What the first period is actually like

Most bleed for two to seven days at menarche. Flow is commonly light to moderate and can be brown or rust-coloured rather than red, particularly at the start and end — that is old blood, not a problem. The second period may arrive anywhere from a few weeks to several months later, and the interval between the first and second cycle is typically the longest of all.

Cramping may or may not be present at the very first periods. Primary dysmenorrhea usually begins six to twenty-four months after menarche, once cycles become ovulatory — so pain that appears a year or two in is expected physiology, not a new problem. Pain that is disabling from the very first period, or that does not respond to anti-inflammatories, is a different matter and is covered by the Period Pain Navigator.Severe dysmenorrhea from menarche onward, or refractory to NSAIDs and hormonal suppression, warrants consideration of obstructive Müllerian anomaly and adolescent endometriosis rather than escalation of analgesia alone.