Vaginal Bleeding In the Prepubescent Child

Prepubescent girls with vaginal bleeding may be referred to or seek care in the emergency department. A thoughtful and systematic evaluation is warranted. Possible etiologies include foreign bodies, urologic conditions, and trauma, as well as endocrine disorders, bleeding disorders, dermatologic conditions, vaginal masses, tumors, and other more rare conditions. Sexual abuse should be considered in all children with genital complaints. A complete examination, likely under anesthesia, may be necessary if the cause of bleeding is not evident based on history and physical exam. This article reviews the potential causes, clinical presentations, and management of vaginal bleeding in the prepubescent child.