My first period never arrived, even though I was a teenager. what is the reason?

The first menstruation or what is called menarche is the first bleeding from the uterus that occurs in a young woman. Menarche is a sign that a young woman is entering the maturity stage of her sexual organs. For some children, menstruation or their first period can be late, unlike other friends. This may leave parents wondering. What is the real reason why the child's first menstruation hasn't come?

The average age at first menstruation occurs approx ages 9-16 years. If menarche has not occurred until the age of 17 years and over, you should consult your doctor. However, if your child hasn't turned 17 years old, there's no need to worry. Basically, every child has a different pattern of growth and development.

Why doesn't the child's first period come?

There are a number of factors that influence when a girl will get her first period. Among others are:

1. Heredity

The pattern of growth and family development can also affect the difference in when your child menarche with their peers. Girls who will start menstruating are usually not very different from the age of their mother or grandmother or sister when they first started menstruating.

If there is a history like this, there is usually no need for special treatment, menarche will occur automatically when the time comes. As long as it's still within the normal age range for menarche you don't need to worry.

2. Currently undergoing treatment

Drug consumption can also affect the age at which menarche occurs. Research in the Journal of Clinical Endocrinology Metabolism shows that treatment with metformin (for diabetic patients) at the age of 8-12 years can have the effect of delaying the age of the first menstruation.

Other medicines can also affect the hormonal cycle of girls, thereby affecting the timing of their first period.

3. Body fat

The amount of fat in a child's body can affect how quickly and slowly the first menstruation occurs. Lack of body fat is a major factor in causing menarche to age more slowly.

Some young women who are on a strict diet are usually at risk of experiencing this reduction in fat. This is because the right amount of fat is needed by the body to regulate hormone levels.

Research in the journal Pediatrics states that the fat levels of girls aged 5-9 years are indeed related to the time of their first menstruation. If the fat content is deficient or too little, it can affect late menarche.

4. Hormones

Hormonal conditions can also affect how fast or slow menarche is. Reporting from Pediatric Endocrinology in 2014, the lack of hormones called LH and FSH or also known as gonadotropin hormones can be one of the causes of late first menstruation.

These two hormones stimulate the development of the gonads, the organs that function in the reproductive process, namely the vagina in women. The hormones LH and FSH are produced from the pituitary gland in the human brain.

5. Lack of physical activity

In the journal Osong Public Health and Research Perspectives in 2016, the arrival of menarche is related to physical activity and sedentary behavior. Lack of active movement will reduce levels of the hormone melatonin. This can then confuse the signals in the brain that function to "command" overall reproductive development, including when the first menstruation occurs.

6. Height

Girls who are stunted due to long-term malnutrition will affect their development when they enter adolescence.

Stunted children tend to remain short throughout adolescence and adulthood. This will affect their reproductive development at puberty.

In the journal Nutrition and Food Research in 2012, adolescents with stunting or short nutritional status experienced menarche later than adolescents with normal nutritional status. Judging from the number, adolescents aged 10-15 years in the normal height group as much as 54.3% percent have experienced menarche. Meanwhile, in the group of adolescents aged 10-15 years who experienced stunting, only 37.8 percent had menarche.

A girl who is tall usually the level of sexual maturity will be reached earlier than girls who are shorter. This is because girls who are taller have better nutritional status, so that they can stimulate hormone growth and spur the arrival of their first menstruation.

7. Socio-economic status

The socioeconomic status of the family can also affect the age of menarche. Research in the Journal of American Science in 2012 shows that the average age of menarche in the city of Mansoura, Egypt is 12.14 years. More girls aged 12 years in the high and middle socioeconomic level groups who have experienced menarche, compared with 12 year old girls at low socioeconomic level.

This is related to the availability of food in the household. Food availability has an impact on the nutritional adequacy of the family, especially the nutrition of girls which can affect the age of menarche.

The availability of food sources that are rich in protein, fat, vitamins and minerals is essential for development and growth during puberty. For example, it was reported in the Annual Review that the lack of intake of animal protein substances such as seeds and nuts was associated with delayed first menstruation.