What are Labial Adhesions

Labial adhesions occur when the two inner folds at the entrance of the vagina (labia minora) attach to each other.

This condition is most common in females aged 3 months to 6 years.

Labial adhesions usually go away on their own when your child reaches puberty. They do not affect your child’s future fertility, menstrual cycle, or sexual functions.

What are the causes?

This condition is caused by irritants that affect the labia over a period of time. The irritants make the labia sore. When they heal, the labia may stick together. These irritants may include:

• Urine.
• Stool.
• Soaps or wipes that contain strong perfumes.
• Solutions or soaps that are used to create a bubble bath.
• Skin infection in the genital area.
• Pinworms.
• Injury to the labia.

The low level of the hormone estrogen in females before puberty may also cause or contribute to labial adhesions.

What are the signs or symptoms?

Usually there are no symptoms, but sometimes a child has:

• Soreness in the external genital area.
• Dribbling urine after using the toilet.
• An inability to urinate. This is uncommon. It happens when the labia are stuck together along their entire length.

How is this diagnosed?

This condition may be diagnosed during a physical exam.

How is this treated?

Often, treatment is not needed for this condition. Labial adhesions are usually harmless. However, treatment may be necessary if:

• Your child has difficulty passing urine.
• Your child gets bladder infections.

If this is the case with your child, treatment may include:

• Application of estrogen cream to the affected area. The cream is usually applied 1 or 2 times a day for up to 8 weeks.
• Surgery to separate the labia. This is rarely needed.
• Applying a lubricating ointment like petroleum jelly, and applying gentle pressure to the adhesions.

Follow these instructions at home:

Bathing and cleaning

• Wash your child’s genital area daily. Pat the area dry with a soft towel.
• Change your child’s diapers soon after they become wet or soiled to reduce irritation. Clean the diaper area using plain water.
• Bathe your child in plain water. Do not give bubble baths.
• Avoid using soaps that contain strong perfumes on the genital area.
• Wipe your child’s genital area from front to back after she passes urine or stools.
  • This prevents urine or stool from coming into contact with the labia.
  • Teach this wiping method to older children who wipe themselves.
• If your child is potty trained, allow her to sleep without underwear.
• Apply a barrier cream or a lubricating ointment to the labia after diaper changes.

Estrogen treatment

• If your child is being treated with estrogen cream:
  • Apply the cream as directed by your child’s health care provider.
  • Color change (pigmentation) may occur where the cream is applied, and the breasts may enlarge. This is normal. The pigmentation and breast enlargement will reverse when you stop applying the cream at the end of the treatment.

General instructions

• When the treatment is complete and the labia have separated:
  • Apply petroleum jelly or zinc oxide to the area after each bath until the labia have completely healed (usually after 1 week or longer), or until your health care provider instructs you to stop.
  • Keep the labia lubricated during healing to prevent the condition from returning.

How is this prevented?

To prevent the labia from sticking again:

• Keep the area clean and dry.
• Avoid irritating soaps, bubble baths, and wipes.
• Change diapers frequently.

Contact a health care provider if:

• The labia remain attached to each other even after you have applied estrogen cream for the recommended time.
• The labia become attached again.
• Your child complains of pain when urinating.
• Your child who is potty trained begins wetting the bed or has daytime urine accidents.
• There is inflammation in the genital area.

Get help right away if:

• Your child feels that she has to pass urine and cannot do so.
• Your child develops severe pain in her abdomen.
• Your child who is younger than 3 months has a fever.
• Your child who is older than 3 months has a fever and persistent symptoms.
• Your child who is older than 3 months has a fever and her symptoms suddenly get worse.

Summary

• Labial adhesions occur when the two inner folds at the entrance of the vagina (labia minora) attach to each other.
• Labial adhesions usually go away on their own when your child reaches puberty.
• This condition is caused by chronic irritants that make the labia sore.