If you have a teenage girl, it's inevitable, hormones and mood swings. It's not always the easiest conversation for parents to have with their kids but it may be time to talk about your daughter's menstrual cycle.

According to pediatrician Dr. Manny Cirenza, most girls begin their menstrual cycle between the age nine and 13. If it happens before the age of nine, a doctor should be consulted. Girls with low body fat may get it as late as age 16.

"First and foremost, the hormones surges can be really quite dramatic and can set a girl off and can set a girl in a significant negative mood, it can trigger migraines and it can trigger depression," said Cirenza.

Hormones aside, teenagers' moods can be affected just by the pressure of learning how to manage their monthly cycle.

"Other issues tied to having the menstrual period that is making them uncomfortable, nervous about having it, embarrassed, that can trigger a lot of emotionality, some depression, some negative feelings," Cirenza said.

Parents should not only address hygiene, but help deciding which is the better choice, tampons or external pads?

"For the most part, the pads are going to work out the best and going to be the easiest to use. Obviously to a certain extent, I think everybody has a certain comfort level to what a person likes to use," Cirenza said.

While most young girls do not choose to use tampons, some girls, usually athletes, do.

"I think it's ok to use that if the adolescent is interested in or want to use but you are going to have to encourage them to be careful and how they use them and when to change that out so they don't put themselves at risk for any significant vaginal infection," Cirenza said.

The common symptoms women experience is low back pain and cramping which is often relieved with over the counter products like Tylenol or ibuprofen. In certain situations for women who have endometriosis where cramping is even more severe, other medication, even birth control pills are prescribed.

Birth control pills are sometimes used to regulate a woman's cycle, reducing symptoms like painful cramps but for some parents, it's a sticky subject.

"That tends to open up a whole new can of worms part from any parent so now they are going to be concerned their adolescent girl has a license to be sexually active. I don't think that is the case," said Cirenza.