Vulvodynia in Pre-Menarchal Girls: A Case Series


      Vulvodynia refers to a neuropathic pain syndrome described as vulvar discomfort occurring in the absence of relevant visible clinical findings or a neurological disorder. While vulvodynia has been estimated to occur in 9-12% of American women, little has been published about this disorder in the pediatric population. Vulvodynia has been called one of the most neglected issues in women’s health. The objectives of this study are to: (1) Determine typical presentation features of vulvodynia in the pre-menarchal population; (2) Identify the need for investigation and the criteria for diagnosis; (3) Assess treatment response.


      This is a retrospective case series of 13 pre-menarchal girls with a diagnosis of vulvodynia. All presented to the Royal Children's Hospital in Melbourne, Australia between January 2010 and January 2015. Data was collected on demographics, symptoms, examination findings, treatment, and response to treatment. Descriptive statistics were used to present findings.
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      Vulvodynia occurs in the pre-menarchal population, and its presentation is similar to adults. In addition to vulvar pain and pruritis, urinary symptoms are common. Diagnosis can be made on history and physical examination alone, in one clinic visit. Tri-cyclic antidepressants are an effective treatment in this population. With greater awareness, this condition can be diagnosed and treated in a timelier manner.