrible cramps, it’s time to call your doctor.”
It seems like I’m losing too much blood. How heavy should my period be?
In general, you shouldn’t need to use more than six pads or six tampons per day. For periods heavier than that, Wang says she’ll sometimes prescribe hormonal contraception, like birth control pills, to quell the bleeding. “Birth control pills can help with many period symptoms,” she says. “That includes extremely heavy periods, severe cramping and even moodiness and bloating.”
Why is my period sometimes more brown than red—and what are those lumps?
Your period will probably be dark red on its heaviest days and brown or pink on lighter days. Streicher adds: “During your period, you’re shedding the inner layer of the uterus, so if there’s the occasional small clot or something that looks tissue-y, that’s fine.”
(Photo by Matka Wariatka/thinkstock.com)
I hate wearing a bulky pad to class, but putting a tampon in is uncomfortable—even painful. Any advice?
If you’re having trouble inserting a tampon, try lying on your back with your legs spread open while putting it in. “You may have to push it in farther than you think,” Streicher says. “Your tampon can’t get lost up there. And it will hurt if it’s not in far enough.”
If you’re experiencing extreme pain and can’t push it in at all, see your doctor. There are several possible explanations, including a physical blockage to the entrance of your vagina.
If I leave my tampon in overnight, will I get toxic shock syndrome?
“Sleeping with a tampon is fine—but don’t forget it’s in there,” says Streicher. Opt for a pad if you plan on snoozing for more than eight hours. Toxic shock syndrome (TSS) is a bacterial infection that’s incredibly rare but potentially life-threatening, which is why many tampon boxes warn to change your tampon about every four hours during the day.
If you’re a dancer whose menstrual cycle has stopped, you could be wondering what’s happening. Are you pregnant? Is it early menopause? You may even be thinking, “Big deal, so I don’t get my period.” But it is a big deal, not only for overall health, but also for the future of your dance career. Besides leading to reproductive problems and osteoporosis, amenorrhea, the condition in which your body refuses to menstruate, may increase susceptibility to stress fractures.
There are two types of amenorrhea: primary and secondary. Primary amenorrhea occurs when a woman hasn’t had her first period by age 16. Secondary amenorrhea, more common among dancers who train long and hard, occurs when regular periods stop for three months or longer. Up to 30 percent of classical dancers have stopped or will stop getting their periods at some point in their careers, says Dr. Michelle P. Warren, a professor of women’s health in the department of obstetrics and gynecology at Columbia University who has studied this condition for 20 years.
Address the Causes
Reduced caloric intake, over-exercising and stress are typical causes of amenorrhea. “The body has a way of picking up when there aren’t enough calories around, [so] it shuts down reproduction,” says Warren. In other words, if your caloric intake is too low to sustain your activity level, your body will divert calories from reproduction to fuel vital organs.
Spending long days training in the studio is part of being a dancer, so exercising less in order to restart your menstrual cycle may not be an option for you. There are other ways to address the issue, however. Increasing caloric intake, especially from such nutrient-rich foods as red meat, spinach and yogurt, can stop amenorrhea by sending the appropriate signals to your ovaries to restart the cycle. Eating consistently, never skipping meals and avoiding yo-yo diets will also help to keep periods regular. Manage your stress with yoga, massage and relaxing baths. Also avoid using supplements as meal replacements. According to Warren, there’s a high incidence of fractures in women who replace food with supplements, because nutrients aren’t absorbed as well from supplements as they are from food.
Failure to reproduce is an obvious side effect of irregular periods, but amenorrhea can also interfere with the amount of calcium deposited in your bones, even if your diet is high in calcium. For young dancers, it’s especially important to build bone density, because bone growth stops after about age 25. (The exact age varies according to the individual.) If irregular periods cause your body to build less bone than it should before you stop growing, the chances of stress fracture and early osteoporosis rise.
While calcium is vital for healthy bones, protein is just as important. Studies have shown a correlation between low protein intake and low bone mass. “In an effort to keep weight down, I see young dancers who are vegetarians, and you have to be very careful on this diet because it’s hard to get enough protein,” Warren explains. “You can’t just make trips to the salad bar and expect to be on a well-balanced diet.” Lean meats such as chicken and fish are good protein foods, however, these don’t provide enough iron, another valuable nutrient that promotes growth and maintains high energy levels. Warren recommends eating spinach and parsley and cooking in iron skillets. Vegetarians may even need to consider eating red meat—if only in small amounts. “I usually ask [my patients] if they would consider eating at least three ounces of red meat at least three to four times a week,” says Warren. Amenorrheic vegetarians can also strategize with their nutritionists on ways to increase protein without eating meat.
Luckily, secondary amenorrhea is reversible in most cases with diet change and lower stress. If your periods don’t return within three months (barring pregnancy), schedule an appointment with your ob/gyn immediately.