• Q. My daughter has had labial adhesions since 14 months of age. Can you tell me more about this and what to expect for treatments?

  A. Labial adhesions are just that, a sticking together of the labia (lips) of the vagina. It is not an uncommon finding in pre-pubescent girls and often may be without symptoms and therefore go undetected.

  The cause of this condition is uncertain, but likely is related to the low levels of estrogen in girls before puberty. Also, because the skin covering the labia is so thin in girls before puberty, local irritation from strong detergents, rubbing, or anything else may lead to itching and scratching of the area. This may cause the skin to break and re-adhere together.

  When symptoms do arise, they are usually related to the blocked flow of urine. Therefore, pain on urinating, a burning sensation on urination and/or recurrent infections in the vagina are what you would notice most.

  If the condition is not causing any symptoms, it may not need to be treated. Once she goes through puberty, estrogen levels will rise and normally the labial fusion resolves. If symptoms are a problem:
  

• A trial of estrogen cream to the area will usually seperate the labia ( use cream twice a day for 10 days). But because she will still have a low level of estrogen, recurrences are common until puberty.

• Good hygiene in the area and removing any possible irritants to the area will help avoid relapses.

• If all else fails, a fairly minor surgical procedure can solve the problem. You will need to see a specialist in the field (pediatric gynecology) if this becomes necessary.

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