### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
Hi, my daughter is 9 1/2 years old, she was playing roughly this morning at home and she has overstreched herself and started complaining from soreness in the vaginal area, and started bleeding ... took her to the local GP, and he send her back home saying that this is her first period starting...now it has bee 3 hours since the incident, she is bleeding heavily in that area and chuncks of blood are coming out... is that normal for a first period? should we investigate further... ? please let me know.

### output:

Hello, First monarch (first period) can be many changes happen before that 2 years, such as growing taller, Breast development, Pubic hair and acne. Normal Monarch start from age 10 to 15. Normal amount in blood loss in with each menstrual flow is 30 to 50ml. There is no practical way to measure the amount of flow. If she bleeds more than 90ml, it is abnormal which is related to immaturity of Hypothalami Pituitary Ovarian axes(part of the brain). Other cause include pregnancy, infection, stress, weight change, bleeding disorder. Less common causes are cervical polyps and leiomyoma such as fibroid. It is not necessary for a girl to see a gynecologist just because they started their period. The first period often very heavy and painful. Your girl 9 years and 6 months, her first monarch is a little earlier than normal but can be normal in some cases. You should recognize the change I had mention above like breast development, public heir happen 2 years before first period. If your child has no those change and keeps bleeding heavily please bring her to see Gynecologist to make sure. Hope I have answered your query. Let me know if I can assist you further. 