Have you ever noticed that your little girl's labia are stuck together while bathing or changing her diaper? Sometimes it can even look like the vagina is completely closed. As you can imagine, any mother or father would be a little scared when they see something like this. "Is my daughter seriously ill?" you might think. But in reality, most of the time, this is nothing to worry about. Today we are talking about this condition, which is medically called 'Labial Fusion' or 'Labial Adhesion'.
Simply put, what is Labial Fusion?
This is a very simple thing. What happens is that the labia minora, the delicate lips inside a girl's vagina, stick together. To be precise, these lips are connected by a thin membrane between the two. This is usually a painless condition.
This condition is most common in girls under the age of seven, especially between the ages of 3 months and 3 years . Why does it only occur in children of that age? The main reason is that the level of the hormone estrogen in the body of girls decreases before puberty. Due to this low estrogen level, the skin in the vaginal area becomes very delicate and thin. Then, even a small inflammation or infection, the lips of that delicate skin are more likely to stick together.
The important thing is that this is not something that is present at birth. It usually only appears after the baby is a few months old.
What are the reasons that lead to this situation?
As we discussed earlier, the main cause is a lack of estrogen, but there are several other reasons why the labia may stick together. Let's look at them in a table.
| Cause | A simple explanation |
|---|---|
| Skin irritation | The outermost layer of skin in young children, the stratum corneum, is much thinner than that of adults. Therefore, it is very sensitive. Inflammation caused by conditions such as diaper rash, which occurs when a diaper is not changed on time, can be a major cause of these labia sticking together. |
| Vaginal infection (Vaginitis) | An infection called vaginitis can occur due to an imbalance in the amount of bacteria and yeast that are needed to keep the vagina healthy. Harsh soaps, sprays, and even certain types of clothing can cause this. The swelling and inflammation that comes with this infection can cause your lips to stick together. |
| Trauma to the vaginal area | Swelling and inflammation caused by a traumatic event, such as an accident, injury during childbirth, or sexual abuse, can also be a cause. |
| Causes affecting older women | During breastfeeding, serum prolactin levels increase. This causes estrogen levels in the body to decrease (a 'hypo-estrogenic' state). Also, postmenopausal women have low estrogen levels. This condition can sometimes be seen in these situations as well. |
Why is child hygiene important?
Imagine that your daughter is constantly scratching her vagina and you notice that it is red. This could be a condition called vaginitis. This type of infection can occur due to things like not cleaning properly after using the toilet, staying in a wet swimsuit, or wearing tight clothing. The inflammation caused by this infection can pave the way for labial fusion. Therefore, it is very important to keep your child's vagina clean, dry, and avoid using harsh soaps.
What are the symptoms of this?
The main symptom is the adhesion of the labia minora. However, there are several other symptoms that can occur, especially if the adhesion is severe.
- Difficulty urinating: Sometimes the urethral opening can also be covered by this membrane. This makes it difficult for the child to urinate, and the urine may not flow straight through, but may flow to the side. In some severe cases, urination may stop altogether.
- Recurrent urinary tract infections (UTIs): Since urine can remain in the vagina for some time, it is more likely to cause bacterial infections.
- Vulval soreness: This symptom can be seen especially with an infection.
- Increased vaginal discharge.
- Pain during activities that spread the legs: When doing things like riding a bike, the child may feel pain due to the stretching of the attached skin.
But remember, many children with labia minora may not have any of these symptoms . No one may even know until their mother accidentally notices them while changing their diaper.
How can this be treated? Should I be worried?
Here's the important thing. In most cases, this doesn't require any treatment. As the child grows older and approaches puberty, the body's estrogen hormone naturally increases. Then these stuck labia will separate on their own without you having to do anything.
However, if the child has the symptoms we discussed earlier, that is, if it is difficult to urinate, if they often get urinary infections, or if they are in pain, then they need to be treated.
There are two main treatment methods:
1. Estrogen Topical Cream:
This is the most commonly used treatment. This cream, which the doctor prescribes, should be applied very gently to the affected skin once or twice a day. After using this for about 4-6 weeks, the thin film slowly dissolves and the two lips separate.
- Side effects: This cream may cause slight darkening of the skin in the vaginal area, slight burning, or slight spotting after stopping the cream. However, these are temporary and will go away in a few days. There is nothing to worry about.
- Sometimes, your doctor may recommend using an emollient instead, which is a cream that softens and moisturizes the skin.
2. Surgery:
This is done very rarely . That is, only in cases where ointments have not worked, urination has stopped completely, or there is a severe infection. This is a minor surgery. Since it is painful, the child is given general or local anesthesia. After the surgery, the doctor will advise you to use a special ointment to prevent re-adhesion.
The most important warning:
Before starting any of these treatments, you should definitely consult your doctor. Never use medications, especially hormonal creams, on your child based on your own feelings or what someone else has told you.
Take-Home Message
- Labial fusion in girls is a common and usually not dangerous condition.
- The main reason for this is the decrease in estrogen hormone before puberty. This usually resolves itself as the child reaches puberty.
- Treatment is only necessary if the child has difficulty urinating, pain, or frequent infections. Otherwise, it is best to be patient.
- In any case, if you have any doubts about this or if your child is experiencing discomfort, it is best to consult a pediatrician or your family doctor for advice.
- Good hygiene practices, such as changing diapers frequently, avoiding harsh soaps, and keeping the vaginal area dry, can help prevent inflammation and infection.
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