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The Period Doctor Explains Puberty: What Every Parent Needs to Know

When should you start talking to your child about puberty and periods? What’s actually normal when it comes to cramps, mood changes, and cycle symptoms — and what’s not? In this episode, Dr. Sheryl sits down with pediatric and adolescent gynecologist Dr. Charis Chambers, also known as “The Period Doctor,” for a conversation that every parent of a tween or teen needs to hear. Together, they talk about: - why puberty conversations need to start earlier than most parents think - the signs puberty has already begun - how to talk about periods without shame or fear - what severe period pain can signal - the truth about endometriosis in adolescents - the myths we’ve inherited about girls’ bodies - how parents can help kids feel informed, calm, and connected to their changing bodies This episode is both deeply practical and unexpectedly emotional — especially for parents realizing how little support they themselves received growing up. Thank you to our partners for making this episode possible: - Equip: https://equip.health/goodinside): Learn about Equip's at-home eating disorder treatment at equip.health/goodinside

Dr. Charis Chambersguest
May 13, 202642mWatch on YouTube ↗

EVERY SPOKEN WORD

  1. 0:00 – 0:56

    Intro

    1. SH

      Eating disorders don't always look the way we expect. As parents, sometimes the hardest part isn't noticing something feels off, it's figuring out what to do next. Early support can make a real difference, but finding help is often confusing, slow, or disruptive. That's why I'm excited to tell you about Equip, a virtual eating disorder treatment program that helps your child recover at home with a full care team and support for you as parents every step of the way. Equip treats all eating disorders, works with all ages, has no wait list, and is covered by insurance in all 50 states. If you're worried about your child and don't know where to start, visit equip.health/goodinside to learn more about Equip's eating disorder treatment. That's equip.health/goodinside.

  2. 0:56 – 3:31

    Period pain is underestimated—and it disrupts real life

    1. CC

      One in five folks with periods miss school because of those periods, and even the ones that do make it there are having difficulty focusing and concentrating in the classroom. So we don't have the best understanding of the true impact of period pain. Women, girls, we have been conditioned and, and, and valued according to our ability to have kids. I tell my patients every day, I'm like, "Guess what? I care about you right now. I care about you in eighth grade trying to attend your soccer game. I care about you right now as a freshman in college who just wants to be on the debate team. I care about you today."

    2. SH

      At some point, it becomes part of almost every girl's life. Half the population will go through it. Most will spend decades living with it, and yet somehow we're still wildly underprepared for what it actually means. A kid gets their period, and suddenly everything can feel different. Big emotions, faster reactions, shutdowns, irritability, sometimes things that look like anxiety or even depression. And as parents, we're left trying to figure out, is this just hormones? Is this behavioral? Is something wrong? Welcome to the In Between Years. I'm Dr. Sheryl. No one really teaches us how to understand what's happening in our kids' bodies, or how deeply that can shape what's happening in their emotions. So we either just brush it off, we say, "It's just PMS," or we worry we're missing something serious. Meanwhile, our kids are having a real lived experience, one that they often don't have language for and we don't have a framework for. Today, I'm talking to Dr. Charis Chambers, also known as The Period Doctor. She's a pediatric and adolescent gynecologist, and if you didn't know that was a thing, you're not the only one. She helps young people and their parents actually understand their changing bodies, not just medically, but in a way that connects to mood, behavior, and everyday life. I know I learned so much in this conversation that I didn't know before, and I'm so excited to share it with you today. I'm so lucky 'cause I got a little sneak peek preview, um, of reading The Period and Parenting Revolution.

    3. CC

      Mm-hmm.

  3. 3:31 – 6:51

    Why this work is personal: Dr. Chambers’ mom and first-period ‘rules’

    1. SH

      And I actually wanna, like, before diving into any of that, I wanna, I wanna start from where you start, which is your story about your mom, and I wanna just hear about her, how she impacted your life. I... Let's start there.

    2. CC

      Yes. Oh, I love the idea of starting with my mom because my book starts with my mom, of course, in the story context, but also my dedication is to my mom.

    3. SH

      Mm-hmm.

    4. CC

      Uh, so she is an integral part of this story, of this topic, and of course of me. Um, she's like everything that I, I am, and everything I, um, have achieved, I c- I owe it fully to her. So my mom, just to describe her, was just one of those vibrant people who, um, came from, [laughs] uh, LaGrange, Georgia, and attended Emory University, and elected to pursue a career in law. And so one thing that she shared with me when I was really young was that, uh, while she was a student there, her advisors didn't really think she could do it. Uh, and it was just one of those things where she was always, um, pushing beyond the expectations that other people set for her. And so in that same context, she had four kids, was a practicing attorney, ended up running my father's practice, and was just one of those people who led with such grace and determination. I was taught really young that grace and determination could coexist. Um, and so in my book, I start with telling my mom that there, there's blood, right? And I tell her because she told me to tell her, and I did not wanna get in trouble. So she was also very firm. She was a, a serious mama. Uh, she ran a tight ship, but I also always felt safe with her. And the way in which she responded to my period, I think spoke to a lot of things. It spokes to kind of her progressive mindset, but also her, um, beliefs in what was protective for a young child, for a young Black girl in the South navigating the world with a period. So she gave me the rules that I used to govern my period and to manage my bleeding for years and years. Uh, and she passed away while I was in residency, in OBGYN residency. And so she carried me through every major milestone of my life. Um, and it felt kind of odd because I, I needed to critique it. I needed to have the lens that I have as an expert to say, even though I had the best mom I could have, I could have had better period education, but I also needed the world to know, um, that the grace and love and everything that she gave me was more than I could have really, truly asked for as a child. So my mom is my hero. She's everything to me, and I only wish she could be with me to see this book come to light. Um, but I know that she is proud from, from heaven, so it makes me feel really happy to be her daughter.

    5. SH

      Aw, that's, that's, um, I think it's so sweet, and I think, you know, throughout, um, all of the years of giving this, you know, class that I was giving-

    6. CC

      Mm-hmm

    7. SH

      ... for g- girls and their moms, uh, mostly I will say only moms came, although it was open, right? But only moms came. I have yet to have a dad, um, in the class. But I will say that, um, you know, most people when I say, "Did anybody ever talk to you about getting your period, or talk to you about what puberty was," or, you know, "Did you go to your mom or a parent once you did get your period?" Everybody raises their hands to, "Nobody talked to me," and nobody raises their hand to, "Somebody

  4. 6:51 – 10:10

    How pediatric & adolescent gynecology became her calling

    1. SH

      talked to me," right? Um, so what, what did your mom actually say to you? And the second part of that is, did that actually impact how you then got on the journey, let's say, instead of law, to go into medicine?

    2. CC

      So my mom, um, in the moment said, "Yes, you've started your period." And then the kind of focus shifted because we were headed to the pool. And so I think it's really interesting that when you're thinking about, like, a young teen, tween, you know, my focus was on the activities of that day. I didn't care what this meant for my life. I didn't care about potential for pregnancy, cramp. None of that was at the forefront of my mind. I was like, "So what are we going to do so I can go swimming?" [laughs] Um, and so, and so she just quickly talked with me about how to use a tampon, and so I used a tampon with my very first period, the very first time, and it was fine. I had no issue because I didn't associate any type of taboo or discomfort. My mom said it was fine, and so I used it, and it was fine, and I was grateful to be able to go swimming. So later on, we talked about it in more detail, and the ultimate guidance was, "No one should know you're on your period," and that did stick with me. I think it stuck with me because in that moment, I didn't have, like, the wherewithal to say, "Well, why?" Like, why should no one know you should be on your period? And then just the, you know, the obvious conflict. It was like, "I told you. You told me you should know." So there, there's obviously an exception to that very rule, but you learn very young not to argue with a lawyer. Um, and so I'm like, "Okay, we'll take that." Um, she talked about how to use tampons. Uh, she talked about how to dispose of tampons and just the general, uh, guidance on, on, like, cleanliness of wrapping the pad and all of those things and putting it away in the trash can, other trash can, all those things. And so it just felt like I got new responsibility. It didn't open up the idea of, you know, sexual, uh, attraction or sexuality or, um, even what to really look for, like pain that would be too bad or bleeding that would be too much. There were no parameters given. It was a very, very short list that I governed, you know, appropriately, thinking, "I'm in this secret society of bleeders, and people can't know, so I'm gonna do the best I can to not disappoint my mom." I don't know that that truly impacted me, like, consciously in my choice to go into medicine, but it definitely, um, became something that I reached for when I was exposed to pediatric and adolescent gynecology. So my first exposure to that was as a medical student on a rotation, and I said, "Wait a second, this is a real thing?" And it was us talking to a mother and daughter pair and seeing that the daughter only cared about playing basketball. Like, she just wanted to know what to pack in her away bag for ba- basketball. Like, if this is a white uniform, do I need that? Like, what is that? Her mom was like, "I need to know you're not pregnant." And it was the most interesting dynamic 'cause I was like, I love this cross-generational space. And so it made me think about my period experience. I was like, "Wait, that's what my mom told me. There is room here. Like, even my mom didn't quite get it right, and this mom wants to get it right, but she doesn't have the tools." I think that's the first time the seed was planted, honestly, for this book. At that time, I didn't know. I was a med student. You're just trying to survive. But that gap between became very clear, and just for me, it was more of an opportunity than a gap. So that was a long way of saying yes and kind of no. [laughs]

  5. 10:10 – 12:13

    “You’re a what?”—what pediatric/adolescent gynecology actually is

    1. SH

      Yeah. You know, I wanted to say to you, the first time I ever heard the term, now I remember, 'cause you said pediatric and adolescent gynecology, was truly when I was doing the research on my book.

    2. CC

      Yes.

    3. SH

      And I, because I was talking about earlier puberty, and then all of a sudden, that got into the mix, and I was like, wow, I'm today, you know, years old [laughs] and I just found out that this exists. So is that... I mean, I'm thinking maybe I'm not the only one. Like, do you find that people are like, "Wait, wait, what? You're a what?"

    4. CC

      Every time I say the words.

    5. SH

      [laughs]

    6. CC

      Every single time. So much so that when I told my father that was the subspecialty I wanted to pursue, he was like, he'd never heard of it. Remember, my father's an OBGYN. And so even within our field, it isn't that well known of a subspecialty. Now, the nature of all pediatric subspecialties is that they are born out of folks that have cared for adults and said, "These kids, they're different," right? [laughs] "There's something here." So pediatric cardiology was the first pediatric subspecialty, uh, to be kind of recognized on a larger scale. Uh, and then of course, you get your peds endocrinology, peds neuro. All of these subspecialties are kind of born of like, hey, this is worthy of studying more and training better, um, so that we can take better care of these patients. Uh, and so a lot of people don't know it exists, but that's one of my core missions, to elevate that. Even when I started my platform, The Period Doctor, back in 2019, I was still in fellowship, and I was so frustrated by having to explain myself to every single person I met. So I was like, "Why don't more people know about this?" And it's because we have to actually take it to the people. You know, we talk so much to our colleagues. I just went to the World Congress, a peds adolescent gynecology conference in San Francisco. There were folks there from all over the world. Um, and so we know it's important. It's globally important. If you ask a parent, they would say, "This is important," but we haven't done a great job of elevating the awareness around this subspecialty, um, and letting people know that this exists, and we're really helpful, especially during this transition.

  6. 12:13 – 14:25

    When to see a pediatric gynecologist vs. a pediatrician

    1. SH

      Okay. So, uh, the, all I'm thinking right now is somebody's listening and they have a nine-year-old, maybe they have an 11-year-old, or a 15-year-old. What would make somebody say, "Huh, I, I, instead of going to my pediatrician, I'm going to go to this pediatric gynecologist?" Like [laughs]

    2. CC

      Yeah.

    3. SH

      The two words almost seem like they don't go together-

    4. CC

      Right

    5. SH

      ... as I say them out loud. [laughs] Yeah, what does this mean? Like, why would somebody go to you versus their pediatrician?

    6. CC

      Yes.

    7. SH

      What brings people to you?

    8. CC

      Right. So to just kind of bring out the, the, the feeling like it almost being like an oxymoron, the pediatric gynecology part, right? The fact is our youngest patients have the gynecology parts, right? That's a vagina, that's a cervix, that's a uterus, ovaries, and they have issues that arise with those parts. So I've had consults on babies that are two days old because there's something abnormal with their genitalia, and we need to look at that. Because I see so much and my volume is so high, a lot of the times pediatricians are referring their patients to me 'cause they're like, "Hey, this left the realm of what I'm comfortable with. And so I want her to see someone who's specialized," or, "I want someone who sees this more than I do," or, "I've done everything I can as it relates to her dysmenorrhea. Maybe there's something else going on," or, "I've tried out my tried and true contraceptive options and she wants something else that I'm not particularly comfortable with. I'd like for you to see her." And so really, it, it's, it's a blend of what just arises naturally, and if you possess these parts, there can be an issue with it. You know, that's just the nature of being a human being. But also, with pediatrics, you guys do everything. Like, you literally do everything. And so the expectation that you could know everything about gynecology in your patient population with all of the various, you know, rare things that arise is really not that feasible, uh, and all, not all that realistic. And so there's a point with every pediatrician where comfort ends, and it's like, "Hey, maybe this is a little bit more rare. Maybe this needs some a l- some more focus." And so that's often when we receive patients. It varies. Some pediatricians are like, "You talking periods? I got someone for you," you know, just based on comfort. And then there's others who are like, "I feel really comfortable with my PCOS and even my early dysmenorrhea, but this, this is where it gets beyond my wheelhouse, and I'd love for you to, to consult on this patient." So it's a blend.

  7. 14:25 – 15:45

    Dysmenorrhea 101: normal cramps vs. red flags

    1. SH

      Okay. So I don't know if everybody knows what dysmenorrhea is, so why don't you first define that?

    2. CC

      Yes.

    3. SH

      And then I've got your next question.

    4. CC

      Perfect. So dysmenorrhea, and I, I'm sorry I said that, because I was just doing an article on the topic. Um, dysmenorrhea is just period pain or pain with periods. There are different types of dysmenorrhea. So there's, like, the primary type, which is more the expected, like, I don't have an underlying condition or a problem, so to speak. I just have some baseline cramping. And then there's secondary, which means there's something else going on, like an endometriosis or a structural issue or something of that nature. So we, we have an umbrella term, and it's split into two categories, but ultimately it just means, like, period pain.

    5. SH

      Okay. Like, who knew? Like, y- you're right. As part of your mission, right, to educate the masses, I think we have to know that period pain actually does have sort of a medical term to it.

    6. CC

      Yes.

    7. SH

      And that maybe it's not something to just say, like, "Yep, this is just what happens. Every month you're gonna be in pain, and that's gonna be that." I, I was thinking about my own experience, uh, when I had... I mean, honestly, the whole time I ever had my period, but I would miss school. Like, I would miss probably two days every month just dying in pain.

    8. CC

      Right.

  8. 15:45 – 19:08

    Endometriosis in teens: earlier symptoms, earlier intervention

    1. SH

      And one of the things I thought about was, I was later, when I was maybe around 30, I was diagnosed with endometriosis. And so when you said that, like, in, you see this in adolescent patients, is that something that probably developed when I was younger, and then it just gets worse? Is that how endometriosis works?

    2. CC

      That is correct. So, um, there's, there's so much to say there. One, there's really good evidence that about one in five folks with periods miss school because of those periods. And even the ones that do make it there are having difficulty focusing and concentrating in the classroom. So we don't even have the best understanding of the true impact of period pain. So that's one piece of the picture. Then, one of the things I like to convey to my patients, and I write about in my book, is the line of when normal becomes abnormal, right? And missing school is one of the key indicators that I look for, the red flags, that I ask patients about every single patient that comes into my office, "Are you missing school?" 'Cause as we know, when we get to the point where anything affects our daily activities, we have tipped over from just kind of bothersome to truly, like, a disorder, as in something needs to be done about this. We've departed from what is expected. Um, and so endometriosis is a chronic and inflammatory condition that's characterized by cells that are similar to the endometrial lining being found outside of the uterus. This can be on the bladder, on the bowel, on the tubes that connect to the uterus. It can even be in the lungs or in the brain, which is kind of insane. Um, it is chronic and progressive, which means it doesn't get better and it doesn't go away. So we used to categorize it as a gynecologic condition, but now we know that it can be a systemic condition or can affect the entire body. There are some studies that look at folks who are diagnosed with endometriosis, and I believe it's about a third of them say that they had symptoms before the age of 15. And so the youngest I personally diagnosed with endometriosis was 12. The youngest in the literature is age eight. What we realize is that endometriosis often does present much earlier than we thought. And if we can get to it earlier, we can prevent the progression of the condition. So endometriosis is a chronic condition. It's chronic and progressive, meaning it doesn't go away, and it doesn't spontaneously get better. But if we start early, maybe we can prevent some of the further progression of disease. Maybe we can prevent it before it starts to impact future fertility. And so that is the basis, um- ... of my work. Like, we need to be doing things upstream. The problem is that we only valued investigating this type of work when folks wanted to have babies. Because women, girls, we have been conditioned and, and, and valued according to our ability to have kids. And I tell my patients every day, I'm like, "Guess what? I care about you right now. I care about you-

    3. SH

      Mm-hmm

    4. CC

      ... in eighth grade trying to attend your soccer game. I care about you right now as a freshman in college who just wants to be on the debate team. I care about you today." And I think society has gotten it wrong because we have emphasized that intervention should only be around things that we value as a patriarchal society. Childbearing, you know, uh, having, you know, an intimacy with your partner. What about the 12-year-old in front of you who tells you she is in horrible pain, who is missing school? That matters today.

  9. 19:08 – 21:03

    What parents (and adults) should do when the ‘wheels are turning’

    1. SH

      Yeah. Let me, let me really just say, I wanna emphasize what you just said, because what I'm imagining right now is there's, there's going to be some women listening.

    2. CC

      Mm-hmm.

    3. SH

      And they're gonna be like, "Hold up. Right now I am 35, and I have terrible pain-

    4. CC

      Yes

    5. SH

      ... every month. Uh, should I go get checked out for endometriosis? What, could that be it? How do I know if that's it? Is that too much? Is that too much of a reason?" So there's, there's the woman listening right now who's thinking about her own self, maybe her own history, right, like I, like I just did. And then there's also the parent listening that's saying, "Okay, hold on. This, my daughter does miss school sometimes, and, you know, I give her the hot water bottle and the ibuprofen, and it helps a little bit, but she's really miserable. Is there something more I should be doing?"

    6. CC

      Yes.

    7. SH

      So what do you say to these parents who are listening with their wheels turning right now?

    8. CC

      I say that the fact that your wheels are turning means that you need to be, you need to pay attention to that. This is hitting something, it's triggering something, it's activating something in you that knows that more needs to be done. And so whether it's for your child or for yourself, if you are in pain, if you are feeling discomfort that is bothersome, it deserves evaluation and treatment. I don't think we say that enough, especially to moms. Um, I wrote this book obviously for parents to guide their kids through puberty and periods better. Um, but this is also a healing tool and an education and a liberation for the parent. Like, I'm sorry that this was ignored for 20 years. You deserved this then, and you still deserve it today. And so part of the reframing is teaching your child, your daughter, what she deserves and how to advocate for her, but I hope that it also teaches moms how to advocate for themselves and what they should expect in their doctor-patient relationships, and what's normal for their bodies, too.

  10. 21:03 – 22:39

    Family history matters: the heritability signal for endometriosis

    1. SH

      Yeah, so is there a, is there a factor that this is inherited? Like so, right?

    2. CC

      Mm-hmm.

    3. SH

      Do girls more, are they more likely to have this if their mom or grandma had?

    4. CC

      Absolutely.

    5. SH

      Okay.

    6. CC

      Absolutely. And so what we see is that endometriosis risk increases according to, like, first-degree relative. And so I ask that in the visit. I always say, "Mom, tell me about your periods." And they're like, "My periods are terrible," [laughs] but, you know, they're thinking about their kid. And I'm like, "Yeah, you know, a lot of what happens with you affects your daughter." So that's another reason why it's worthwhile to get your stuff checked out, so we know what we're working with. And so the first-degree relative of course means mom, you know, sibling, or child. If any of them have endometriosis, it increases your risk by about threefold. And so that's a significant increased risk relative to the general population. So it makes me-

    7. SH

      Yeah, let, let me say that again.

    8. CC

      Mm-hmm.

    9. SH

      You are three, your child is three times more likely to have endometriosis if you-

    10. CC

      If you

    11. SH

      ... Mom, have endometriosis.

    12. CC

      Yes. It's not an absolute.

    13. SH

      I didn't know that.

    14. CC

      It's not an absolute.

    15. SH

      Mm-hmm.

    16. CC

      You know, not-

    17. SH

      Yeah

    18. CC

      ... many things are. And so I have pa- moms that come in with endometriosis and they're like, "Does my daughter have this?" I'm like, "Okay, I understand why you're concerned. It is not-

    19. SH

      Mm-hmm

    20. CC

      ... an absolute. You have a partner that contributed some genetic material here, [laughs] so it's possible that she doesn't," but it is in the back of my mind always, and I'll be evaluating her with that context.

    21. SH

      Amazing. I mean, I think just this conversation, and just the normalization of this-

    22. CC

      Mm-hmm

    23. SH

      ... right, this is the way we reduce stigma. This is the way-

    24. CC

      Right

    25. SH

      ... when a doctor looks at you and says, "Oh, tell me about what your period was like," that we don't have that feeling of, like, "Oh, my gosh, I'm so uncomfortable. I've never been-

    26. CC

      Right

  11. 22:39 – 26:09

    Cycle syncing: why it feels true but isn’t supported by evidence

    1. SH

      ... asked this question. I don't wanna talk about this." Um, so amazing. Okay. So one of the things I'm wondering is, um, you talk about some myths. I, I was-

    2. CC

      Yeah

    3. SH

      ... looking on social media and looking at some of your stuff, and there's a myth that you say is a myth that I'm like, no, I think I might have to, I might have to disagree with you on this one. We gotta go at it. Okay. You say that cycle syncing-

    4. CC

      I knew you were gonna say that. [laughs]

    5. SH

      'Cause I don't believe you. Nobody believes you. You gotta tell us about this. What, cycle syncing, like, I, the first thing I think about, right, and you can define it more formally, but is, you know, girls who live, they're roommates in college.

    6. CC

      Mm-hmm, mm-hmm.

    7. SH

      And their cy- And I'm like, you cannot tell me that that's not true. But you're saying it's not true.

    8. CC

      You know, and, and of all the myths, it is my, it's, like, the most benign myth, and so it's not the one that I go toe-to-toe with, right? 'Cause because it make, it doesn't make you feel, like, inconvenient, incapable, or inferior. Those are the myths that really bother me. So this myth, I'm like, eh, you know. But I did want to address it because, um, one of my other hats that I wear is, um, being the chief medical officer at Clue, which is, uh, an app for menstrual tracking. So they did the study, this is why I bring them up, looking at cycle syncing and seeing if cycles do actually sync, and there's no evidence that this actually exists. So what, um, we attributed it to is more of, like, a recall bias sort of situation in our brains. We're not gonna remember when our cycle didn't sync, but we are gonna remember when it did. The other feature is that if you are bleeding 7 days out of 28, that's like walking around a track, right? You know those tracks where you have to do, like, four laps in order to do a full mile. And so being like, oh, my goodness, someone's gonna get on the track and they're also running miles, but they also start just one lap behind you. And at some point, you're gonna be near them. You're gonna be like, "Oh ... it is just sheer odds. And so we only have a quarter here, a quarter here, and that's with everyone having seven-day cycles, and then it starts to overlap. Overlapping is inevitable. It is not wrong, but there is no scientific basis to it. And so my whole point is to try to use science to explain the world around us, and to not, you know, uh, endorse myths, especially because many of these myths can, in fact, be harmful. That one doesn't bother me as much, but until I see the science that supports it, I cannot endorse it. [laughs]

    9. SH

      I love your answer. So I'm gonna, um, I'm gonna unite with the moms that are listening right now, and they're just like, "What? No. For four years, I was on the same cycle," [laughs] um, and just say, like, you know, "I really trust you, but-"

    10. CC

      [laughs] However, I disagree.

    11. SH

      But-

    12. CC

      That's what-

    13. SH

      Two things can be true. You're brilliant, and I'm pretty sure that... [laughs]

    14. CC

      No, it's totally fine.

    15. SH

      Women... And I think the reason why I think, too, though, I think women, like, are, you know, probably laughing right now, or whatever, is because I think we feel like we bond with other women. I think it's actually-

    16. CC

      Oh, yes

    17. SH

      ... a bonding thing, right? Like, if I just spend enough time with you, like, we are so in sync. Like, everything's in sync, even our menstrual cycle.

    18. CC

      Right.

    19. SH

      And that just... I think it feels, like, amazing, and I think it highlights... Like, it, it's sort of like, before you even realize why you think it's so amazing-

    20. CC

      Mm-hmm

    21. SH

      ... it just highlights, like, the magic of a woman and a woman's body.

    22. CC

      Yes. I agree.

    23. SH

      And so, you know, I think that, I think that's why, like, there's almost some pride in being like-

    24. CC

      Yeah

    25. SH

      ... "Oh, my gosh"

    26. CC

      It's peak girlhood. Like-

    27. SH

      Yes

    28. CC

      ... it is. And people are like, "This is my best friend because our periods are synced."

    29. SH

      Yes, exactly. Period, end of story.

    30. CC

      Period. [laughs]

  12. 26:09 – 27:40

    Where sex/period education should start: before the first blood

    1. SH

      ... from a scientific perspective. Um, okay. So I wanna hear a little bit more about... You know, you talk about reproductive sexual education.

    2. CC

      Yes.

    3. SH

      And I'm curious, what do you think that we're getting right?

    4. CC

      Mm-hmm.

    5. SH

      And what is... I know there's probably a lot, but what's, like, the first thing? What's, like, if, if a parent is listening and they're like, "Oh, my gosh, I haven't talked to my kid about any-"

    6. CC

      Mm-hmm

    7. SH

      ... "of this stuff, and no one talked to me about any of this stuff," where do they start? What's the most important thing, do you think?

    8. CC

      Yeah. I think the most important thing for me that I'd love to see change is parents talking about periods before there's blood. Before your child starts bleeding, please, please, by all means, bring it up. You don't have to give a full course on it. You don't have to cover the whole full curriculum, but do not let them start bleeding without having any idea what's happening. And that happens in about 40% of folks who have periods. They start bleeding, and they have no clue what's going on. So my thought is, if we are expected to manage something, if we're headed into something new or unexpected, any general human wants to have some sort of insight into that. As someone who has dealt, dealt with anxiety in my life, to decrease anxiety, if you just give me an overview, if you just manage my expectations, I feel better. So why? Why, as a parent, would you not want to improve your child's ability to manage this by just giving them a heads-up? And so-

  13. 27:40 – 31:32

    How to talk when you feel unprepared: normalize through everyday life

    1. SH

      Okay. Wait.

    2. CC

      Mm-hmm.

    3. SH

      I'm gonna role-play why.

    4. CC

      Okay.

    5. SH

      'Cause I've seen hundreds, if thousands, probably, of moms. Okay, I'm gonna role-play this with you.

    6. CC

      Uh-huh.

    7. SH

      "Well, I mean, because no one ever talked to me about this, I have no idea what to say, and I don't wanna scare my kid."

    8. CC

      Right.

    9. SH

      "I know, I know my kid. If I tell them there's gonna be blood-"

    10. CC

      Mm-hmm

    11. SH

      ... "and the day you look down in a toilet bowl or in your underwear and you see blood, you need to tell me, I'm just gonna be fueling my kid's anxiety, and why would I do that to them?"

    12. CC

      Right. And so you can think about, one of the things I like to use to encourage parents is, like, do you remember when your child started to lose teeth? Like, do you remember that? Like, we all talked our kids through losing your teeth, maybe there being a little bit of blood, the tooth being gone, and just reassuring them it's coming back, because this is a normal process, right?

    13. SH

      Mm-hmm.

    14. CC

      And no one said, "This is crazy. Blood is insane. They won't be able to chew ever again. They'll be afraid of apples." Nobody said that, because we don't place this unnecessary weight on it that is informed by all of the shame and all of the things that we carry. So that's, that's one truth, of just normalization of things that don't actually make a ton of sense, that would invoke anxiety, that we also lead with because it's just normal, right? So that's, that's one. The secondary thing I would say is not knowing where to start is a real thing, but our kids are being exposed to a variety of things that open up the conversation all around us. So if you are a menstruating mom and your kid walks in the bathroom, right, they're not gonna scream and say you're dying if they see some blood. Y- That's an opportunity to say, "Well, Mommy has a period, and this happens, and look, I'm okay." So it doesn't have to be about their body. It needs to be talking about the world around them. And so it could even be as simple as, "Have you noticed that someone in your class has started to wear a bra or wear deodorant? Have you noticed that your bodies are changing? Yeah, bodies change. Mommy once looked like you, a little kid, but now I'm taller, and there's different parts about my body." These are some of the things. And so you don't have to put it in the context of them bleeding. It is in the context of the world around them. And so if they ask, "Is this gonna happen to me?" say, "Yes, one day it will, but I'll be right there to help you." And so you model that by using the world around you. I also point up to my child, who's 17 months, that there's an airplane in the sky, right? And I say, "That's an airplane," right? I don't say, "Well, he's afraid of heights, so I can't tell him that people are sometimes in the sky." I don't say, "He doesn't understand physics, so I can't point that out." No, that is the world that he lives in. It is around him, and so it is my job to point out those things and fill in the gaps before he looks for other sources to fill those in. So that's what I encourage parents to do. You're potty-training-

    15. SH

      Okay

    16. CC

      ... your kid. You know-

    17. SH

      Mm-hmm

    18. CC

      ... there's opportunities that arise across the board. And so it's not saying, "Blood is coming, terrible things." No, no, no. We start with, "There are differences in our bodies. Our bodies change over time. When you're potty-training, you're gonna wipe like this, and your brother might stand up." That is talking about reproductive health We just don't frame it in that way. So we do it already. It is more so giving parents the tools to say, "You've already done this. Stop overthinking it, and normalize it with the world around you." That is the entry point.

    19. SH

      I love that. Stop overthinking it. It does, it does feel scarier until you actually do it, because since I h- you know, t- do these classes and, you know, at Good Inside, we have actually a puberty class where we go through all the things. And it's, it's scarier, I think, like thinking about doing it, but once the words actually come out of your mouth, you're like, "Oh, that wasn't that bad." And my experience is the younger you do it, it's, it is sort of like they're just more accepting. They're just like, "Oh-"

    20. CC

      Right

    21. SH

      ... okay, cool.

    22. CC

      Because you're not saying tomorrow.

    23. SH

      Or, "Oh, that sounds gross." Yeah.

    24. CC

      Right. Right.

    25. SH

      They're like, "'Kay. Okay, whatever." And then they go on their day, and like you said, the number one question I personally get is, "What do I do if I get it at the pool? What if I do if I..."

    26. CC

      [laughs]

    27. SH

      It's always about the pool.

    28. CC

      Always.

    29. SH

      It's like-

    30. CC

      That's what it's always

  14. 31:32 – 35:46

    Puberty is starting earlier: timing, signs, and the ‘breast buds’ cue

    1. SH

      ... always about the pool. Um, okay, so how do you, with kids going through puberty earlier-

    2. CC

      Mm-hmm

    3. SH

      ... as we know this is happening, parent might be listening and they're like, "Okay, well, I, I, I missed the potty training portion. I'm, uh, my kid's now in third or fourth grade, so how do I do this now? Or is this too early? When, when do I know? What's the sign that it's time to start having this talk if I've done none, none of it so far?"

    4. CC

      Sure. So if you've done none of it so far and your kid is in third grade, that is your sign. [laughs] It is, it is time, right? [laughs] And the reason I say that is because the normal range of first period is starting at age nine to about 15. And people, for whatever reason, just throw that out of their brains. They're like, "Nope, it's 12 and up." No, no, no. 12 is average. That means that there's a good proportion that start before that. We also know that if you have a child that has African ancestry, they may be more likely to start before that. If they are of Hispanic heritage, they may be more likely to start before that. And so there, there are other things that you need to consider. So I would say if you were at third grade, which is like eight, age eight, like seven or eight, it's time to start. It's time to start. And so that can just be like, I mean, I love the entry point of, "Hey, what's happening in your class?" But your kid might be the one in the class that's having the changes. And so if you start to notice any changes, I'm talking about more sweat, having acne, definitely breast development, all of those things, um, hair under the arms and pubic area, it's go time. Look alive. [laughs] Like you are on the clock. And so I tell my parents, of course, that the onset of breast buds, and that doesn't mean full breast development, like wear a C cup. No, no, no. Changes of the breast, the tiny budding just around the areola area, that means things are starting. That is a sign of the presence of estrogen. You have roughly, not perfectly, not in calendar, you know, years, two years before that first period starts, roughly. That means you need to start thinking about it, and you can tie it all together. Your body is changing. These are some of the changes that we're going to expect to see, and I am right here with you.

    5. SH

      I love that. I mean, again, just listening to you, I'm like, yes. This, we can do this, people. We can do this. I, I also wanna say what you just said, and, and I, I agr- you know, I wanna underscore, it's not a science. But when you start to see the breast buds, that is when you know that, A, puberty has begun.

    6. CC

      It has begun. It is-

    7. SH

      It has begun.

    8. CC

      Mm-hmm.

    9. SH

      It is-

    10. CC

      It's here

    11. SH

      ... it is, it has arrived.

    12. CC

      [laughs]

    13. SH

      And secondly, one of the things that I notice is that parents, and this, this goes from, you know, moms and dads, grandparents, caregivers, anybody, they see an eight or nine-year-old still as like, "That's my baby."

    14. CC

      Right.

    15. SH

      And so I might see a bud. So sometimes I say, um, "So do you think that puberty has begun?" And they, in my office, right? And they'll be like, "No."

    16. CC

      [laughs]

    17. SH

      And then I'll say-

    18. CC

      Okay

    19. SH

      ... "Oh, okay, 'cause I think I see some breast buds." They're like, "Oh, th- those aren't breasts. They're just, like, little, there's, like, little mounds," or-

    20. CC

      Right

    21. SH

      ... "Uh-huh." And that's a bud. [laughs]

    22. CC

      That is a bud.

    23. SH

      That is a bud.

    24. CC

      I had a patient-

    25. SH

      So-

    26. CC

      Oh, so sorry. I had a patient once who was like... I'd said, "When did breast development start?" on her intake form. She was like, "Not yet." I mean, 15, periods. She just didn't think they were big enough, so she was like, "I don't have them yet." [laughs] And I was like, "You absolutely do." [laughs]

    27. SH

      That, that is, it's, it's so true. I mean, and there, and I love the conversation that we're having, and I know it has to happen more because the, I think the reason why sometimes an adolescent girl doesn't see her breast development is because there could be some shame there. There could be that discomfort with the body changing, or again, "Nobody's talking to me about this, so I don't even know."

    28. CC

      Right.

    29. SH

      And it might even be a little bit tender, and if nobody said-

    30. CC

      Yes

  15. 35:46 – 42:48

    Common parent FAQs: tampons, product choices, and the ‘feminine hygiene’ aisle

    1. SH

      I get the, I have, like, my frequently asked questions. Mine is about the pool.

    2. CC

      Mm-hmm.

    3. SH

      I'm curious for you, what are maybe your top two most frequently asked questions?

    4. CC

      Yeah, I think one of them is, when can she use tampons?

    5. SH

      Mm-hmm.

    6. CC

      Like, like when is that okay? Like, is there a certification program? Is there a perfect age? [laughs] You know, all of these things. And that's obviously my, one of my favorite questions, and I love talking about this because there's so much shame and stigma around tampon use, um, largely because anything where we're, you know, understanding our anatomy and, and even having to touch the vagina, there's some discomfort there, um, regardless of age, and that can carry across generations. So I love telling folks that, hey, actually, as young as starting their first period, as long as they know where to go, they know how to tell time, and they feel comfortable, you know, removing it, then you can use tampons from the very first period. And I'm not just saying that. Like, I literally did. Did I know at that time that I was just, like, trying to be a model or an example of something I would say to patients in the future? Of course not. I just wanted to swim, and your child probably feels the same way. They just wanna dance. They just wanna play rugby. They just want to cheer, and they're maybe a flyer, and they don't wanna have the bulk of something like a pad. Um, another thing that folks ask me about is, what do you recommend for period products? Like, what is your go-to? I always say whatever works best for you. I want you to have the product that works for your life, that makes you feel comfortable, that supports your values. If sustainability is really important for you, go for it, right? If you love that new period underwear because it makes you feel super comfortable and you can wear it if you're on your period or not, and if your periods are irregular, it makes you feel protected, go for it. If you're like, "I am not touching a tampon with a 13-foot pole," then don't use it, right? Don't touch a menstrual cup if you don't understand it. Don't feel obligated to use this product just because someone else uses it. Use what works best for you. And people are always taken aback 'cause they want a clear recommendation, but my recommendation is for you to understand your body, get to know your body, and do what works best for you. That's the ultimate goal.

    7. SH

      I, I love that. Um, okay, I lied. I do have one more question, and then we really will wrap up. Okay. So I have been seeing on the market all of these products that are, you know, I guess, vaginal health, and I don't even know what else they say. It's a whole... The, the product line is getting wider and taller. It's huge, all right? And so what is, what is this about? Is this a social media thing? Like, what is happening? Because I know you say basically the vulva is self-cleaning, right?

    8. CC

      So the vagina is self-cleaning.

    9. SH

      The vagina.

    10. CC

      Mm-hmm.

    11. SH

      Okay.

    12. CC

      The vagina is self-cleaning, so of course we don't need to clean internally. And I also think that people don't realize the vagina is an internal structure. Like, it's entirely internal. So what you see on the outside is the vulva. Um, but there's a lot of feminine care products and things, and I think one of the kind of clearest hypocrisies is that this aisle does not exist for, for men, right? There's n- nothing. It's like, ooh, m- you know, masculine care pro- Like, that doesn't... That's not a thing. That's number one. Two, what I try to reiterate to my patients is that none of those items on that aisle are, um, indicative of or supportive of health. Now, there might be preferences. If you wanna smell like a strawberry, you know, shortcake, live your best life, okay? But many of those things, dyes and fragrances and all of those things, actually cause irritation. So if you are someone who struggles with irritation, who struggles with odor or whatever, maybe this isn't your best bet. Oftentimes, less is more. So we're talking warm water, clean hands, and less of harsher soaps, soaps that have... You know, are unscented, uh, and more of, uh, you know, clean ingredients. That's my preference for my patients. But I don't also, um, berate patients for wanting to use something that makes them feel whatever. Fill in the blank, right? Again, I'm open for patients to choose what works best for them. What I do know is that a lot of the literature shows that, uh, women in minority groups tend to use more of those products and have more issues, and that is more predatory to me, and I don't like that. Um, so if patients or, or if, if moms are watching and they're thinking about what they should use, you do not need to use anything from that feminine care aisle to improve the health of your child. I wanna say that again. You do not need to use anything from the feminine care aisle to improve the health of your child or your personal health. If that is your personal preference, live your best life. If you are having irritation, then you probably need to stop that. And so when I have patients that come in, I say, "Please stop all of those items. All... That 20, 20 item, you know, regimen that you have for your vulva, please discontinue." [laughs] "And then let's find something that works for you." So, um, I know there's people that feel really, really strongly about the predatorial nature and the ways in which it is, um, marketed to younger girls to tell them that this is necessary. I think that we need to be raising our girls in the next generation to desire healthy bodies and not desire bodies that are made to be desirable for another partner or for someone else. And so when we change that focus, that, "I wanna be healthy for me, I wanna be healthy for my future, I wanna be healthy for the life I wanna live," I think that changes the focus, and then we can honor the choices that people make by saying, "That's your body, that's your agency, and I respect that."

    13. SH

      I had no idea there's an actual medical term for menstrual pain, or that so many of us miss school because of this monthly thing that happens to half the population. Talking about periods is literally one of the oldest taboos, and we still have such a hard time with it. That's why I'm so grateful to Dr. Charis for bringing more clarity, more steadiness, and a lot less confusion, and maybe even giving each of us a little more compassion for ourselves, too. At Good Inside, our approach for raising tweens and teens tackles today's challenges while building lifelong skills. Every day, I'm helping members in the Good Inside community navigate issues just like these. You can learn more at goodinside.com. Okay, let's zoom out. Deep breath. This in-between stage feels hard because it is hard. If you remember nothing else, remember this: They act like they don't need you, they still need you. I'll see you next week. [outro music]

Episode duration: 42:49

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