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"Menarche" is the term given to the time in a female’s life when menstruation first begins. Typically, this happens between twelve and thirteen years of age, but anywhere between nine and eighteen is considered normal. During these years when young women are beginning to menstruate, they experience a range of physical and emotional changes. For some, these changes happen with no obvious problems, whilst for other girls, there may be an array of issues and symptoms and as a result they may have difficulty coping.
Depression and anxiety are the most common mood changes experienced during the years when the menstrual cycle and hormones are becoming established and regular. This can be related to the hormonal fluctuations or to other factors which become harder to deal with because of the additional stressors of puberty.
PMS is the combination of symptoms that woman may experience a week or so before their period. Symptoms appear before the period starts and will often disappear as soon as the period begins or soon after. Symptoms can affect both the body and the brain and the intensity of these symptoms can vary from person to person.
There are a wide variety of symptoms that young woman may experience at the time of their period. These include the following.
Abdominal bloating, acne, anxiety, clumsiness, confusion, depression and lowered mood, difficulties in concentration, memory lapses, digestive upsets (constipation and diarrhoea), drop in self-esteem and confidence, fluid retention, food cravings, headache and migraine, increased appetite, irritability, mood swings, weepiness, sleep changes (insomnia or excessive sleepiness), and swollen and tender breasts.
In addition to all these physical and mental changes comes a dramatic increase in the nutrient requirement for young woman as rapid physical maturation and growth are taking place. This means that a young woman’s mineral requirements escalate dramatically and calcium, magnesium, iron and zinc are in especially high demand and it can also mean that deficiencies in any given nutrient can cause particular PMS symptoms.
Calcium is essential during puberty because of the rapid growth of bones. A young woman’s calcium requirements increase by 50% during these years. Calcium is better absorbed and maintained in bone when magnesium intake is at a sufficient level also. Calcium supplements can relieve water retention, mood changes, food cravings, and pain in young girls with PMS. When combined with Vitamin D, calcium also helps improve menstrual migraines. The Recommended Dietary Allowance (RDA) for calcium for girls between 9-18 years is 1300 milligrams per day.
Magnesium deficiency has been associated with depression and depleted levels of dopamine. Dopamine improves feelings of alertness and relaxation, but low levels can lead to tension, irritability and anxiety. Magnesium is also necessary for normal sugar metabolism. A deficiency leads to increased insulin secretion and may cause blood sugar instability premenstrually. Magnesium supplementation can therefore help reduce PMS symptoms such as aches and pains, depression, irritability, mood swings and fluid retention. Magnesium deficiency has been linked to menstrual headaches and migraines, particularly when calcium levels are relatively high in relation to magnesium.
The RDI for 9-18 year old girls is 240-360 milligrams per day.
Iron is vital for transporting oxygen in the bloodstream. With the onset of menstruation comes the additional iron needs for girls.
Iron deficiency is very common in young girls and is associated with anaemia, fatigue, reduced resistance to infection, dizziness, faintness and poor concentration. This need for iron increases as a direct consequence of rapid growth and the expansion of blood volume and muscle mass. As young woman’s bodies change and they gain muscle mass, more iron is needed to help their new muscle cells obtain oxygen for energy.
The RDA for iron is between 10-15 milligrams per day.
Zinc plays a vital role in the metabolism of hormones linked to sexual maturation and growth and the biochemical functions of various endocrine organs. It is especially important for its role in helping to prevent the development of acne and can be especially useful when acne is excessively inflamed as it also a key component of collagen. Additionally, zinc is necessary for the formation of insulin and therefore helps prevent sugar cravings and blood sugar fluctuations. The RDA for females between 14-18 years of age is 9mg day.
Hormone modulation is a helpful first line of treatment for those women who have symptoms of PMS. There are a number of herbs that can regulate these hormonal changes and help with symptom relief. For general hormone regulation use Vitex agnus castus (chaste tree) and Paeonia lactiflora (paeonia) indicated for mood swings, fatigue, breast fullness or heaviness and abdominal bloating.
Menarche can be a challenging time for a young woman and parents alike. Relationships with teenagers can be strained as they strive for independance and the additional hormonal changes can add to the stress.
Listed below are a number of tips that can be implemented in order to help young woman and parents to cope with the changes that menarche may bring.
Make sure you don’t dismiss any concerns, however trivial they may seem to you, they may be important to her and teenagers are often easily embarrassed.