No one seems to talk about this one, but Labial Adhesions are a common occurrence in little girls. It's when the inner vaginal lips (labia minora) fuse together appearing to close off the opening to the vagina. It's thought to occur in 1-2% of girls aged 3 months to 6 years.
A parent may notice labial adhesion, but they usually cause no symptoms and are noticed only at a routine well-child checkup with a pediatrician. They are easy to treat, if they need to be treated, but the doctor may want to rule out any other vaginal disorders before treatment.
What Causes Labial Adhesions?
Experts aren't 100% sure what causes labial adhesions, but most agree they are caused when the labia become irritated or inflamed, as could be the case in a wet diaper. When the raw skin heals, it creates tissue that fuses the labia together. Soap residue on clothing may play a part as well as low levels of estrogen, which is normal before puberty. They may be the result of sexual abuse, but this is certainly not the reason for the majority of cases.
Labial adhesions can cause blockage of the urinary tract. A child may also complain of ‘drips' or parents may notice urine-stained underwear. Even if the adhesions are not fully blocking the urethra, a pocket of skin may form, trapping small amounts of urine, which are released when the child stands.
Bladder infections may be more common in girls with labial adhesions. Urine trapped in the extra tissue may make it's way back up into the urethra cuasing infection.
Some doctors like to treat labial adhesions, while others believe that left untreated they most like will resolve on their own at puberty.
Treatment usually consists of the application of topical estrogen cream to the affected area. This causes the tissue fusing the labia to dissolve, separating the labia. Once separate, antibiotic cream is used to promote healing.
If your doctor opts to treat your daughter's labial adhesions, don't be surprised if they separate, heal, then later return.
Always follow the advice of your pediatrician. Never try to separate the labia with force. It will hurt and traumatize the child and usually cause the adhesions to heal worse than they started. In rare cases, the labia may need to be surgically separated by a doctor.
Effects of Estrogen Cream
It's important to note that estrogen cream can have side effects. Girls and even infants may show some minor breast development during estrogen treatment. The skin around the labia and/or nipples may darken. Stopping estrogen may even cause vaginal bleeding, but this should be very minimal and not a cause for concern. These symptoms usually subside after estrogen treatment is stopped and most girls will use estrogen without any side effects.
Prevention of Recurrence
Good vulvar care includes avoidance of irritants. Keep diapers dry and use fragrance free detergents. Don't scrub, but clean the vulva daily with water. Stay away from the bubble bath! And teach your daughter to wipe from front to back. Let the area get some air every day. Apply a lubricant like petroleum jelly to the labia at night.
The main thing is to remember it's nothing you did wrong, and it's a very common occurrence - even if no one says so!