Jill Writes:
My daughter turned 16 in November and still does not have her period. She is very athletic. Should I worry about this?
I remember reading,  “Are you there God it’s Me, Margaret?” when I was about 10. I couldn’t wait to get my period. Now I can’t wait for it to go away.
Seems like when the period starts in a girl is a major news bulletin and there can be a lot of concern if it is not right on time. That time may be dictated by when all of her friends started but the reality is there is  about a 7 year time frame that girls start their period.
The average age that girls start their period is about age 12 but 9-16 is considered normal.
There is a certain amount of fat that is required to get the show on the road so very athletic girls or girls that are anorexic can have delayed puberty and that can be a concern.
Jill, as far as your daughter, the question that I would ask is does she have any breast development or pubic hair? Breasts, a growth spurt and pubic hair usually precede the start of menstruation or period by about a year or so.
If she does have breasts and pubic hair then I would expect her to get her period sometime this year, before she turns 17.

If she does not have any of this development by age 16 then I would talk to your doctor. They may run some blood tests like FSH, TSH and Prolactin and perhaps a bone age. These tests check for “gland problems” and they may refer you to an endocrinologist.
Rarely girls can have an imperforate hymen, which is the very thin membrane that covers a girl’s vagina. (Crudely known as a girl’s cherry as it is “popped” after first intercourse or sex). Most girls have a small opening that allows the period to come out of the vagina but an imperforate one does not have any opening. This can be fixed surgically so it may be worth having your daughter use a mirror or have you check to see if she can see a small opening in the hymen. Again this is very rare but I wanted to mention it as if not treated the blood does not get released, builds up and causes a lot of pain.
A final note, many girls feel a lot of pressure to be thin and eating disorders are rampant. Talk to your daughter about good nutrition and seek professional help if you suspect an eating disorder. Check out National Eating Disorders for more information.

Thanks for writing,
Dr. Deb