Labial adhesions

What are labia?

Labia is the medical term for the lips of the female genitalia. There are 2 outer lips (the labia majora) and 2 inner lips (the labia minora). The labia are designed to cover and protect other structures including the vagina and the urethra (where urine comes out of the body).

In girls before puberty the labia are small and not developed.

What are labial adhesions?

Labial adhesions means that the labia are stuck together.

This usually refers to the labia minora (the inner lips) and is also known as labial fusion.

Labial adhesions can vary from mild (only a small area is stuck) to more severe (a larger area is stuck).

What causes labial adhesions?

Primary labial adhesions happen in girls before puberty, commonly aged 3 months to 8 years of age. This is thought to be because of a low level of oestrogen (the main female hormone).

Secondary labial adhesions are much less common in children, and usually happens because of ongoing scarring or inflammation. This could be associated with skin conditions such as lichen sclerosis or dermatitis. Your doctor will discuss this with you if it applies to your child.

Other disorders also need to be ruled out. These include:

• scarring due to trauma, including sexual abuse
• structural abnormalities where the genitalia have developed differently
• female genital mutilation (FGM) can also occasionally be mistaken for labial adhesions

Signs and symptoms

Primary labial adhesions in girls usually do not cause any symptoms. They are often found during an examination for another reason.

Occasionally girls have symptoms such as:

• wee getting trapped behind the adhesions and dribbles out later on, often when the child stands up or moves around
• an increased number of urine infections
• very rarely, the adhesions can cause irritation or soreness

Treatment

Primary labial adhesions are usually mild and do not cause any problems. They therefore do not require treatment, and will usually resolve at the time of puberty.

If the adhesions are more significant or if they are causing problems, then there are treatment options available. They are:

• oestrogen cream applied to the labia in small amounts for a short amount of time. If prescribed, it will be explained in detail how to use this safely
• gentle stretching and pressure may separate the labia, but there is a risk that this will cause further irritation and adhesion will recur
• surgery may be needed in very severe cases, but this is unusual and will only be considered if other treatments have not been successful and your child has lots of symptoms caused by the adhesions

For more information, please this NHS page and video about labial fusion.