Are you worried about your little girl's labia sticking out? Let's talk about these (Labial Adhesions)!

While changing your little girl's diaper or bathing her, you may have noticed that her labia minora, which are located near her vaginal opening, are sticking together. It's normal to feel a little nervous and scared when you see this. This can be a new experience for many mothers. But don't worry, this condition is usually not serious. Today, we will talk about this condition (Labial Adhesions) in a clear and simple way.

What are these labial adhesions?

Simply put, it is the adhesion of the inner lips of a girl's vagina, called the labia minora, to each other. Like a zipper, these lips can close together and cover the vaginal opening and sometimes even the urethra.

Normally, in a healthy girl, the inner labia are located on either side of the vaginal opening, and they only come together around the clitoris. But when these lips are fused, that natural appearance changes.

But remember, this is a harmless condition that often affects young girls. Sometimes it goes away on its own as the child grows up without any symptoms. However, some children may need treatment if they develop symptoms.

Doctors use several other names for this condition:

• `(Labial fusion)`
• `(Fused labia)`
• `(Vaginal adhesion)`
• `(Vaginal fusing)`
• `(Synechia vulvae)` (This is the name most commonly used among doctors)
• `(Labial agglutination)`

Who is most affected by this condition? Are there types?

Yes, there are two main types of labia adhesions:

1. Primary labial adhesions: This is what happens to young children. This condition can usually affect girls between the ages of 3 months and 6 years . It is especially common between the ages of 1-2 years.

2. Secondary labial adhesions: This type can affect older women. This condition is especially likely to occur in women who have recently had a baby or have gone through menopause .

In general, the condition affects fewer than two in 100 girls before they reach puberty. It is even less common in adults. However, there is no exact figure for how many girls develop it.

What are the symptoms of this?

Most of the time, there are no symptoms of labiaplasty in young babies or young girls. It is most often noticed when the mother changes a diaper. However, sometimes symptoms can occur. They include:

• Pain in the vaginal area:Pain can occur, especially when sitting with your legs on either side of a toy (for example, a small bicycle, seesaw, rocking horse, or swing).
• Difficulty urinating : You may urinate in a dribbling pattern, or your urine may feel blocked and not come out properly. You may also cry while urinating .
• Frequent occurrence of urinary tract infections (UTIs).
• Vaginal discharge.
• There may be some pooling of pee inside the vagina behind the labia.

If this condition occurs in older women, they may experience other symptoms along with similar symptoms:

• Itching or inflammation (vulvitis) of the vulva.
• Pain or other discomfort during sexual intercourse (dyspareunia) .

What does a labiaplasty look like?

This usually looks like a thin membrane, or a bridge of tissue covering the vaginal opening and/or urethra. There may be only a small gap.

Why is this happening? What are the reasons for this?

In fact, doctors still haven't found the exact cause of this vaginal dryness. However, it is currently believed to be related to a decrease in the level of the hormone estrogen .

Did you know that estrogen is a hormone that is essential for the development of a girl's sexual and reproductive systems as they reach puberty? For example:

• Things like breast growth, hip enlargement, and body hair.
• The beginning of menstruation.
• Pregnancy.

Before girls reach puberty, their estrogen levels are very low. As they reach puberty and estrogen levels increase, these primary labia adhesions often heal on their own.

In older women, this condition can occur after having a child or after menopause. This is because estrogen levels decrease after having a child. After menopause, the ovaries stop releasing eggs and estrogen levels drop significantly.

Why does this happen to little babies?

In young babies and toddlers, the labia can also become stuck due to frequent skin irritations. Examples:

• Vulvar dermatitis.
• Diaper rash / diaper dermatitis.
• A skin condition called lichen sclerosus.

How does a doctor recognize this?

A doctor can diagnose a disease with a simple physical exam.This can be diagnosed by examining the baby's vaginal area. A urine test (urinalysis) may also be done to check for a urinary tract infection (UTI).

Is there treatment? What can be done?

If your child has labia minora but is not experiencing any symptoms or having any problems urinating , the doctor may take a "wait and see" approach. This is because once the child reaches puberty and starts producing estrogen, there is a good chance that it will go away without any treatment.

However, if you or your child have symptoms, you will need to seek treatment.

Types of topical treatments

If the labia minora is covering a larger area, your doctor may prescribe a vaginal cream containing estrogen (conjugated estrogens vaginal cream) or a corticosteroid cream (such as betamethasone 0.5%) . Your doctor will explain how much to apply and how many times a day to apply.

After your lips have separated from these cosmetics, you may be asked to apply something like petroleum jelly (Vaseline®) for a while to stop the delicate skin from sticking back together (re-adhering).

Manual or surgical separation

Sometimes, these creams may not be able to separate large, thickly attached labia. In very rare cases, a doctor may be able to separate the labia manually (manual separation). This may require local anesthesia and possibly sedation.

Most importantly: Just like unzipping a stuck zipper, don't try to do this at home. Only an experienced doctor should do this.

Surgery is only performed if the condition is so severe that it is impossible to urinate and other treatments have failed. Also, in rare cases, surgery may be necessary if the labia become stuck after having a baby.

What can we do at home?

The most important thing is to keep the baby's vaginal area clean.

• Every time you change your baby's diaper, wipe from front to back to prevent urinary tract infections (UTIs). If you talk to your baby and explain why you're doing this, he'll be more likely to do the right thing when he starts going to the toilet on his own.
• Clean all the folds and creases around your baby's labia thoroughly and keep the area dry and free of moisture.
• When bathing, wash the vulva with a mild soap and clean, lukewarm water .
• If the doctor recommends it, to that areaYou can also gently massage petroleum jelly.

Again, a reminder: Do not, under any circumstances, attempt to separate these skin folds yourself. Only an experienced doctor should do this.

Can this happen again? Are there ways to prevent it?

Since the exact cause is not known, it is difficult to say exactly how to prevent it. However, keeping the vaginal area clean and paying attention to signs of skin irritation (e.g., discoloration, skin damage, pain) can help reduce the risk to some extent.

Even after treatment, there is a chance that this condition will recur. Therefore, continue to keep the area clean. If necessary, use ointments such as petroleum jelly as directed by your doctor.

How long can this situation last?

In most cases, when the child reaches puberty and the body begins to produce the hormone estrogen, this vaginal lip adhesion will improve on its own.

When should I see a doctor?

If you see anything like this, see your child's doctor:

• If you see that the baby's labia are covering the opening of the vagina.
• If the child seems to be having difficulty urinating due to labia adhesions.
• If there is pain in that area.
• If you get frequent urinary tract infections (UTIs).

When do you need to go to a hospital (ETU) as soon as possible?

If your child is unable to urinate , go to the nearest emergency room immediately.

What questions can you ask the doctor?

When you go to see a doctor, you can ask questions like these:

• "Doctor, how severe is this labia adhesion my daughter has?"
• "Does this need to be treated? Or can we wait a bit?"
• "If treated, is there a chance this will happen again?"
• "How should I take care of my child at home?"
• "Do we need to see a specialist for this (e.g., pediatric urologist, gynecologist, or urologist)?"

The most important things we need to keep in mind (Take-Home Message)

As parents, we are very aware of the common illnesses our children get, such as earaches and colds. But sometimes, we have to experience things that we have never thought of or heard of when our children are growing up. Labial adhesions can be one of them.

But remember, this is usually a harmless condition. Most of the time, it will go away on its own without any treatment. Be careful of the area when you change your baby's diaper or bathe him, and watch for any signs of illness. If your baby is in pain ,If you have difficulty doing this, or if you are experiencing frequent urinary tract infections, be sure to see a doctor for advice. That way, you can get an accurate diagnosis and receive the necessary treatment.

Also, don't forget that, although rare, this condition can also affect older women, especially during periods when the body's estrogen levels are low. If you have similar symptoms, talk to a doctor.

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