Vulvo-vaginitis (inflammation of the external genital area and vagina) is the only common gynaecological problem occurring before puberty. The genital area is red and sore and there may be discharge from the vagina. It can occur at any age but peaks around five years of age. Little girls are prone to poor hygiene as parental supervision is withdrawn and the child cleans herself inadequately: this can result in a little faecal matter entering the vagina. The natural chemical mechanism protecting the vagina from infection during reproductive years (Q 22.1) is absent in the child so faecal contamination of the vagina will rapidly start infection.
Careful hygiene after every bowel action is essential. Bland creams such as Sudocrem or E45 may provide some protection. Your daughter should be encouraged to wipe in a backward direction to avoid faecal contamination of the genital area. Chemical irritation must be avoided her bath should be thoroughly cleansed and rinsed before she uses it and clothes should be rinsed after washing. Leggings and tights should be avoided as they may keep the genital area moist, and underclothes should not be worn at night.
Young children have a tendency to explore their bodies and sometimes small objects may be introduced into the vagina. This may lead to a smelly, blood stained discharge. The doctor may be able to feel such an object by gently introducing a small finger into the rectum. Ultrasound examination may help to exclude a foreign body. If there is any doubt, there are times when the vagina can be checked with a tiny speculum although this usually requires an anaesthetic.
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- 1 Our baby has had a little vaginal bleeding. Is this worrying?
- 2 What are intersex states?
- 3 Our toddler does not seem to have a normal opening down below. What should be done?
- 4 My little girl has a vaginal discharge. What might be the cause?
- 5 What is puberty?
- 6 What is precocious puberty?
- 7 Our teenage daughter's periods have not started yet. When should we seek medical advice?
- 8 Our daughter's periods are occurring infrequently. Should we be concerned?
- 9 What is adolescence?
- 10 What is acne and how can acne be treated?
- 11 Our teenage daughter seems to have more body hair than we would expect. What should be done?
- 12 Our teenage daughter's periods are so heavy that she has to be absent from school. What can we do?
- 13 How does the doctor determine the treatment of heavy periods for an adolescent?
- 14 How long should treatment of heavy periods be continued with an adolescent?
- 15 Should a D and C (cervical dilatation and curettage Q 24.12) be performed for an adolescent with period problems?
- 16 Are there any particular worries about a teen pregnancy?
- 17 What should be the purpose of sex education?
- 18 My adolescent daughter is being difficult. Could she have an underlying hormone problem?
- 19 Are there any special contraceptive considerations for teenagers?
- 20 What contraceptive options are available to adolescents?
- 21 Are there any medical worries if a young teenager takes the oral contraceptive pill?
- 22 Can a teenager use emergency contraception?
- 23 Where can I obtain more information?
- 24 Could I have some child support groups and teen support groups?
- 25 Could I have some acne support groups?
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This is the personal website of David A Viniker MD FRCOG, Consultant Obstetrician and Gynaecologist at Whipps Cross University Hospital, London - Specialist Interests - Reproductive Medicine including Infertility, PCOS, PMS, Menopause and HRT.
I do hope that you find the answers to your women's health questions in the patient information and medical advice provided.
