What is labial agglutination?
The labia are thin folds of skin around a girl's vagina. When a young girl's labia are stuck together, this is called labial agglutination. Sometimes the skin covers part or all of the opening of the vagina. Sometimes the skin also covers part of the urethra, where urine comes out.
Labial agglutination is also called "labial adhesion" or "fused labia". However, the labia are not permanently stuck or fused together.
Labial agglutination is usually painless. In fact, most parents and children do not notice the condition until a parent or doctor sees the genital area. In some cases, the condition is noticed because the skin is interfering with urination.
No one knows what causes labial agglutination
Labial agglutination happens most often in girls aged between three months and six years old. In girls this age, the skin around the vagina is very delicate. This skin does not contain the female hormone called estrogen. Estrogen helps to stop the labia from sticking together. When girls go through puberty and their bodies start making estrogen, labial agglutination usually goes away without treatment.
Diagnosing labial agglutination
If your child has labial agglutination, she may be sent to a gynaecology clinic. The doctor there will examine her and ask questions. The doctor will want to make sure the child can urinate without problems, and that there are no other problems with the vagina or the skin around it.
If your child is old enough, the doctor and nurses will explain to her what is going on, using words she understands. This will ensure that your child is not scared and does not feel pain during the examination.
Mild cases
If the labial agglutination is small and your child can go to the bathroom without problems, your child may not need treatment. You will be asked to apply a barrier cream such as petroleum jelly (Vaseline) or zinc oxide on the labia. This will keep the labia from sticking together any more. As your daughter gets older and she begins to produce her own hormones, the labia will probably stop sticking together on their own.
If the skin is sticking together more than before or if your daughter has trouble going to the bathroom, you should take her to the gynaecology clinic for another examination.
Treating labial agglutination with hormone creams
Sometimes the doctor will prescribe a hormone cream. The hormone cream contains estrogen. Put a pea-sized amount every day on the place where the labia are stuck together. Use a cotton swab or fingertip to gently apply the cream.
The cream may take a few weeks to open the labia. The doctor or nurse will show you how to apply the cream directly on the line of agglutination.
Sometimes, the estrogen cream will make the skin around the vagina change colour. The skin colour will go back to normal after the treatment.
Sometimes the cream has side effects. If it is used for a long time, or in large amounts, it can make a girl's breasts grow a little. This is a normal and temporary side-effect. Your child's breasts will go back to normal once the treatment is stopped.
Surgery for labial agglutination is very rare
Rarely, if the cream does not work, surgery may be needed. If your daughter needs surgery, she will be put to sleep with medicine during the operation.
Stopping labial agglutination from happening again
Labial agglutination can come back. To stop it from coming back, keep using barrier creams such as petroleum jelly and zinc oxide on the labia. This will keep them moist and stop them from sticking together.
If the problem does come back, use estrogen and barrier creams as before.
When your daughter begins puberty, labial agglutination will probably not happen again.
Applying the creams with care
Depending on your child's age, you may let her help you put the cream on, and teach her not to pull on the skin. If she is too young for this, try distracting her with a toy while you are putting on the cream.
Other things parents can do to help
- Zinc oxide or petroleum jelly (Vaseline) cream can be applied two to three times a day to keep the skin moist.
- Teach your daughter to spread her legs wide when she goes to the bathroom, and to wipe herself from front to back.
- A warm shallow sitz bath every day will help soften the skin and keep the area clean. Estrogen cream, petroleum jelly or zinc oxide should be put on after the bath.
- Do not use strong soaps, perfumes or bubble bath. These can irritate the skin around the vagina.
Do not try to force open the labia
Do not try to pull or force the labia open in any way. This will be painful and will distress your child. It can damage the skin. It can also cause problems in the future: your child may get scared if she needs to be examined again.