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Isolated Vaginal Bleeding Before the Onset of Puberty
Natalie G Allen1, Paul B Kaplowitz2
1Department of Pediatrics, Division of Endocrinology and Diabetes, Penn State Health Milton S. Hershey Medical Center, Penn State Health, 12 Briarcrest Square, Hershey, PA 17033, USA.
None:
Isolated vaginal bleeding before the onset of puberty is a rare presentation of isosexual precocity. In most cases, isolated vaginal bleeding without an abnormal genital examination is self-limited with resolution usually within 1 to 3 episodes. Watchful waiting is appropriate in most patients who do not have persistent bleeding, other signs of puberty, or signs/symptoms of an underlying etiology. Workup for patients with concerning features may include puberty hormone levels and/or transabdominal and transperineal ultrasound.
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