Vulvodynia in preadolescent girls.
OBJECTIVE
Although vulvodynia occurs in approximately 7% of adult American women, we hypothesize that vulvodynia also occurs in young girls and that they respond to treatments that are similar to those used in women with this disorder.


METHODS
This is a retrospective case study of vulvodynia in preadolescent girls seen in our referral practice. Records of all office visits and any telephone or e-mailed follow-up were reviewed.


RESULTS
Between October 1996 and April 2006, 6 girls ages 4 to 11 years were evaluated and diagnosed with vulvodynia. Pain had been present for several months to 7 years, and most patients had been seen by several physicians before having this diagnosis made. Treatment was typically initiated with a tricyclic antidepressant, and 5 of the 6 girls noted improvement in their symptoms, including 2 who had marked improvement, and another 3 with substantial improvement who were able to discontinue therapy without a recurrence.


CONCLUSIONS
Vulvodynia does occur among young girls and, when treated as a neuropathic pain disorder, was found to dramatically improve or remit in the majority of those treated in this small case series. This underrecognized disorder should be considered in cases of ongoing vulvar discomfort, regardless of age.
Reed
Barbara D
BD
Department of Family Medicine, University of Michigan, Ann Arbor, MI, 48104-1213, USA. barbr@umich.edu
Cantor
Lauren E
LE
D000929:Antidepressive Agents, Tricyclic / Q000008:administration & dosage / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D005260:Female; D006801:Humans; D009661:Nortriptyline / Q000008:administration & dosage / Q000627:therapeutic use; D010146:Pain / Q000188:drug therapy / Q000453:epidemiology*; D012189:Retrospective Studies; D014845:Vulvar Diseases / Q000188:drug therapy / Q000453:epidemiology*
D000929:Antidepressive Agents, Tricyclic; D009661:Nortriptyline