The most common reason pre-pubertal females go to the gynecologist is concern about vaginal discharge and vaginal odor.[28] The causes of abnormal vaginal discharge in pre-pubertal girls are different than in adults and are usually related to lifestyle factors such as irritation from harsh soaps or tight clothing.[28] The vagina of pre-pubertal girls (due to lack of estrogen) is thin-walled and has a different microbiota; additionally, the vulva in pre-pubertal girls lacks pubic hair. These features makes the vagina more prone to bacterial infection.[28] The bacteria that are more commonly responsible for vaginal discharge in pre-pubertal girls are distinct from those in other age groups, and include Bacteriodes, Peptostreptococcus, and Candida (yeast). These can derive from the colonization of the vagina with oral or fecal bacteria.[29] Another cause of vaginal discharge in pre-pubertal girls is the presence of a foreign object such as a toy or a piece of toilet paper.[27] In the case of a foreign body, the discharge is often bloody or brown.[27]