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Quick reference medical handouts used by Pediatric offices


Vaginitis in Children


Vaginitis refers to any inflammation or infection of the vagina. This is a common gynecological problem found in girls of all ages, with most having at least one form of vaginitis at some time during their lives. When the walls of the vagina become inflamed, because some irritant has disturbed the balance of the vaginal area, vaginitis can occur.

The following are the most common symptoms of vaginitis in children. However, each youngster may experience symptoms differently. Symptoms may include:

  • vaginal itching
  • vaginal burning
  • vaginal discharge which may be clear or colored. It can be thin or thick with or without an odor. A white, cottage cheese-like vaginal discharge is typically seen in candida vaginitis. 
  • occasionally girls complain of pelvic or abdominal pain

 

Yeast infections are caused by one of the many species of fungus known as candida, which normally live in the vagina in small numbers. Since yeast is normally present and well-balanced in the vagina, infection occurs when something in a female's system upsets this normal balance. For example, an antibiotic to treat another infection may upset this balance. In this case, the antibiotic kills the bacteria that normally protects and balances the yeast in the vagina. In turn, the yeast overgrows, causing an infection. Other factors that can cause this imbalance to occur include pregnancy, which changes hormone levels, children taking steroids and diabetes, which allows too much sugar in the urine and vagina. Other causes of yeast overgrowth include wearing tightly fitting clothing and if the girl is around too much heat and moisture. 

The following are the most common symptoms of a candida infection. However, each adolescent may experience symptoms differently. Symptoms may include:

  • a thick, white, cottage cheese-like vaginal discharge that is watery and usually odorless
  • itchiness and redness of the vulva and vagina
  • burning on urination (dysuria) 

The symptoms of a vaginal candida infection may resemble other conditions or medical problems. Therefore, parents should always consult with their child's physician for a diagnosis.  

Treatment for candida may include:

  • anti-fungal, vaginal creams and suppositories
  • vaginal tablets
  • antibiotics

Prevention of candida vaginitis includes: 

  • Washing and rinsing your daughter's  external genitals and bottom regularly
  • Wearing clean underpants every day. Cotton panties with a cotton crotch are best.
  • Avoiding vaginal spray deodorants and irritating soaps.
  • Remind your daughter to  wipe front to back, never back to front..

Most vaginal itching or discomfort is due to a soap irritation of the vulva. The usual irritants are bubble bath, shampoo, or soap left on the genital area after a bath.  Occasionally, it is due to poor hygiene. Before puberty, the lining of the vulva is very thin and sensitive. If the vagina becomes infected, there will be a vaginal discharge. This problem almost always occurs before puberty.

Treatment includes:

  • Baking soda, warm water soaks in a basin or bathtub of warm water for 20 minutes. Add 4 tablespoons of baking soda per tub of warm water. Be sure she spreads her legs and allows the water to cleanse the genital area. No soap should be used. This will remove any soap, concentrated urine, or other irritants from the genital area and promote healing
  • Hydrocortisone cream Apply 1% hydrocortisone cream (a nonprescription item) to the genital area after the soaks on the advice of your child's doctor. 
  • Prevention of recurrences
    1.
    Avoid bubble baths.
    Don't put any other soaps or shampoo into the bath water. Don't let a bar of soap float around in the bathtub.  If you are going to shampoo your child's hair, do this at the end of the bath.
  • Keep the bath time less than 15 minutes. Have your child urinate immediately after baths.
  • Wear cotton underpants.  Discourage wearing underpants during the night so the genital area has a chance to "air out."
  • Teach your daughter to wipe herself correctly from front to back, especially after a bowel movement.
  • Encourage her to drink enough fluids each day to keep the urine light-colored. Concentrated urine can be an irritant.

Young girls may put a foreign object in their vaginas. Common objects are toilet tissue, a crayon, or a bead. If the objects are not removed, then an infection can result. Often they are not discovered until the girl is brought to see a physician because she has developed a vaginal discharge.

The most common foreign body in young girls is toilet tissue. Teach your daughter to pat her vulva dry after going to the bathroom rather than rubbing it with tissue. Rubbing causes balls of tissue to break off and become lodged in the vagina.

It is important for parents to try NOT to remove the foreign object. This often pushes the object farther into the vaginal vault and makes it more difficult for the physician to remove it. 

 

While yeast infections are the most commonly discussed vaginal infection, bacterial vaginitis (BV) is actually the most common type of vaginitis in females of reproductive age. This infection is caused by a bacteria, not yeast. With a bacterial vaginitis infection, certain species of normal vaginal bacteria grow out of control and trigger inflammation. The cause of bacterial vaginitis is not known.

The following are the most common symptoms of bacterial vaginitis. However, each adolescent may experience symptoms differently. Symptoms may include:

  • a milky, thin discharge at times, or a heavy, gray discharge
  • "fishy" odor of discharge

The symptoms of bacterial vaginitis may resemble other conditions. Always consult your physician for a diagnosis.

What is trichomoniasis?

Trichomoniasis, trichomonas, or "trich" as it is commonly called, is a sexually transmitted infection. It is caused by a one-celled parasite called Trichomonas vaginalis which passes between partners during sexual intercourse. Since most males do not present symptoms with trichomoniasis, the infection is often not diagnosed until the female develops symptoms of vaginitis.

What are the symptoms of trichomoniasis?

The following are the most common symptoms of trichomoniasis. However, each adolescent may experience symptoms differently. Symptoms may include:

  • a frothy, often musty-smelling, greenish-yellow discharge
  • itching in and around the vagina and vulva
  • burning during urination
  • discomfort in the lower abdomen
  • pain during intercourse

Some girls with trichomoniasis have no symptoms, or their concerns may resemble other conditions or medical problems. 

Treatment for trichomoniasis:

Specific treatment for trichomoniasis will be determined by your young woman's physician based on:

Both partners must be treated for trichomoniasis to avoid reinfection. Treatment generally involves taking oral antibiotics. If a female has more than one sexual partner, each partner (and any of their other partners) should also be treated.

Viruses are a common cause of vaginitis, with most being spread through sexual contact. One type of virus that causes viral vaginitis is the herpes simplex virus (HSV, or simply herpes) whose primary symptom is pain in the genital area associated with lesions and sores. These sores are generally visible on the vulva, or vagina, but occasionally are inside the vagina and can only be found during a pelvic examination. Often stress or emotional situations can be a factor in triggering an outbreak of herpes.

Another source of viral vaginitis is the human papillomavirus (HPV), a virus that is also transmitted through sexual contact. This virus causes painful warts to grow on the vagina, rectum, vulva, or groin. However, visible warts are not always present, in which case, the virus is generally detected by a Pap test.

Chlamydia is the most commonly occurring sexually transmitted disease in the United States, although it often goes undiagnosed. If left untreated, chlamydia often leads to pelvic inflammatory disease (PID), which increases a female's risk of infertility, pelvic adhesions, chronic pelvic pain, and ectopic pregnancy.

Chlamydia, caused by the bacterium chlamydia trachomatis, exists in a number of different strains. This form of vaginitis is most commonly diagnosed in young women between the ages of 18 and 35 who have multiple sexual partners.

What are the symptoms of chlamydia?

Unfortunately, many females have no symptoms, thus prolonging diagnosis and treatment and possibly spreading the disease. The following are the most common symptoms of chlamydia. However, each adolescent may experience symptoms differently. Symptoms of chlamydia may include:
  • increased vaginal discharge
  • light bleeding, especially after intercourse
  • pain in the lower abdomen or pelvis
  • burning during urination
  • pus in the urine
  • redness and swelling of the urethra and labia

`The symptoms of chlamydia may resemble other conditions or medical problems. Always consult your physician for a diagnosis.

Generally, treatment for chlamydia involves taking antibiotics.

 posted 07-25-04 on kidsgrowth.com

 

 

As a reminder, this information should not be relied on as medical advice and is not intended to replace the advice of your child’s pediatrician. Please read our full disclaimer.

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