Vulval pain in young women

In this episode, Saman Moeed discusses vulval pain or vulvodynia in young women and possible underlying conditions.

Topics

intro
Play now
definition and classification of pain
Play now
Who presents with vulval pain?
Play now
How common is vulval pain in paediatric and adolescent populations?
Play now
How do they present?
Play now
Take a history, questions to ask?
Play now
examination & tests
Play now
What about swabs?
Play now
Should we make a specialist referral early?
Play now
Where to refer
Play now
Approach to management?
Play now
What are the outcomes?
Play now
Vaginal pain in the premenarchal child
Play now
take-home messages
Play now

Take home messages

Prepubertal girls do not get Candida or thrush. Any response to treatment is likely due to the emollient effect.
Lichen sclerosus has a bimodal age distribution, and is therefore sometimes seen in young girls. Treatment is indicated to prevent structural changes in the vulva and to prevent disease sequelae.
Vulval pain or vulvodynia is a chronic pain condition, which responds well to neuromodulator therapy.
Anatomical hymenal variants can cause provoked vulvodynia with tampon use.

Resources

Vulval Pain in Paediatric and Adolescent Patients A. Dunford et al. / J Pediatr Adolesc Gynecol 32 (2019) 359e362

Patient Resources

Vulval skin care for children Factsheet (Royal Childrens Hospital Melbourne)
Vulval skin care for teenagers Factsheet (Royal Childrens Hospital Melbourne)
Vulvovaginitis Factsheet (Royal Childrens Hospital Melbourne)
Labial fusion Factsheet (Royal Childrens Hospital Melbourne)
Booklet - What is a vulva? Integrated Contraception and Sexual Health services (iCaSH / NHS)

Presenter

Saman Moeed

Paediatric & Adolescent Gynaecologist

Dr Saman Moeed, BSc, BHB, MBChB, PGDipObstMedGyn, FRANZCOG Saman is a New Zealand-trained obstetrician and gynaecologist, and New Zealand's only fellowship-trained paediatric & adolescent gynaecologist. She worked at the Royal Children's Hospital Melbourne and is currently Service Clinical Director of Secondary Gynaecology at National Women's Health, Te Toka Tumai Auckland, and works in private gynaecology practice at Omnicare Women's Health.