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Labial Adhesions

Conditions

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Labial adhesions occur when the vaginal lips – known as the labia – become stuck together. The area stuck together may be small or extensive.

The condition affects an estimated 2% of girls in the United States and typically develops between the ages of 3 months and 6 years. It occurs most often between the ages of 13 and 23 months.

Patients can be seen by Texas Children's experts in Pediatric and Adolescent Gynecology.

Causes & Risk Factors

While the exact cause is not yet known, contributing factors may include:

  • Irritation or inflammation of the labia – possibly from wet diapers or certain soaps; as the lips heal, they may fuse together
  • Low levels of estrogen – which affect the skin cells; girls’ estrogen levels are lowest between 6 weeks of birth and puberty

Symptoms & Types

Symptoms may include:

  • Pain in the genital area
  • Difficulty urinating
  • Leakage of urine
  • Frequent bladder infections 

Diagnosis & Tests

The diagnosis is made through a physical exam. The condition may be discovered during a routine well-visit.

Treatment & Care

Treatment depends on the individual and the severity of their condition. Never force the labia apart. It will be painful and traumatic to the child and cause the adhesions to recur (possibly worse than the original adhesions).   

Treatment strategies include: 

  • For mildcases – where the vaginal opening is not covered and there are no symptoms, the condition may be left alone to resolve or separate on its own over time
  • For moderatecases – where the lower part of the vagina may be covered, treatment may involve several weeks of a mild ointment and gentle separation
  • For more severe cases – where the vaginal and possibly the urinary opening are covered, an estrogen cream may be prescribed to help dissolve the tissue and separate the labia
  • Surgery, in very rare cases

Living & Managing

Labial adhesions can develop again. To keep the labia open, avoid irritants such as wet diapers and scented soaps/detergents and apply a lubricant like petroleum jelly to the labia.

The condition should disappear at puberty when a girl’s estrogen levels rise.