Labial adhesions in girls: when the labia are stuck together

What are labial adhesions?

In young girls, the inner edges of the labia minora can stick to each other. The vaginal opening is then partly or fully covered by a thin, transparent membrane. This is called labial adhesions (labial synechiae).

It is most common in girls from 3 months to 6 years of age. During this period girls have little estrogen, and the skin is thin and sensitive. After irritation, diaper rash or inflammation, the skin edges heal stuck together.

Labial adhesions are not a birth defect and do not mean that the vagina is missing. They are often noticed by a parent by chance, during bathing.

Symptoms

• there is no opening between the labia; a thin line is seen in the middle,
• often there are no symptoms at all,
• sometimes dribbling after urinating, underwear staying wet,
• recurrent urinary tract infection,
• rarely, the urine stream turned to the side or difficulty urinating.

Treatment

• In girls without symptoms, no treatment is needed. The adhesion often opens on its own as the child grows, at the latest at puberty when estrogen increases.
• If there are symptoms, estrogen cream is applied in a thin layer only to the line of adhesion 1–2 times a day for 2–6 weeks, pressing very gently along the line. In most children the adhesion opens.
• If the cream does not help, a steroid cream is used or, rarely, the labia are separated under local anesthesia.

Never pull them apart by force: it is painful, frightens the child, and the resulting wound heals with an even stronger adhesion.

Preventing recurrence

After the adhesion opens, applying petroleum jelly or a rich cream to the area for a few weeks, washing without soap, and preventing diaper rash reduce the risk of recurrence.