Menarche has always been associated, since the ancient times, with cultural and religious elements. The practices undertaken during menstruation have great role to play in the health of a woman. A cross-sectional study was designed to gain knowledge on the age at menarche, practices during menstruation and medication trends among upper-middle income women in Pakistan. This study involved a door to door survey over a period of six months, from January, 2014 to June, 2014, under the surveillance of trained surveyors. The average age at menarche was found to be 12.5 (±1.21) years. Our study found a significant association between age at menarche and BMI (<0.001). Chi-square test showed strong association (<0.001) between the use of unhygienic absorbing material and incidence of UTIs among upper-middle income women. There were 32% women in the upper-middle income practicing self-medication for dysmenorrhoea in Pakistan. The study has concluded that there is a need to promote health and hygiene education among females in Pakistan. Our study findings added to the existing knowledge of practices undertaken by females in Pakistan during their menstruation cycle.