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VULVOVAGINITIS BEFORE PUBERTY

DESCRIPTION

Vulvovaginitis before puberty is an infection or inflammation of the vagina or vulva before a young girl reaches puberty. The vagina, cervix, vulva (vaginal lips), and skin around the genitals are involved. Vulvovaginitis before puberty can affect female infants and children.
Appropriate health care includes:
  • Physician's monitoring of general condition, medications, and treatment, including removal of any foreign object in the vagina.
  • Home care after diagnosis.

    SIGNS & SYMPTOMS

  • Redness, pain, and itching around your daughter's 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), yeastlike fungi, or viruses. See Vaginitis (several charts in Illnesses section).
  • Allergies to synthetic fabrics, soap, or other items in contact with your daughter's 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.

    RISK FACTORS

  • Diabetes mellitus.
  • Infrequent bathing or unsanitary living conditions.

    PREVENTING COMPLICATIONS OR RECURRENCE

  • Teach your daughter to wipe after bowel movements from the vagina toward the anus.
  • Don't let your daughter sit around in wet clothing--especially a wet bathing suit.
  • Don't provide your daughter with colored or perfumed toilet tissue, scented soap, or bubble baths.
  • Buy your daughter cotton panties or nylon panties with a cotton crotch--not panties made of non-ventilating materials.
  • If antibiotics are prescribed for any reason, your daughter should eat more yogurt and sour cream. This helps prevent vaginal yeast infections.
  • Teach your daughter to resist and report any attempted sexual contact by an older person.

    BASIC INFORMATION

    MEDICAL TESTS

  • Your own observation of symptoms.
  • Medical history and physical exam by a doctor.
  • Laboratory culture and microscopic exam of the discharge.

    POSSIBLE COMPLICATIONS

    Psychological trauma if your daughter's condition is caused by sexual abuse.

    PROBABLE OUTCOME
    Usually curable in 10 days with treatment.

    TREATMENT

    HOME CARE

  • Follow suggestions under PREVENTING COMPLICATIONS OR RECURRENCE.
  • Remove the source of any irritation or allergy, such as soap.
  • Don't try to remove a foreign object from your daughter's vagina. This may be painful or cause her further injury. Take your child to the doctor for removal.
  • If urinating causes burning, your daughter may urinate while bathing or urinate through a toilet-paper roll or plastic cup with the end cut out. This prevents urine from stinging inflamed skin.

    MEDICATION
    Your doctor may prescribe:

  • Medication appropriate for the infection, including antibiotics, anti-fungal or anti-parasitic drugs.
  • Topical ointments to relieve your daughter's pain and itching.
  • See Medications section for information regarding medicines your doctor may prescribe.

    ACTIVITY
    No restrictions.

    DIET & FLUIDS
    No special diet.

    OK TO GO TO SCHOOL?

    Yes.

    CALL YOUR DOCTOR IF

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