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My daughter with anxiety issues is worried about getting her period. What can I do?

Try to be factual and reassuring 

Rachel Busman, PsyD

Co-Director, Selective Mutism Program, Anxiety and Mood Disorders Center
Child Mind Institute

Q:  My daughter is 10 years old and is diagnosed with Generalized Anxiety Disorder, Selective Mutism and Panic Disorder. I have been trying to explain that she will be getting her period soon and that she shouldn't worry too much about it but I know she is freaked out about the idea of blood coming from her body. How do I prepare her for it without scaring her too much? Should I speak to her therapist about it or should I use books on the topic? I'd appreciate any advice you could give me.

A:  It's important to start by finding out exactly what your daughter's fears or concerns are. Has your daughter actually articulated that she's worried about menstruating? I ask this because sometimes we can underestimate a child's ability to cope with things, and I've worked with many girls who have anxiety disorders but weren't inappropriately worried about starting their period. Your first step should be to have a frank conversation with your daughter to determine exactly what her fears and expectations are.

If your daughter is afraid of starting her period or blood coming from her body, then you should discuss these fears with her therapist. Her therapist is there not only to talk about her original issues but also to discuss any new fears that surface along the way. I would even suggest that you make a separate appointment without your daughter to work on building a plan that makes her period seem less scary. Hopefully the therapist knows your daughter very well, and he or she should be in a great position to offer you support and guidance on how to talk with your daughter about puberty. If you think your daughter would be interested in a book, ask her therapist for a recommendation. Sometimes, school health programs may have good suggestions as well.

When you're talking to your daughter about her period, make sure that you answer her questions with honest, age-appropriate answers, correcting any myths and avoiding euphemisms like "becoming a woman" which can be confusing. Most importantly, you want to normalize her period—explain that this is something that happens to every girl and it isn't dangerous.  

It's also a good idea to come up with a plan for what she should do when her period starts. Make sure she knows where to find the sanitary pads in your house and let her know she can always talk to the school nurse if she needs help.

Puberty naturally brings questions, so talking about it shouldn't be a one-time thing. Try to have a series of conversations with your daughter about all the new things going on in her life. For anxious kids especially you want to be both factual and reassuring. Having regular, comfortable conversations should help.

Published: December 4, 2012

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