Primary Amenorrhea: A Teen’s Guide to Your First Period

Starting your period is both exciting and terrifying. You dread it but you also want it to start. While you usually don’t want to start, you don’t want to be the last to start. 

So, what does it mean if you don’t start your periods? We’ve got the answers you need.

When Should Your Periods Start…and What Is Primary Amenorrhea?

I’ll start with what is considered average, or normal.  

The average age in America to start your period is about 12 years old, but it can be anywhere from 11 to 14 years old. Doctors call when you start your first period “menarche.” 

Most girls don’t start out having regular periods. It can take 1-2 years to settle into regular cycles. Doctors consider periods normal when they occur anywhere from 22-35 days apart. Most young ladies will get regular by the time they are 19 years old.  The typical cycle can last from 2-7 days. 

Primary amenorrhea occurs when someone is over the age of 15 and has never had their first period. 

What Happens During Your Period?

There is a lot that must happen to start your period:

• The brain tells your ovaries to release an egg. 
• The ovaries then send hormone signals to the uterus. 
• Your uterus responds to the signals to grow the lining that will accept the fertilized egg. 
• If the egg is not fertilized, you shed that lining, meaning you have your period. All those signals need to be perfect. 
• You must have all the proper anatomy. 
• You must have the proper ratio of body weight to body fat. 

What Do You Do If You Have Not Started Your Period? 

If you have not started your period by the age of 16, you should tell your pediatrician. This could be a sign of primary amenorrhea. The pediatrician will send you to see a gynecologist, a doctor who specializes in treating only females and the reproductive tract. 

Our gynecologist will ask lots of questions and may want to draw blood (it doesn’t hurt). 

You should always tell the truth to your doctor. It may be embarrassing, but we can’t help if we don’t know all the facts. They might need to look at your vagina. There will always be a chaperone, a nurse or a parent or a family member, present when an exam is done. 

ALWAYS remember, no one has the right to touch you without your permission, doctors included!

Once we have all the first set of results, we might know the reason. Sometimes, we must do more blood work (sorry). Once we figure out the cause, we will be able to figure out if you need treatment. Sometimes the only thing you need is more time. If we know nothing is “wrong”, we can decide what to do for you. 

Dallas OBGYNPA: Caring For You Through All Of Life’s Stages

So, why do we care? Not starting your period can mean various things: 

• We want to make sure the cause will not affect your ability to have a successful pregnancy, when/if YOU want to be pregnant. 
• It means you may have primary amenorrhea.
• It can affect your overall growth. 
• It can mean something more serious is happening that we can fix. 

No matter the cause, there is nothing “wrong” with you! We are all individuals and unique. We want you to be the best, most amazing version of you. Just contact us for an appointment.

The content within this article and others on this website is only for educational purposes and should not be considered as medical advice. For any questions or concerns, please consult with your healthcare provider.