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Labial adhesions occur when the inner lips of the vulva stick together. This generally occurs when estrogen levels are low, and can affect infants, toddlers and adults. The condition may go away without treatment when estrogen levels increase. Estrogen creams and manual or surgical separation can treat more severe cases.
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In most people assigned female at birth (AFAB), the inner lips (labia minora) of their vulva are on both sides of their vaginal opening and only come together around their clitoris. But if you have labial adhesions, your inner lips partially or completely stick together, like a zipper, and cover your vaginal opening. It can cover your urethra sometimes, too, making it hard to pee.
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Labial adhesions are relatively common and typically don’t cause any harm. They most commonly affect young children. If your child has a labial adhesion but doesn’t have any symptoms, they may not need treatment — it may go away as they get older. But if they have symptoms, they may need treatment.
Labial adhesions have other names, which may be more informal or medical. These names include:
There are two types of labial adhesions:
Labial adhesions occur in less than 2% of children AFAB before they reach puberty. They’re rarer in adults. But healthcare providers and medical researchers don’t know exactly how often they occur.
Labial adhesions might not cause any symptoms in infants or young children. But if symptoms occur, they may include:
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Labial adhesion symptoms in adults are similar but may also include:
A labial adhesion may look like a thin line or a bridge of tissue that covers the opening to the vagina and/or urethra.
Healthcare experts don’t know the exact cause of labial adhesions. But labial adhesions may relate to low estrogen levels. Estrogen is a sex hormone that rises during puberty. It’s key to the development of many aspects of sexual and reproductive health, including:
Children have low estrogen levels before they start puberty. Once they start puberty and their estrogen levels increase, primary labial adhesions often go away on their own.
In adults, labial adhesions may develop shortly after childbirth or after menopause. After childbirth, estrogen levels decrease. After menopause, the ovaries stop releasing eggs (ova) and estrogen levels drop.
In babies and young toddlers, frequent skin irritations may cause the labia to stick together. This may include:
Labial adhesions can affect anyone with labia. They most commonly affect children under 6 and may also affect people who’ve completed menopause. They rarely affect people of reproductive age — beginning as early as 11 up to 49.
A healthcare provider can diagnose a labial adhesion during a physical exam. They may also order a pee test (urinalysis) to check for a UTI.
If your child has a labial adhesion, a healthcare provider may suggest a “wait and see” approach if they don’t have any symptoms or problems peeing. Once your child reaches puberty and starts producing estrogen, their labial adhesions may go away without treatment.
If you or your child has symptoms, labial adhesion treatment may include:
If a labial adhesion covers a large area, a provider may prescribe a conjugated estrogens vaginal cream or corticosteroid cream (betamethasone 0.5%). They’ll instruct you on how much and how often you should apply a topical treatment.
If topical treatments work to separate the lips, the provider may recommend applying petroleum jelly (Vaseline®) for a period of time. Petroleum jelly helps prevent the raw areas of the separated labia from sticking together again (re-adhering).
Topical treatments may not effectively treat large or thick labial adhesions. In rare cases, a provider may separate the adhesion by hand. This requires local anesthesia and possibly sedation to relax your child. Unlike a stuck zipper, which you may be able to pry open on your own, keep your hands off. Only experienced healthcare providers should perform a manual separation.
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Providers only surgically separate a labial adhesion if you can’t pee and other treatments don’t work. Surgical separation may also be necessary in the rare cases in which a labial adhesion develops after childbirth.
It’s important to keep the area clean. Wipe the area from front to back whenever you change your child’s diaper to help prevent UTIs. It’s a good idea to verbally explain why you wipe from front to back, so your child will understand what to do when they’re potty-trained.
Also, thoroughly clean all the folds and cracks around your child’s labia and keep the area dry. During bath time, wash their vulva with a mild soap and clean, warm water. A healthcare provider may also recommend gently massaging petroleum jelly to the area.
Don’t try to separate the skin folds yourself. Only an experienced healthcare provider should separate the labia by hand.
Because medical experts don’t fully understand what causes labial adhesions, they don’t know how to prevent them. But you may be able to help lower the risk by keeping the area clean and watching out for signs of irritation, like discoloration, skin rashes and pain.
The outlook for labial adhesions is good. For many children, they often go away without treatment once your child begins menstruating. If treatment is necessary, the success rate is good.
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There’s a chance that a labial adhesion will return. Keep the area clean and, if necessary, regularly apply ointments like petroleum jelly.
Labial adhesions often go away on their own when your child reaches puberty and starts producing estrogen.
Schedule an appointment with your child’s healthcare provider if you notice your child’s labia cover their vaginal opening or you notice a labial adhesion affects how your child pees or causes pain or UTIs.
Go to the nearest emergency room if your child can’t pee.
Many parents are keenly aware of typical conditions that affect their young children, like earaches, a cold or the flu. But raising kids always has its share of surprises that you never thought to prepare for. Fortunately, labial adhesions are typically harmless and often go away on their own without treatment. Keep an eye on the area during diaper changes and look for other signs of symptoms. Schedule an appointment with your child’s healthcare provider if they have pain in the area, difficulty peeing or a lot of UTIs. They can diagnose a labial adhesion and recommend the most appropriate treatment.
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And remember, although rare, labial adhesions can also affect adults, especially during times in which their bodies don’t produce as much estrogen. Talk to a provider if you have any symptoms.
Last reviewed on 10/21/2024.
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