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Labial Adhesions

What Is a Labial Adhesion?

Labial adhesions develop when the labia minora (inner lips of the vulva) fuse together. This condition occurs most often when girls are between the ages of 3 months and 6 years old. Labial adhesions range in severity. Sometimes only a small portion of the labia minora adhere together; in more severe cases, they may be completed fused.

Symptoms of Labial Adhesions

Often, there are no symptoms, and the child or her parents may not notice the adhesion. Healthcare providers often identify the condition during a young girl's pediatric well-exam.

Older girls with labial adhesions may experience symptoms like irritation and urine “dribbling” out. Frequent urinary tract infections (UTI) can also be a symptom of an adhesion.

What Causes Labial Adhesions?

The cause is unknown, but evidence suggests that hormone levels during the prepubescent years may contribute to the development of adhesions. Before puberty, estrogen levels are low, and that is when labial adhesions most frequently appear.

We also know that certain medical conditions can cause chronic inflammation that may contribute to the development of a labial adhesion. Eczema, dermatitis, or vaginal infections can lead to this type of inflammation.

When a girl enters puberty, her estrogen levels rise. The higher levels of estrogen may cause the labial adhesions to separate, on their own, without medical intervention. Adhesions among girls who have begun puberty are less common.

Treatment Options

Adhesions may resolve on their own, when girls enter puberty and their estrogen levels rise. If no symptoms are present, no treatment is needed.

If the adhesion causes symptoms, there are different treatment options for separating the tissue. Speak with your child’s physician about the finding the best option to meet her individual needs.

Medication

For some girls, topical estrogen cream can soften and separate the adhesions. Treatment usually takes several weeks of applying the cream to the affected area.

Manual lysis (separation of the tissue)

If the adhesions are thick, and estrogen cream does not separate the tissue, your child’s physician may recommend manual lysis. This process can usually be done in the healthcare provider's office, with the use of an anesthetic cream. In some cases, surgery with general anesthesia in an operating room is necessary. After the adhesion has been resolved, it is important to apply petroleum jelly to the labia so the tissue does not fuse back together during the healing process.