Vulval pain in young women

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

Topics

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

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