VULVOVAGINITIS BEFORE PUBERTY

General Information

DEFINITION--Infection or inflammation of the vagina or vulva before a young girl reaches puberty.

BODY PARTS INVOLVED--Vagina; cervix; vulva (vaginal lips); skin around the genitals.

SEX OR AGE MOST AFFECTED--Female infants and children.

SIGNS & SYMPTOMS

• Redness, pain and itching around the genital area.
• Vaginal discharge, which may or may not smell bad.
• Pain with urination.
• Bleeding from the affected area (sometimes).

CAUSES

• Infections caused by bacteria, parasites (including pinworms), yeast-like fungi or viruses.
• Allergies to synthetic fabrics, soap or other items in contact with the genitals.
• Scratches, abrasions or genital injury from insertion of foreign bodies in the vagina by the child or a playmate.
• Genital injury from sexual abuse.
• Irritation from sources such as bubble bath or bath additives.

RISK INCREASES WITH

• Diabetes mellitus.
• Infrequent bathing or unsanitary living conditions.
• Co-existing pharyngitis or other infection.

HOW TO PREVENT

• Teach the child to wipe from the vagina toward the anus after bowel movements.
• Don't let the child sit around in wet clothing, especially a wet bathing suit.
• Don't use colored or perfumed toilet tissue, scented soap or bubble baths.
• Provide the child with cotton underpants or nylon underpants with a cotton crotch.
• Teach your child to resist and report any attempted sexual contact by another person.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor (examination of vagina).
• Diagnostic tests may include laboratory blood studies and culture of the vaginal discharge.

APPROPRIATE HEALTH CARE

• Doctor's treatment, including removal of any foreign object in the vagina.
• Home care after diagnosis.

POSSIBLE COMPLICATIONS--Adhesions (See Glossary).

PROBABLE OUTCOME--Usually curable in 10 days with treatment.

How To Treat

GENERAL MEASURES--

• Remove the source of any irritation or allergy, such as soap or bubble bath.
• If urinating causes burning, the child may urinate while bathing or urinate through a toilet-paper roll or plastic cup with the end cut out or pour a cup of warm water over genital area while urinating. This prevents urine from stinging inflamed skin.

MEDICATION--Your doctor may prescribe:

• Medication appropriate for the infection, including antibiotics, antifungal or antiparasitic drugs.
• Topical ointments to relieve pain and itching.

ACTIVITY--No restrictions.

DIET--No special diet.

Call Your Doctor If

• Your child has symptoms of vulvovaginitis.
• You suspect your child has been sexually abused.
• Symptoms don't improve in 7 to 10 days or symptoms worsen, despite treatment.
• Unusual vaginal bleeding or swelling develops.