Labial Adhesions

Labial adhesions occur when the two inner folds at the entrance of the vagina (labia) 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.

CAUSES

Labial adhesions may form after the labia become irritated, if the labia stick together when they heal. Labial irritants include:

  • Urine.  

  • Stool.  

  • Soaps or wipes that contain strong perfumes.  

  • Solutions or soaps 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.

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.  

DIAGNOSIS

Labial adhesions can be diagnosed during a physical examination.

TREATMENT

Labial adhesions are usually harmless and do not need treatment. Treatment is necessary if:

  • Your child has difficulty passing urine.  

  • Your child gets bladder infections.  

Treatment may include:

  • Application of estrogen cream to the affected area. The cream is usually applied once or twice daily for up to 8 weeks.

  • Surgery to separate the labia. Surgery is rarely needed.

HOME CARE INSTRUCTIONS

  • Change your child's diapers soon after they are wet or soiled to help limit irritation. Clean the diaper area using plain water.

  • If your child is potty trained, allow her to sleep without undergarments.

  • 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.  

  • Wash your child's genital area daily and dry it using a soft towel.  

  • Bathe your child in plain water. Do not give bubble baths.  

  • Avoid using soaps containing strong perfumes on the genital area.  

  • If your child is being treated with estrogen cream:

  • Apply the cream as directed by your health care provider.

  • Pigmentation may occur where the cream is applied, and the breasts may enlarge. This is normal. The pigmentation and breast enlargement will reverse after the treatment is complete, when you stop applying the cream.

  • 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 at least 1 week) or until your health care provider instructs you to stop. Keeping the labia lubricated during this time prevents the condition from recurring.

  • To prevent the labia from sticking again:

  • Keep the area clean and dry.

  • Avoid irritating soaps, bubble baths, and wipes. 

SEEK MEDICAL CARE IF:

  • The labia remain attached together even after applying 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.  

SEEK IMMEDIATE MEDICAL CARE IF:

  • Your child feels that she has to pass urine and cannot do so.  

  • Your child develops severe abdominal pain.

  • 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 symptoms suddenly get worse.