BNF for Children 2011-2012

BNFC 2011–2012 3937 Obstetrics, gynaecology,and urinary-tractdisorders7.1 Drugs used in obstetrics 3937.2 Treatment of vaginal and vulvalconditions 3937.2.1 Preparations for vaginal andvulval changes 3937.2.2 Vaginal and vulval infections 3947.3 Contraceptives 3967.3.1 Combined hormonal contraceptives3967.3.2 Progestogen-only contraceptives 4037.3.2.1 Oral progestogen-only contraceptives4037.3.2.2 Parenteral progestogen-onlycontraceptives 4047.3.2.3 Intra-uterine progestogen-onlydevice 4057.3.3 Spermicidal contraceptives 4067.3.4 Contraceptive devices 4067.3.5 Emergency contraception 4087.4 Drugs for genito-urinary disorders4097.4.1 Drugs for urinary retention 4097.4.2 Drugs for urinary frequency,enuresis, and incontinence 4107.4.3 Drugs used in urological pain 4127.4.4 Bladder instillations and urologicalsurgery 4127.4.5 Drugs for erectile dysfunction 4137.1 Drugs used in obstetricsThis section is not included in BNF for Children. SeeBNF for management of obstetrics.For the management of ductus arteriosus, see section2.14.7.2 Treatment of vaginal andvulval conditions7.2.1 Preparations for vaginal and vulvalchanges7.2.2 Vaginal and vulval infectionsPre-pubertal girls may be particularly susceptible tovulvovaginitis. Barrier preparations (section 13.2.2)applied after cleansing can be useful when the symptomsare due to non-specific irritation, but systemicdrugs are required in the treatment of bacterial infection(section 5.1) or threadworm infestation (section 5.5.1).Intravaginal preparations, particularly those that requirethe use of an applicator, are not generally suitable foryoung girls; topical preparations may be useful in someadolescent girls.In older girls symptoms are often restricted to the vulva,but infections almost invariably involve the vagina,which should also be treated; treatment should be asfor adults, see BNF section 7.2.2.7.2.1 Preparations for vaginaland vulval changes7 Obstetrics, gynaecology, and urinary-tract disordersTopical oestrogen creams containing estriol 0.01%(Gynest c ) are used in the treatment of labial adhesions(for details of preparation, see BNF section 7.2.1);treatment is usually restricted to symptomatic cases.Estriol cream should be applied to the adhesions onceor twice daily for 2–6 weeks; adhesions may recurfollowing treatment.