We’ve all been talking about this for years… girls seem to be getting their first periods earlier than their parents and grandparents.  A new study in the JAMA Network Open highlights some trends and possible reasons for early menstruation. 

Among the findings:

-The trend toward earlier periods appears across all demographics, but it is much more pronounced among racial and ethnic minorities and those from poor families. -More girls are taking longer to reach regular menstrual cycles, and irregular cycles are associated with several health issues, including polycystic ovary syndrome (PCOS)

-Early age of first menstruation is linked to several adverse health risk factors, including a higher risk of cardiovascular disease, obesity, miscarriage, and early death, as well as several cancers, including ovarian, endometrial, and breast.


The flood of news reports about this study offers insight into possible causes and outcomes and some point to guidance for parents in the wake of the findings. Parents critically need this information to be aware of their part in helping their children get adequate sleep, nutrition, medical interventions, etc. But the real target of this report must be our American institutions, including our healthcare and education systems, that fail these exact families, at every turn. These findings are a result of the systemic racism that persists in medical care and school curricula and our failure to meet the most basic needs in our communities. Our focus should be on:

-Ensuring every reproductive health curriculum includes period health lessons that teach safe management of periods, a basic understanding of menstrual-related conditions, and linking all of that to overall and future health;

-Enshrining the use of the menstrual cycle as a vital sign in policy employed by pediatricians. The American Academy of Pediatricians has endorsed the policy but Marni Sommer, DrPH, RN, professor of Sociomedical Sciences at Columbia’s Mailman School of Public Health, points to a recent survey that “suggests that many pediatricians may not routinely provide any guidance on the menstrual cycle, ask about the last menstrual period, or discuss menstruation at all.” Sommer links some of this to the limited time pediatricians have with patients, and she and her colleagues have offered guidance on prioritizing menstrual health for adolescents.

-Eradicating period stigma. Many parents are embarrassed to discuss periods, their own or their child’s, even with a medical professional. Generations have been taught, overtly or through societal norms, that periods are private. Having their own symptoms minimized or their own menstrual cycles ignored has a profound effect on a parent’s comfort and ability to deal with their child’s well-being as measured through menstrual health. 

Reproductive health education is important not just for those who get periods but for all people. Being aware of and sensitive to the process and the complications creates empathy and can help ease the stigma surrounding periods.

Demystifying Menstruation: Understanding Periods and the Menstrual Cycle


The causes and implications of earlier onset of menstruation in children are vast. We all have something to offer in making changes that will positively impact the health of those who get periods. Here are some things every one of us can do:

-Talk with kids (all of them, regardless of gender) about periods. Reducing stigma and creating allies is critical to any change. Change in the education and medical systems will take decades. In the meantime, we must empower individuals to care and advocate for themselves.

-Get period products in all the public spaces you use. Workplaces, schools, etc., all should have freely available basic supplies, just like toilet paper.

-Look more closely at the institutions where you work or learn. Engage with those who are traditionally on the outside to see how your influence can improve their experiences and how their input can elevate yours.

The potential outcomes of not seeing this kind of report and making changes are clear and devastating. While we need to rethink whole systems to make long-term systemic change, there are things we can and must do now.