Vaginal Bleeding in 7y/o

Nurses General Nursing

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Hello everyone!

I'm a first semester ADN student. My 7 y/o came home from school complaining of pain on urination, urge but inability to initiate a stream, and frequency. I immediately thought UTI and was told to bring her to the doc's office to leave a sample. The doc wasn't in, but later prescribed an antibiotic based on her symptoms, until lab results are in.

That night my daughter wet her bed and the urine was blood tinged. While bathing her the next morning I noticed blood on the washcloth and a little piece of tissue (like a piece of a clot), I also noticed some in the toilet, as she didn't flush after going. Later that evening we are out having dinner, my daughter says that she has to go to the bathroom, I take her. Well, there is a lot of blood on the tissue this time. I kind of hoist her up to take a look,and there is blood sort of pooled at the introitus and a little running down her leg! I take her to the emergency room (closest one, instead of the children's hospital) and tell the doc what happened. He basically regurgitates the info back and tells me to schedule a follow up with her pcp.

The next day (today) I call the pcp, who says that she would have told me to go to Children's because the hospital that I took her to, doesn't really serve peds. She said if it continues tomorrow to take her to Children's. Also says that on Monday, she will refer us to a pediatric urologist. It happened again tonight, I gave her a sitz bath, most of bleeding goes away still scant.

History

She was diagnosed with a prolapsed urethra in 99. There was some bleeding then, but was told to give her sitz baths and that everything would be fine. The bleeding went away, but I still see something peeking from the lady parts. I assumed it to be the urethra, but her new doc says that it is a skin tag. She said that if it isn't bothering her (it does from time to time) not to worry about it. She said that the only treatment for it would be to use an estrogen cream, but that the cream would cause her to grow hair under her arms and on lady parts. (Never really felt sure about that info)

I say all of that to ask if any of you have experience with prolapsed urethra's, or does it sound like precocious menarche. I have a terrible feeling that it's menarche. My daughter feels fine though, not a complaint at all. Just a little scared to be bleeding. If it is menarche do any of you know about treatments so that she continues to grow. I believe that the hormonal changes associated with menarche will cause her not to grow as tall as she could be. She's somewhat short now. Also isn't early menarche associated with breast cancer? My mom died of breast cancer at 48. I'm scared. Any info would be greatly appreciated.

Thanks.

Can't say anything about whether it's menarche or not but can comment on the height issue. I began at 12 and was 5'6". I finished growing my freshman year in college (18-19 y/o) and finished at a height of 5'11". Hope that helps a little??

That's good to know, thanks Nurse Izzy.

Is there a gyn in your area that has some exp. treating kids? She might be more comf. with a female doc. The first thing I thought of was that she might be one of those unfortunate cases of early menarche (I can't imagine having to deal with a period at 7y). Is she showing any other secondary sex characteristics...breast buds, any hair under arms, pubic hair? It is unusual not to have other sx., to just start with a period.

I think she needs to be seen by a pediatric gyn if at all possible.

Oh, boy. But that's what I am thinking toofab4fan. She's had underarm odor since she was about five, and needs to wear deodorant in the summer.

I'm going to call Children's tomorrow and find out if there's a pediatric gynecologist there, or if there's one in the area. I did a search last night for the MD/DC area and didn't find any names.

Thanks for your thoughts.

Specializes in Peds, Pre and post op.

dont worry about the growth issue too much. I started when I was 13 (almost 14) and I still only grew to be 5'4

but I would take her to a gyno, because I'm a firm believer in 2nd oppinions . If you cant find a ped one maybe try finding a good regular one.

What state are you in? What city?

I agree with the above reply's take her to a specialists.

I started in grade 3 age 8

I am 5' tall.

Associated with breast ca. never heard of it.

Follow up with a children's specialists and voice all your concerns

Hope everything turns out

Keep us updated

Specializes in Hospice, Critical Care.

My daughter had underarm odor since about the age 5, too, and I was convinced she had a pituitary tumor. Nope. :) She is now 13-1/2 and hasn't started her period yet.

I would certainly have her evaulated by a specialist but I'm most inclined to think it is a urinary problem rather than menarche. But definitely have it checked out.

My kids' doctor told me that menarche usually (of course everyone is different) occurs about 6 months after the development of underarm hair--not pubic hair as one might think, but underarm hair. Her prediction was quite true for my other daughters who are identical 13-1/2-year-olds. (The other daughter is fraternal to these two).

Specializes in Telemetry, Case Management.

Sixes, one of the things they relate as a breast Ca risk is menarche at age 11 or earlier. That's in most of the breast Ca risk lit.

But I am with the rest of you, this child needs a specialist at once.

And some kids do have odors very early. My two adopted kids and their cousin by blood have always had funky odors since they were quite young.

I had pv bleeding when I was 7, turned out to be false menarche - stopped after two episodes and didn't start again until I was 10 1/2 when my periods started in earnest. Had to have lady partsl pessaries and ABx, my Mum can't remember what my hormone test results were but said they weren't abnormal. I'm now 5'6" but I've only grown a couple of inches since I started menstruating.

Don't know if that helps or just complicates things.

Read about precocious puberty on some of the medical sights and see if the signs match. Meanwhile, get a specialist.

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