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Vaginal Symptoms-Teen

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Definition

  • Genital symptoms in teen girls (after puberty)
  • Symptoms include pain, itching, discharge, bleeding and rashes
  • Vaginal discharge is the most common problem
  • This care guide covers symptoms not caused by an injury

Symptoms Covered in this Topic

  • Vaginal symptoms include discharge, bleeding and pain.
  • Vulva symptoms include itching, pain and pain when passing urine.
  • Genital area skin symptoms include itching, pain, rash and swelling.

Vaginal Discharge in Teens: Normal versus Not normal

  • A clear or whitish discharge is normal.
  • Yellow or green vaginal discharge can mean an infection.
  • A bad-smelling discharge is also not normal.
  • An abnormal discharge can also cause a genital rash.

Causes of Abnormal Vaginal Discharge in Teens

  • Sexually Transmitted Infections (STIs) are infections that can be passed from either the female or male partner to the other.
    • Gonorrhea and Chlamydia are the most well-known. Symptoms include yellow or green vaginal discharge, pain with passing urine, pelvic pain, and bleeding.
    • Another STI is Trichomoniasis. It causes a foamy, yellow-green foul-smelling discharge. Both partners need to be treated with antibiotics to prevent it from coming back.
  • Vaginal discharge with vulval itching in teens is usually a yeast infection. Symptoms are a thick, white, cottage cheese-like discharge. This kind of discharge has no smell to it. Bacterial vaginosis gives a white-gray discharge, fishy odor discharge. Both only occur in females and are not STIs.
  • Pelvic inflammatory disease (PID) is an infection of the tubes connecting the ovaries to the uterus. PID is a serious infection which requires hospital admission and antibiotics by vein. The symptoms of PID include lower abdomen or pelvic pain, fever and vaginal discharge.
  • Vaginal Foreign Objects (such as a forgotten tampon) can cause a vaginal infection and discharge.
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When To Call

Go to ER Now

  • From sexual abuse or assault

Call Doctor or Seek Care Now

  • Vaginal discharge plus pelvic pain
  • Vaginal discharge plus fever
  • Severe genital or pelvic pain
  • Vaginal foreign object (such as forgotten tampon)
  • Your teen looks or acts very sick
  • You think your teen needs to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

  • Vaginal discharge that is not normal (yellow, green, smells bad or a large amount)
  • Pain or burning when passing urine
  • Vaginal pain
  • Sexually transmitted infection (STI) suspected
  • Genital area looks infected (such as spreading redness, draining sore)
  • You think your teen needs to be seen, but the problem is not urgent

Contact Doctor During Office Hours

  • All other female genital symptoms. Exception: mild rash for less than 3 days.
  • Rash or itching lasts 3 or more days, using this care advice
  • You have other questions or concerns

Self Care at Home

  • Normal vaginal discharge in teens
  • Mild skin rash of genital area
  • Preventing sexually transmitted infections (STIs)
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Care Advice

Normal Vaginal Discharge in Teens

What You Should Know:

  • A normal discharge usually begins in girls when they start breast development and puberty.
  • It is due to increased estrogen (hormone) levels.
  • The discharge is clear or whitish, thin and small in amount.
  • These secretions are like tears in the eyes or saliva in the mouth.
  • They have a cleansing purpose and are very normal.

Call Your Doctor If:

  • Discharge becomes yellow or green
  • Discharge becomes foul-smelling
  • Causes pain, itching or a rash
  • You think your teen needs to be seen

Mild Skin Rash or Itching of Genital Area - Treatment

What You Should Know about Genital Rashes:

  • Rashes can be caused by skin irritants. The hand may touch the genital area when passing urine. Rashes are often from an irritant that was on the hands.
  • Examples are a plant (such as an evergreen) or chemicals (such as bug repellents). Fiberglass, pet saliva or even food can also be irritants.
  • Most small rashes can be treated at home.
  • Here is some care advice that should help.

Clean the Area:

  • Wash the area once with soap to remove any irritants.

Steroid Cream for Itching:

  • For itchy rashes, use 1% hydrocortisone cream (such as Cortaid). No prescription is needed.
  • Do this 2 times per day for a few days.

What to Expect:

  • Small rashes from irritants should go away in 2 days with treatment.

Prevention of Rashes:

  • Teach your teen to wash her hands before touching her genital area.

Call Your Doctor If:

  • Rash spreads or gets worse
  • Rash lasts more than 3 days
  • Fever occurs
  • You think your teen needs to be seen
  • Your teen becomes worse

STI Prevention

How to Prevent Sexually Transmitted Infections (STIs):

  • Most STIs are spread by exchange of body fluids (semen, vaginal fluids or blood). This can occur during oral, anal, or vaginal sex.
  • They can also occur from direct contact with any sores during sex.
  • Condoms are the only trusted way to prevent most STIs during sex.

Abstinence and Other "Safe" Sexual Activities:

  • Abstaining from sex is the only 100% effective means of not getting STIs. This means not having sex (vaginal, oral or anal).
  • Actions which are believed safe (and don't often spread STIs) are holding hands and hugging. Touching and kissing (if no sores on lips or in mouth) are also safe.

Use of Condoms:

  • Condoms are the only trusted way to prevent most STIs during sex.
  • Putting on a condom: (1) Hold the condom at the tip to squeeze out the air. (2) Roll the condom all the way down the erect penis. Don't try to put a condom on a soft penis.
  • Taking off a condom: (1) After sex, hold onto the condom while the penis is being pulled out. This will keep the condom from coming off before the penis is out. (2) The penis should be pulled out while still erect, so that sperm (semen) doesn't leak out of the condom.
  • Buy latex rubber or plastic condoms. Never use condoms made from animal skins. They can leak.
  • If you use a lubricant during sex, make sure it is water-based (like K-Y Liquid). Do not use petroleum jelly, vegetable oil or baby oil. These can cause a condom to break.
  • For more facts about condoms, see website Condom Effectiveness.

Actions that Don't Prevent STIs:

  • Douching (rinsing out the vagina with water or other fluids) does not prevent STIs. Neither does taking a shower after sex.
  • Withdrawal (when a man pulls his penis out before he ejaculates or 'comes') is not a way to prevent STIs or pregnancy.
  • Having an STI once does not prevent you from getting it again. You can also get different STIs.
  • Using other forms of birth control won't prevent you from getting an STI. If you are using an IUD, birth control pills, implant or shot, you still need to protect yourself with condoms.

Call Your Doctor If:

  • You have any symptoms that you think might be an STI.
  • You have sex without a condom or the condom breaks during sex. Reason: emergency contraception pills can prevent pregnancy if taken within 72 hours.
  • You miss your period and might be pregnant.
  • You have other questions or concerns.

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Barton Schmitt MD, FAAP
Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.
Copyright 2000-2024. Schmitt Pediatric Guidelines LLC.
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