Menarche

Menarche is one of the most important biologic signals in the life of a woman. Its importance is reflected by the wide attention which this theme has provoked in today's psychologic and anthropologic literature. Educational points should play their role next to the humanistic value of cyclic bleeding in the female self-assurance. Education for understanding of menstruation should stress that it primarily expresses femininity and should avoid depicting menstrual bleedings as a repetitive nuisance. The timing of menarche is determined by reaching a certain body weight. It is the adipose tissue of the adolescent girl that takes in many ways part in the synchronization of the future reproductive functions. In comparison to what has been observed through the past centuries, growth and bodily maturation of young girls is accelerated today. That acceleration depends rather on nutritional factors from early childhood than on a so-called trauma of urbanization. When girls experience their first menstruation, affirmative as well as negative attitudes can be observed. Hygienic details should be addressed when menarche is impending. Pads (sanitary towels) are first choice, but under particular circumstances tampons may be used as well. The description of toxic-shock syndrome after tampons were left intravaginally was a scientific hit a decade ago, but this syndrome does not play an important role in Europe and never has. However, long duration and/or severity of bleeding should prompt a differentiated diagnosis and certainly calls for medical control.