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Fused labia

fused; labia; estrogen; oestrogen; vulva; vagina; bladder; infections;

In girls and women the external female genitals include the labia majora (larger outer lips) and the labia minora (smaller inner lips). Sometimes the labia minora are stuck together, leaving a smaller opening (or rarely, no opening). This is called ‘fused labia’, or ‘labial adhesions’.

Contents

In girls and women the external female genitals include the labia majora (larger outer lips) and the labia minora (smaller inner lips). These lie along the sides of the opening from the bladder (urethra) and the opening of the vagina.

Usually the labia minora are separate, with a clear opening between them. But sometimes the labia minora are stuck together, leaving a smaller opening (or rarely, no opening). This is called ‘fused labia’, or ‘labial adhesions’. Fused labia most commonly occur when girls are between the ages of about 6 months and 6 years.

This is not uncomfortable, and usually does not cause any problems. The labia always separate as a girl gets older as the levels of the hormone oestrogen rise in her body, but if there are any problems the labia can be separated earlier.

The causes of fused labia

  • The labia are normally separate at birth, and for a couple of months after birth, because the hormone oestrogen from the mother has crossed through the placenta to the baby.
  • After 3 to 6 months, when oestrogen levels have become very low, the labia may become stuck together, possibly because of irritation of the skin  – maybe nappy rash, or not keeping the skin clean, or irritation due to some products such as soaps or bubble bath.
  • Rarely the irritation causing the labia to become fused is due to chronic sexual abuse, but this is not the usual reason for fused labia.

What does it look like?

  • The labia are joined together by a thin membrane (thin 'skin'), starting from the back of the labia (near the anus), usually with a hole at the front that urine can come through. The entrance to the vagina can be completely hidden.

What problems can occur?

  • Small amounts of urine may get trapped inside the membrane, and the girl can get an infection, and irritation of the skin and lining of the vagina.
  • Sometimes a girl may have repeated bladder infections.
  • Sometimes there can be trouble with toilet training, because a little urine gets caught above the fused labia (inside the vagina), and leaks out after she gets off the toilet, wetting her pants. This can be confusing for a very young child who feels like she has let all her wee out, only to have some more trickle out.
  • Pulling the fused labia apart can be painful, and there can be a little bleeding along the edges of the labia. As the labia heal, the edges can fuse together again.

What needs to be done?

  • Mostly, fused labia do not cause problems, and they separate without any treatment as the girl gets older, and her oestrogen levels rise.
  • If she has irritation around the labia, or bladder infections, it may be helpful to separate the labia.
    • The labia should not be just pulled apart. This would hurt her, and often they will fuse back together again.
    • Anything that could be irritating the skin should be stopped (for example no bubble bath).
    • A cream containing oestrogen can be tried (you will need a doctor’s prescription for this). It needs to be rubbed on the membrane that is joining the labia together until the labia have separated and the skin healed. This usually happens quickly (often within a week), although you may need to apply the cream for several weeks to prevent the labia from fusing again. Even when this treatment works, it is fairly common for the labia to fuse again.
    • Sometimes it is useful to rub on a gentle cream, such as creams used for nappy rash, regularly for several months to keep the skin healthy.
  • If the join is strong, and does not separate with oestrogen cream, and there are health problems, the girl may need an anaesthetic so that the labia can be separated without causing her pain.
  • If she is not having problems, no treatment is necessary.
  • Check with your doctor if you are worried.

References

Better Health Channel (Victoria) 
http://www.betterhealth.vic.gov.au/

The Royal Children's Hospital Melbourne 
http://www.rch.org.au/rch/home.cfm 

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The information on this site should not be used as an alternative to professional care. If you have a particular problem, see a doctor, or ring the Parent Helpline on 1300 364 100 (local call cost from anywhere in South Australia).

This topic may use 'he' and 'she' in turn - please change to suit your child's sex.

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