Lela Davidson is a mother and writer, passionate about healthcare and education for women and children.
What Are Labial Adhesions?
No one seems to talk about this one, but Labial Adhesions are a common occurrence in little girls. It's when the inner vaginal lips (labia minora) fuse together appearing to close off the opening to the vagina. According to the doctors at Medscape, this disorder most often occurs in girls aged 3 months to 3 years.
A parent may notice labial adhesion, but they usually cause no symptoms and are noticed only at a routine well-child checkup with a pediatrician. They are easy to treat, if they need to be treated, but the doctor may want to rule out any other vaginal disorders before treatment.
What Causes Labial Adhesions?
Experts aren't 100% sure what causes labial adhesions, but most agree they are caused when the labia become irritated or inflamed, as could be the case in a wet diaper. When the raw skin heals, it creates tissue that fuses the labia together. Soap residue on clothing may play a part as well as low levels of estrogen, which is normal before puberty. They may be the result of sexual abuse, but this is certainly not the reason for the majority of cases.
Labial adhesions can cause blockage of the urinary tract. A child may also complain of ‘drips' or parents may notice urine-stained underwear. Even if the adhesions are not fully blocking the urethra, a pocket of skin may form, trapping small amounts of urine, which are released when the child stands.
Bladder infections may be more common in girls with labial adhesions. Urine trapped in the extra tissue may make it's way back up into the urethra cuasing infection.
If you want to see a picture of what it looks like in a baby, there is one at the bottom of this page:
Effects of Estrogen Cream
It's important to note that estrogen cream can have side effects. Girls and even infants may show some minor breast development during estrogen treatment. The skin around the labia and/or nipples may darken. Stopping estrogen may even cause vaginal bleeding, but this should be very minimal and not a cause for concern. These symptoms usually subside after estrogen treatment is stopped and most girls will use estrogen without any side effects.
Some doctors like to treat labial adhesions, while others believe that left untreated they most like will resolve on their own at puberty.
Treatment usually consists of the application of topical estrogen cream to the affected area. This causes the tissue fusing the labia to dissolve, separating the labia. Once separate, antibiotic cream is used to promote healing.
If your doctor opts to treat your daughter's labial adhesions, don't be surprised if they separate, heal, then later return.
Always follow the advice of your pediatrician. Never try to separate the labia with force. It will hurt and traumatize the child and usually cause the adhesions to heal worse than they started. In rare cases, the labia may need to be surgically separated by a doctor.
Prevention of Recurrence
Good vulvar care includes avoidance of irritants. Keep diapers dry and use fragrance free detergents. Don't scrub, but clean the vulva daily with water. Stay away from the bubble bath! And teach your daughter to wipe from front to back. Let the area get some air every day. Apply a lubricant like petroleum jelly to the labia at night.
The main thing is to remember it's nothing you did wrong, and it's a very common occurrence - even if no one says so!
Common Sense Medical Disclaimer:
Just in case you wonder, I'm not a doctor or any other kind of medical expert. I am just an experienced mother. Information contained in this article is intended as an educational aid only. It is not intended as medical advice for individual conditions or treatment. It is not a substitute for a medical exam, nor does it replace the need for services provided by medical professionals. Talk to your doctor or pharmacist before taking any prescription or over the counter drugs (including any herbal medicines or supplements) or following any treatment or regimen. Only your doctor or pharmacist can provide you with advice on what is safe and effective for you or your child.
anakasha on August 13, 2012:
Hello, I have a daughter who is now 17. She had this as a baby. We used the cream. The only thing about the cream was it made her really sensitive and she would touch herself a lot. That is the only thing we had happen because of the cream. I stopped putting the cream on her once she was potty trained, but the cream stopped it from growing back together after the doctor opened it up. She didn't cry or get upset when the doctor opened it up and does not even remember it.
The problem now is that her opening is the size of a pencil and our doctor told me it needs to be opened surgically. She can not have sexual relations and she can not wear tampons because its so small. My question is at her age what can I expect after the surgery? Can it grow back even at this age? Also she did not have any other adverse reactions to the cream we used on her as a baby. Her breasts are normal size except one seems to be a bit larger then the other. Her doctor says that having one bigger than the other is a common thing. Nothing the cream caused. If anyone has had this surgery at an older age I would appreciate some info on what to expect and how to show her to care for it so it does not happen again.
fire4life from Twentynine Palms, California on December 10, 2011:
I came to this page looking for answers for myself. After reading all of the comments (yes, all of them), I am glad that I did not come here for my baby girl. Especially the pediatrician who's pediatrician forcibly 'fixed' her little girl without discussion. I felt so strongly upon reading that particular comment, that I know that in the same situation, I would not have been able to restrain myself, and I am a very cool customer, not prone to intense empathy, much less genuine outrage.
Many of the other comments saddened me. It seems that there is a lot of bad information out there leading to poor clinical practice, avoidable trauma (both psychological/emotional and physical, whether manual or surgical), and simply inexcusable doctor patient relations. If these pediatricians were communicating effectively, less than half these comments would not be here, because the parents would not have felt the need to resort to the internet for answers to begin with! Part of a doctor's job is to answer the questions that the patient is too overwhelmed or ignorant to ask.
After all, the doc is supposed to be an expert. The patient (or patient's parent(s)) doesn't have years of medical study to inform them. The average American can not be expected to understand much when you start throwing Latin at them... especially right immediately after they realize that you just said their kid's junk is abnormal. That's some scary stuff! Most people I've met don't know much Latin to begin with and get very confused when you start dropping fancy words into the conversation. I imagine that it's a thousand times more difficult to follow under acute stress.
I'm here because I've been battling what I thought was a secondary infection of a sutured wound for the last six months. I thought that, because that's what THREE different doctors told me it was, upon cursory examination. What I believe now, after a quick wikiwalk, is that the inflammation that LOOKED like an infection was actually an adverse reaction to, or rejection of, the dissolving stitches my OB/GYN used before thinking to ask someone known to be hypersensitive to chemicals if they (being I) had ever had them before and could be sure it would be safe or not.
If I'd been given a choice, I'd have chosen not to experiment with my junk. Especially considering I went into it knowing I'd walk out with a tiny invalid to look after. I barely had time or energy to care for myself in those first, most demanding, few weeks. I did not even realize it was a real problem until long after it was supposed to be a fading memory.
My husband has been helping me track the fallout the last couple of months, as I seem to get better one week and worse the next. I finally start to feel almost better and suddenly it's back to dreading toileting so badly that I'm subconsciously allowing myself to dehydrate to avoid having to pee, because urinating on the irritation burns like I'm being branded every time I have to go. Chronic dehydration leads to constipation, hard stools, and anal tears, which makes me even more skittish about using the toilet. Honestly, I've got a nervous disposition, but I manage my anxiety and I've worked through most of my major phobias. I don't need to develop a new phobia now that my functioning level of paranoia is almost indiscernible from 'normal' people.
Tonight... well, I guess last night, now. Last night I felt a weird tension, a pulling sensation, that wasn't there before. I had my husband check my injury and he said it's very strange, but that it was both better and worse. The worst of the swollen bits was much improved, but it had somehow fused to one of the smaller sores on the opposite side.
Most of the original tears were really no more than minor abrasions of the vulval vestibule, with the worst tear separating the posterior edge of one of my minor labia from the perineal area. Which, oddly, was the part that caused the least trouble while healing, though it will never be like it was before (which would be a lot to expect after having a baby, at any rate!). I believe that at this stage, my labia are just doing the best they can given the circumstances.
I am breastfeeding a greedy little glutton, who (even at six months!) thinks she's starving to death if she isn't eating every two to four hours AT NIGHT, every twenty to thirty minutes for at least two hours twice a day, and no more than ninety minutes to two hours the rest of the day. I attribute the constant feeding to being very small chested, and I really don't mind. I've been an insomniac most of my life and have struggled with it on and off over the last year. She sleeps, someone has to. (Thank goodness she's taken after her daddy! They'll sleep most of the night and half the day if you let them stay in bed! She fights sleep when she aught to nap if there's anything even remotely interesting going on though, so I guess she got something from me in that regard, too.)
I think the idea that babies should sleep through the night without care is ridiculous, though. Just because she sleeps through, doesn't mean I get to. She needs two to four diaper changes most nights, very occasionally she stays dry all night, but I always check at her regular times. Like I said, I don't mind the midnight snacking, but it's easy to handle since we co-sleep and I still have to get up to wash my hands after diapering, which requires significantly more effort than breastfeeding. I could see it being a pain for formula babies, so maybe that's where the impression comes from? I didn't sign up to take shortcuts, so I don't resent losing precious sleep. I just value what sleep I do get that much more.
Besides... what could be sweeter or more indulgent than getting to curl up for a nap with the cutest cuddlebutt ever born on a slow afternoon? (Of course, we all think ours is the best, but mine really is ;) ) Speaking of which: in the time it took to read all of these comments and ramble on, I've had to stop three times to do rounds of feeding and diapering, the last two only an hour apart. It is now morning, so I'm going to try to sleep. Days like this make me really glad that we planned for an extended maternity leave. No work for the weary! I get to be a zombie all day and hubs will change a couple of diapers!
sissy on September 17, 2011:
my daughter is 20 months old and has surgery in 6 days she has been on the cream for 6 months with no luck. she is so closed that they couldn't even get a cather in her for test on her bladder for her other med problems. she was born with congenital scoliosis and spina bifida her scoliosis curves to the left and can affect all of her major organs the doctor said her curve is already at 40 degrees lying down so we don't know how bad it will be when she has a xray standing up in nov. please pray for her.
soflagal on September 07, 2011:
I am so thankful for this article and the informative comments. My daughter is 7 years old and was diagnosed as an infant (actually, her twin has no problems with this.) We were initially given the Premarin which did nothing but irritate her, and which made me very uncomfortable to use due to the hormones. We have had no problems with uti or urination at all but she just started telling me she is dribbling after she urinates. I think I will try the flax first and if that doesn't help I will schedule a ped urology visit.
I would appreciate hearing from anyone whose child had the surgery and what the recovery was like. (She is in first grade and I want to be sure she has enough recovery time at home before heading back to school, so might possibly schedule a procedure before Thanksgiving.)
kristin on August 25, 2011:
my daughter is now 19 months old. we found out about her adhesions at her 6 month well checkup. the doctor notices them and put her on premarin cream and it didn't work at all. we took her to have the surgery done and they also did a cystoscopy(she was only having 1-2 diapers a day at 8 months old) and 2 months after it was lasered open, it came back and now we are waiting for her to hit puberty. she was on an oral medication from month 8 to 13 months. after she came off of it, she was having febrile seizures occasionally and fevers once a week. it has all stopped now, thank God! but we are still fighting with the adhesions. it hurts every time we wipe her and she doesn't want to potty train anymore (we started practicing potty time at 14 months).
Louise on May 10, 2011:
Hi, Just to let you know that my 4 year old daughter just had surdery last month on her 'bits' as she calls them. So far, best thing we could have done. She had quite bad adhesions, and so far the surgery seem to have done the trick. It was relatively simple - the operation and didn't upset her that much... just a few painful wees in the bath afterwards. I am happy to chat about my experiences if anyone wants to.
Shirley on April 01, 2011:
I've just found I had it and I'm 17 and I've become so upset about it. I don't feel like it's normal at all. I apparently had it at six weeks old and that all they did was 'apply estrogen cream' but It has sort of depressed me a little. I'm extremely upset.
magmouse1 on March 25, 2011:
Thank you for all the information and reading from a Dr. is a blessing. My daughter is 10 and has had this since birth. As a toddler we tried the Premerin, as a mom my gut told me don't do it so I stopped after 2 weeks and decided to just let it be. For a couple of years it seemed to cause no problems at all. At the age of 7 the UTI infections began, urination combined with different antibiotics causes diarreha and a constant reminder to my daughter that "something" is wrong with her vagina. I worry about her sexual intimacy later in life and worse that she asked me the other day if she would ever get to be a mommy. Last week the urologist(not pediatric)referred us to a GYNO for the surgical procedure. I'm so frightened of scarring her for life and don't know what to do. Seems by reading here that even surgery does not work. My insticts as a mother say no don't do it. One of my concerns though is that she will start her period and this will not be resolved. We live in California. What do I do?
Viola on March 17, 2011:
My daughter is almost 8 and this is her second time with adhesions. The first time, ( approx 6 yrs. old) the MD ordered Premarin cream which made her begin to devolop dark pubic hairs and breasts which now she has to wear a bra daily in the second grade. She is complaining of urinary retention and etc, urinalysis show no bacteria but yet as she urinates she cries that it is so weird feeling. The doctors seem uncaring about this but it isn't his kid sitting there crying on the toilet. This site has been so helpful and made me realize that my daughter is not the only one out there experiencing this. We go back to the MD tomorrow for the second time this week, the other day he only ordered baking soda baths and hydocortisone cream to the labia, its ridicoulus. Thank you everyone for sharing your stories.
MotherOfPearl on March 03, 2011:
They say, don't freak out. How can I not freak out when I see words like UTI and infections!!? I'm so sad right now.
MotherOfPearl on March 03, 2011:
Pardon me... MotherOfPearl and AmazingAmazon are the same person.
AmazingAmazon on March 03, 2011:
Also, I'd like to mention that her case is mild. The doctor didn't seem too worried and asked me to keep an eye.
MotherOfPearl on March 03, 2011:
As my eight-month old sleeps, I read your comments and wonder what to make of all the different points of view, Ladies. I'm confused as to what the common voice is here. Here's my own small list of specific questions. Please, someone reply...
1- While bathing my baby, I wash her with baby wash rather nicely in the name of good hygiene. Now, when I read labial adhesion could be a result of soap irritation, I blame myself for bringing this upon my innocent child. Am I right in thinking this way. Also, I don't change her diaper during the night. Should babies be changed more frequently?
2- Her doctor has prescribed A&D ointment. Is that okay to use, or does it have side-effects, too?
3- A&D ointment vs leave it alone? What's better?
4- Do I need to completely dry the specific area before applying cream/flaxseed oil?
5- Is olive oil a good idea?
6- How do I prevent rash in that specific area? I use cornstarch with every diaper change, but I don't go there?
7- Does this condition hurt, irritate or make babies uncomfortable?
Brooke on February 22, 2011:
Hi I just found out my daugherty has this but hers is a little diffrenet she has a problem that she got from me we are both very extra sensitive down there and get infections very easily whice irritate that area which makes it worse and close more so she has to be very clean at all times she is not allowed to take a bath only showers she has to wipe with baby wipes not tolit paper and has to spray water down there after waking up and playing outside anytime she swets and anything she sits on needs to be cleaned so we can do what we can to keep her clean so it doesn't close anymore she will live with the sensitivity for ever but will more than likley grow out of the labial adhesions so make sure if your child has this that you keep them clean becAuse it could make it worse.
Lisa on February 21, 2011:
Thank you so much for the information!! We just found out that my 2 yr old daughter has this. She also has been getting UTI's so this might be the cause. The picture was also very helpful.
Still Worried on February 09, 2011:
My daughter who is almost 2 now has been battling these adhesions since she was just over 10 weeks old. At first it was not much of a concern, our pediatrician mentioned the adhesions but did not think there was any need for concern. About 6 months ago, FINALLY most of her 'adhesions' had cleared up at least enough to reveal yet another concern. That she is absent a vaginal opening. We were then sent into a whirlwind of questions that no mother want's to consider and sent off to a Pediatric Gynocologist at Children's Hospital. He examined my daughter with the utmost respect and believes that the absence of an opening is due to a very thick adhesion that is covering the opening, however there are other things it could be and we simply won't know until puberty. Once she hits puberty the natural hormones of a girls body will cause the adhesion to dissolve and hopefully it will reveal all the normal parts and functioning of a normal female. I am not posting this to scare anyone, but it is important to keep up with the adhesions so you can know your daughters anatomy and advocate for her at her appointments. We are back to the doctor tomorrow because her adhesions have worsened and she is pretty much zipped up all the way to her urethra and I am concerned she will get a UTI (which my first daughter got often as a baby and it is horrible). If you don't keep an eye on these adhesions and use the vaseline (in our experience) they will continue to get worse. I have to use vaseline after every diaper change, change her diapers often, as well as put her in a tub of warm water daily for at least 20 minutes to help keep the natural healing bacteria of her body at bay and not trying to heal her together in her neither regions. We are still worried about the other diseases as they can be very difficult for girls as they get older but we must just wait and see.
Nervous Mom on February 01, 2011:
About two months ago, my one year daughter was diagnosed with a labial adhesion. She was prescribed the Premarin and despite my apprehension, we used it for three weeks and her issue cleared up fairly quickly. I was uncomfortable with giving my one year old hormones, but I trusted her pediatrician. Now, two months after the initial diagnosis, it has come back, though I think we caught it before it got too bad. What concerns me most, besides using estrogen to clear up this problem, is that from all that I've surmised from others on the internet, it seems that this issue will repeatedly come back. My daughter's doctor made it sound as though it was just a matter of changing her diapers frequently. I do change her frequently but we've still go the problem. I now wonder if it has anything to do with the fact that she is in cloth diapers. On top of that, the nurse I spoke with last suggested using petroleum jelly at each diaper change. And maybe I'm being a bit too squeamish, but I just feel really uncomfortable with having to get into my daughter's "business" at every diaper change. It seems too much and she's starting now to get to the age wherein she's resisting more. She has had no UTI as of yet and seemed to be in no discomfort when the adhesion was at it's worst. I'd really like to just let it be and see what happens from there but I guess I'm feeling pressure from the pediatrician. I don't want to end up with my daughter in worser condition but I also don't want to somehow scar her both literally and figuratively at every diaper change. I appreciate Dr. Michelle's words above but don't feel as though our pediatrician will have the same sensitivity. Maybe I'm over analyzing things. We see the pediatrician again in another two weeks and I think I'll just be honest with my apprehensions and just stick to the Premarin for once a day for now. In the meanwhile, if anyone has any more natural remedy (i.e. diet or something), I would really appreciate it. Thanks.
Janette s on January 30, 2011:
I discovered my daughter had this problem 4 yrs ago, she is now 6.We went with the cream and it did work but it closed back up again not long after.We were advised by a gynaecologist not to continue with the cream.Now at 6 yrs old she has developed a constant discharge of which we are awaiting pathology reports.Now we are reconsidering our options.She is wearing a mini pad to school that frequently needs changing by me.This imformation on the net is very useful, but we are still undecided of what course of action to take.Any advice would be helpful.She is my fifth child and I thought I had seen it all at nearly 50 yrs old, obviously not as this has shocked and bewildered me.PS a photo 4 yrs ago would have been helpful
Katie on January 18, 2011:
When I was little I had fused labia, at least I know that's what its called now. I was very young but I remember going to the doctor and they would rip the opening back open. Id have to ask my mom but back then (I'm the 80's) they didn't offer up cream.
My whole life I have had a separate little hole, it's like a thin piece of skin creating an alternate entry into my vaginal area. I've had tampon strings get wrapped around it. Sex and other activities can hurt if it goes in there.
Just today I had this corrected. Once the pain and swelling go down I'm hoping it gets better.
lisa on December 15, 2010:
Today i changed my grandaughters nappy and found she has this condition,I am glad i googled this,as we were sure she used to have an opening,(we thought we going crazy)now reading articles i know shes going to be ok thanks a not so worried granny
cynthia on December 08, 2010:
MY DAUGHTER HAS HAD THIS PROBLEM FOR YEARS. IT STARTED WHEN SHE WAS 8MONTHS AND NOE SHE'S 4 YEARS OLD THEY GAVE ME A CREAM AND IT WORKED IT OPENED AND THEN CLOSE SO NOW SHE'S GOING TO THE DOCTOR AND THEY SAID SHE WILL HAVE TO SEE A SPECALIST.
THIS HAPPENED TO MY FIRST DAUGHTER AND IT ALL WORK OUT FINE BUT WITH MY YOUNG ONE IT'S A BIT MORE HARDER. I JUST HOPE IT ALL WORKS OUT WITHOUT SURGERY
Angry Pediatrician on November 15, 2010:
So my daughter's one year well child was today, and she was found to have labial adhesion, and then forcefully opened manually by her pediatrician with NO WARNING. He said that it was good we found it now so we didn't have to mess with creams and such later. Are you kidding me?? She has been crying with every diaper change and every time she urinates. I have never been so angry. And get this.... I'm actually a pediatrician too. I take my kids in for their shots and for another set of eyes to make sure they are fine. Never again.
So in short, excellent article.... excellent responses for the most part. I would prescribe the Premarin for a short course IF there are complications of recurrent UTI's etc. Beyond that, for more complicated cases or recerrance, I would be referring the cases to a pedi urologist. Make sure you are taking your children to a PEDIATRIC urologist, even if you have to travel to see them.
I'm going to go hug her again now. Poor thing. It was horrible. And I'm used to having to make kids cry.
Heather on November 02, 2010:
@Milk Mommy: From what I understand, there is no need to be scared. Adhesions aren't really talked about, but they are fairly common. From what I've read, in many cases they resolve on their own eventually and it's okay to leave them alone as long as it's not bothering the baby or preventing urination - just make sure to monitor it in case it closes too much. If the adhesion is significant or there is a risk of infection because the adhesion covers the urethra and traps the urine, then it might be necessary to treat it (we used flaxseed oil instead of the Premarin after checking with our pediatrician). Once it opens, our pediatrician said to apply an ointment (Alba Un-Petroleum jelly is good, and we've been using calendula oil) to keep the area open and soothed (irritation can cause it to close again). Once it's open, there is definitely a chance the adhesion will come back, so be prepared for that, and try not to worry. Remember that this is a temporary condition that will eventually go away and that your baby will be just fine. Whatever you decide, talk it over with your pediatrician (and don't be afraid to find another pediatrician if yours isn't willing to talk over different options with you or answer any questions you have). Good luck!
Milk Mommy on November 02, 2010:
I found out last week that my 10 month old has a vaginal adhesion. I was scared and Im still concerned I hope that she'll open up and never have to go through this again. I'm using the cream the docor said put it on once a day 4 10 days the once every other day afterward with a q tip and try to separate it as I apply only on that little area. I see that its starting to look like its trying to come back now. I want her to be healthy and have babys when she grows up I hope she gets back to normal. I need to look up flaxseed oil thats sounds more natural then this cream I hate side effects.
Heather on October 25, 2010:
Our pediatrician diagnosed my 10 month old with a labial adhesion about a month ago and prescribed Premarin cream. Instead of using the cream, we opted to let it be and watch it instead since it didn't seem to be bothering her. Once we noticed it closing more, we decided to try flaxseed oil, and the adhesion opened up after about 4-5 days of applying the oil after every diaper change. For the last day or so we've been using calendula oil to soothe the area and keep it open - so far so good!
Laurie on October 23, 2010:
Premarin works great. My 9 month old went into the doctor and was given Premarin it worked in only a week or two. She had it when she was 3 months old as well but it was so thin (the growth of the labia) that the doctor just pulled it apart easily. I wouldn't do surgery unless Premarin wasn't working. It worked wonders on my little one. Although reading through this my Ped told me that it was common in larger babies. Is this a misconception that it normally happens in bigger or chubbier babies?
Tisha on October 21, 2010:
Alison-I agree that if your daughter isn't having any serious complications why rush to do something so serious as a surgical procedure. Not only will she better understand it when she is older (IF she actually needs it then), but who knows in the next 8 or so years if a new treatment will be out that will be less invasive.
Alison on October 18, 2010:
My 4 1/2 year old has had this since she was months old. We've moved 3 times since she was first diagnosed and have been given so many different opinions about treatment from her different pediatricians. I am so confused on what is the "best" thing to do. I appreciate all of your comments and thoughts...you've helped me realize it's okay to go w/ my "gut" instinct and leave her alone!
She had the surgery once about 6 months ago and they have since closed back together. The pediatric urologist whom we were referred to has said she thinks it would be worth trying it one more time. This particular Dr. (who is differnet from the one who did the 1st surgery) wants to clip part of the skin away and hold the rest back w/ stitches so the skin isn't tempted to fuse back together. While this makes sense...I can't stand the thought of putting my little girl through this again. It got to the point that it was more pshychologically painful than anything. She doesn't suffer from anything due to the adhesions...no UTI's or dribbling at all. The part that worries me is that we've had 2-3 different Dr.'s tell us that her adhesions are more "dense" than normal and they probably won't open on their own. My thought was that if they need to be surgically opened when she's older then at least she'll understand more about what's going on. This last specialist we saw didn't seem to agree w/ me about this...so again, more confusion!
I'm definitely feeling like we need to wait on this, because I don't want to "scar" her emotionally & if it's going to keep growing back together then what's the point?!
NeMa on October 12, 2010:
my daughter was diagnosed with this today. Never heard of it and scared me cuz i wandered why her diapers were like someone emptied a water bottle in it after every change. looking back it makes so much sense now. this information was very informative. the pic i used as a comparison. yes i understand being a mother i agree with the angry comment regarding the pic but if you found it on another website then you are not to blame. without it i wouldn't exactly felt reassured what this was. the dr. showed me but i was like a deer in the headlights. o_0 so thanks for the pic for educational purposes. you helped ease my mind. thanks.
mom of 4 kids on October 11, 2010:
mom of three girls you are crazy. You do need to inspect. If this affects the urine flow then it is problem. Who cares if you can see it or not.
Dayna on October 08, 2010:
my daughter is now 4. when she was 3, she kept developing bladder infections. finally the doctor noticed that her upper labia was closed. we used premarin and it opened. later it closed back up and we are back to using the premarin. since I have kidney/bladder problems with a family history, her doctor is sending her to a pediatrician urologist to make sure there are no deformaties. she said that if it shows that it's only the labia closing that is causing the problems, then she will off and on have to use premarin to keep it open. She should outgrow it about 6-8 yrs old.
Mom of three girls on September 30, 2010:
My 4-year-old DD has a minor adhesion, nothing that covers the vaginal opening, but seems to cause her urinal flow to go slightly forward, not directly down. It's not a problem, she just needs to pay more attention to how she sits on the toilet.
I cannot believe how many moms - after reading this and other information regarding this condition - still choose to apply hormone creams and schedule their babies, toddlers and little girls for surgeries - sometimes repeatedly!!! WHY???
All girls (including moms, who all used to be little girls) know how little use vagina has prior to puberty. Most little girls have no idea they have one, it's not something that sticks out like a penis does on little boys. Even if they run around naked, no one can see any difference. So who cares if the opening is closed, when there is no need for it anyway?
Just let it be, ladies. Let your little girls enjoy their carefree childhood. No need to pass on to them your own anxieties about your bodies & sexual organs. In all likelihood their condition sorts itself out by the time they become aware of how things "should" be. And should they need a medical intervention, the time for it is much later, when they are more capable of understanding the reasoning behind it.
If your daughter is not in pain, and the urine flow is not affected, stop inspecting their girl parts!!!
Mamaberts on September 05, 2010:
The Premarin cream did not work on my 23 month old after 2 weeks of applying. Specialist just prescribed Betamethasone Dipropionate. Researching online but don't see many medical connection between labial adhesions and this cream treatment. If this does not work they specialist will prescribe another cream. Has any other Mom used this Betamethasone Dipropionate on their baby girls? Thanks.
momof3 on August 23, 2010:
My daughter has just been diagnosed with this at 4 months. I am using estrogen cream because she has an extremely small opening to urinate through and we do not want to risk that opening becoming smaller or completely closing. My sister and I were both diagnosed with labial adhesions as infants and my pediatrician would pull the vaginal opening apart each year at my check-up. My mother also did this to us some. We never used any kind of cream. It was an extremely painful experience and it hurt terribly to urinate for a couple of days afterward. From what I read now, pulling it apart like that can cause it to close worse. This treatment continued on my sister and I both until we hit puberty (about 13 years old). My understanding now is that it naturally corrects itself at puberty and the treatment we were put through was not only painful and useless but completely unnecessary. I am very hopeful that the estrogen cream will work for my daughter. It is reassuring to see so many people going through the same thing!!
thank you all for the great advise. on August 18, 2010:
My daughter has this condition and just had surgery. Although that is not what I wanted to comment on. I think it is uneducated (in the particular subject of discussion) people who are offended by a picture that is used to educate others on a matter which is very serious. Those who were offended by the picture that was linked to this mothers website are very uneducated in this matter. IF YOU LOOK AT DOCTORS WEBSITES ON THIS SUBJECT YOU WILL FIND PICTURES OF A CHILD'S VAGINAL AREA!!! IT'S FOR EDUCATIONAL PURPOSE; NOT PORN, STUPID IGNORANT PERSON WHO WAS OFFENDED!!!
Marianne on August 03, 2010:
I can remember having this when I was younger, probably around five or six years old. I found this article because I was curious about whether vaginal adhesion as a child could cause problems when I am trying to get pregnant. Thank you so much for clearing things up for me! I am so sorry that other women have had bad effects from this later on in life. I can remember going to a special doctor who examined me, and that my mom applied a cream every night. My mom explained what she was doing and why she needed to do it, so I was never afraid of having the cream applied. If your daughters are old enough to understand or to remember it later, make sure that you explain what you are doing. If they remember a doctor or a parent touching them later in they life, they may be confused, hurt, or scared.
Lea44 on July 15, 2010:
I am 66, and just developed fused labia. It was surgically corrected, and immediately fused again. I did not understand it at all, and my uro-gynocologist couldn't tell me much. All of you have given me the information I need to heal this. Currently I am using estrace, and I'll see if it works. ASAP I will begin probiotics, because I have recurrent yeast infections, am always itchy. I was being treated for a fungal condition but they didn't make the connection with the labial fusion -- I now know to call it labial adhesions.
Liv on July 12, 2010:
My daughter has been dealing with this since she was an infant. We originally tried the cream (Premarin) with no success. I have also tried different doctors. She has had it surgically opened 3 times. We have tried Vaseline, and A&E ointment with no success. It continues to come back. She will be 7 and the dripping is a big issue for her. I pray that puberty helps out, but surgery does not guarantee it will stay open.
Barbara on July 10, 2010:
I have twin girls that will be 3 in August. One has had an adhesion since she was about 6 months old. At 6 months the Dr. prescribed the premarin cream with no success. Recently another Dr. represcribed the cream, again with no success. After my daughter got her first uti a few weeks ago, her Dr. has referred me to a urologist for surgery. Is this necessary? I was never even informed of the fact that it is likely to happen again if the surgery is done at a young age.
Lisa on June 18, 2010:
I need to add a comment to my post. I should have wrote that it scares me to put the Premarin cream on my daughter since it is intended for adult women going through menopause. I've read some posts that explain some side affects of this cream. Again I'm very thankful for coming across this BEFORE I started treating her and feeling better about making an educated decision.
Lisa on June 17, 2010:
Thanks so much to everyone sharing their information about this condition. I noticed this on my daughter when she was about 6 mos. We went and saw a specialist here in Canada who told me to wait about a year and see if it will open on it's own. She mentioned that potty training might be difficult for her. I took her back this past week because it has not opened. She prescribed me the Premarin cream. I had no idea what this was but when the pharmacist came to give it to me, he questioned if I knew. He said he had never prescribed this to someone so young before. Alarms went off in my mind. I came home and have been reading for a very long time. This cream is normally prescribed to women going through menopause. I'm thankful for reading all these posts because I have decided to let it be for now. I will continue to potty train her and if I feel the need to do anything, I will first try a natural product before trying this cream. Thanks to Dr. Michele who helped me make my decision.
Anna on June 17, 2010:
Again I want to emphasize Dr Michelle's previous instruction - the best thing to do is NOTHING unless there is sign of infection or urinary obstruction - both my girls and I have labial adhesions - for me and my older daughter the adhesions have been from the inner labia to the outer - this has caused me pain during "hand-holding" with my husband because of friction causing forceful opening. However it is not a nuisance at all to my older daughter who is now 5 - the last time she had irritation I checked - she had a mild yeast infection and was still adhered - about 7 mos ago...
My younger daughter is 21 mos old and she has had more extreme adhesions - covering the entire hymen as in the linked picture and inner labia to outer labia and inner to inner, but still enough room to urinate... when hers got this bad (and it happened quickly) I started using probiotics with her(baby jarrodophilus) within 3 days some of the adhesions had released - diet is important to some of these babies suffering from adhesions and should be addressed before creams/antibiotics (unless there is sign of infection) - please don't brutalize your girls genitals - this generally resolves by pre-pubescence remember and as long as she is not in any pain then she is fine. Your preconceived versions of normal and her not being that is more harmful than the actual condition. Be gentle on your daughters.
gaea on June 01, 2010:
Survivor: I too had these when I was a child, but they didn't use cream. My parents told me about it as I was growing up, and in my twenties I dealt with memories of my parents holding me down and "opening" me when I was about three...I felt totally violated by the action tho I don't remember pain. They told me that the doctor did it in his office when I was younger, so they decided to do it at home when it happened again. I've gotten through most of the charge I had on the experience by thinking about it and releasing the energy. I also called my dad a few years ago and asked him detailed questions about what happened, because all I remembered was being held down and screaming. I was not a screamer as a child, I tended to be fairly calm and quiet.
How its effected me is that I've thought of my vagina as an "open wound" for years, and it still feels like its more sensitive to the touch than most people's. I've done some healing work around reclaiming my body as my own, getting through some anger about how men touch my vagina (if a man was touching me in a way that I didn't like, I'd feel this rage in my body, and though I wouldn't tell him, I'd feel "violated" or angry afterwards.)
I have gotten through all of this as far as I can tell, and don't have much charge on any of it now, tho I still seem to easily get infections and my skin feels sensitive and easily feels painful if its touched the "wrong" way. The reason I found this site today was because I wanted to look up how common this was for other girls, and its good to know its pretty common. I'm glad my parents didn't use the cream, and I think they did the best thing they could do. They surely didn't have a clue that their actions would follow me through my adult life or into my sex life. Only thing that would have been better is if they had actually explained what they were going to do and treated me like I was involved with what was happening with my own body. I was a reasonable kid, but children back then were done to more than reasoned with. I'm 37 now.
Kristin on May 30, 2010:
My daughter is going to be having surgery for her Adhesion in 3 days. she is 7 now and has had this problem for about 2 yers.. We tried the cream several times and had no luck so he sent us to a speclist. the Specialist said that the skin was extermly thick in that area... My concern is will it look funny after they surgically open it? i dont want her to feel insucure about her self when shes older... Shes already been through 2 heart surgery (one being 2 monthes ago) so she has been though a lot in her 7 years... also, what should we expect after surgery?? pain? recovery? and yes i asked the docter and he gave me the standered answers but i want answers from other parents who have gone through ot! Thanks so much!!
denise on May 29, 2010:
we used the cream to treat our daughter(4 month) and it made her very moody i was wondering if this happened to any other parents out there? thanks for the page it is very helpful and good to know that our little ones not alone with this thanks
Survivor on May 28, 2010:
I am a 28-year-old woman who just found out that I had labial adhesions as a child. My mother mentioned it, and I have been researching online ever since. For many years I've had disturbing memories of my doctor "pulling me apart" and my mother applied cream (not sure what kind) from the age of 4 until about 8 years old. I do have some sexual disorders now, mainly that I'm married and am never in the mood. Granted, this could be due to any number of reasons, but I can't help but think that my feelings about sex being "unsanitary" result from this trauma as a child where my vagina had to always be cleaned with this cream and I always had to be careful to get everything when wiping. I had several UTI's from the age of 3 onwards, but never had surgery. My doctor and mother simply pulled me apart with a great deal of pain and I'm worried that it has now affected me sexually. I also have enormous breasts that developped when I was around 12, long after the cream stopped, and I wonder if the years of cream caused this. It's not genetic; no other women in my family have breasts the size of mine. I'm an F-cup. One other note... I've noticed that I never remember having a hymen. Perhaps this was also "pulled apart." I'm curious to know if any other women out there have similar experiences to mine, or if anyone can tell me definitively whether or not my treatment could qualify as "abuse" and have caused my current sexual disinterest and large breasts. I feel so shocked that I never knew about this until just recently!
Sarah on May 22, 2010:
Well, our doctor had us apply estrogen creme for 2 more weeks, this time applying 2 times a day. Her vagina just opened up a few days ago. How likely is it that it will grow back together, and is there anything that we can do to keep it open? Also, is this painful for her? She has cried for months now every time we change her diaper.
Dr Michelle on May 17, 2010:
I agree you should have your daughter seen by a doctor familiar with this condition, and one who is gentle with little girls. You'd have to travel a long way to see me - I'm in Cape Town, South Africa! Generally I say to distant patients to ask around their community - often someone will have come across a doctor with a good reputation and will be happy to pass their details on to you.
Once your daughter enters puberty, her oestrogen levels will rise, and har labia should divide on their own. Since menstruation occurs on average 2 years after the onset of puberty in girls, the labia are usually well open by the time her periods arrive. A gentle non-invasive examination of her genitalia once her breasts have started developing will give your doctor some idea on how she is progressing.
Good luck to you and your daughter.
Sarah on May 07, 2010:
We just finished a month of applying estrogen creme nightly, and my 14 month old's vagina is still grown shut. We're headed to the doctor today to see what she suggests the next step should be. My baby is running a 104.1 fever and I'm wondering if she has an infection now.
Kathy on May 06, 2010:
I have a 10 year old daughter and am confused. I am in the process of looking for a doctor for answers. We are at the stage of puberty and I am worried that she will begin menustruating and still be closed. She had the operation about 5 years ago and was in awful pain after. Any help would be appreciated--we live in Nebraska but are willing to travel for an expert. Dr. Michele???
shandel on May 04, 2010:
I wish I had known all of this 5 1/2 years ago and asked a lot more questions. My daughter first pediatrician did not give her a cream at first. Not once but three times he forcefully opened her using his hands. No numbing cream no special tools. At the time I trusted him and his decision. Until I moved to another state and transferred her records to find out that was a no no. He later prescribed estrogen cream which by that time it was too late. She also has kidney reflux in both kidneys. It has been a very long and traumatizing road for her. She is still grown together and suffers from pain and uti's. She has been opened 6 times and they refuse to do another unless her uti's get worse, which they currently are. We could be facing many problems when she hits puberty. Im curious to find cases that may be similar to hers.
Janice Veal on April 08, 2010:
My daughter has had this problem since she was born. She is now 5 years old. When she was a baby, our doctor prescribed Permarin cream and it worked, with no side effects. About 3 weeks ago it happened again, we took her in and again was prescribed premarin. We were using as directed, 2 times a day. But 6 days ago my daughter started complaining her nipples hurt. We took her in and she is starting to grow Breasts due to the premarin. I DO NOT suggest anyone use premarin after this. I cannot believe my baby is getting breasts because of it. We are opting for natural remedies and suggest anyone with this problem do the same. For now, we are using A&D ointment at night to help the dryness. Her Vagina is almost all the way open again. This article definitely helped me to know that I am not the only mom with this worry. Thank you!
sarah on April 07, 2010:
I took my 13 month old to the doctor yesterday, and she prescribed estrogen cream to be applied nightly for a month. I questioned the length of time, and she said it would be fine. Does anyone have any advice on what I should do? Should I get a second opinion? I'm worried about what effects a whole month of treatment will have on her.
Meredith on March 17, 2010:
THANK YOU Dr. Michelle. That's exactly what I needed to hear. My 10 week old has a small adhesion, not fully closed. We are applying Aquaphor with each diaper change and keeping an eye on it. I definitely want to leave her alone as much as possible and hope this will resolve on its own and not worsen.
Dr Michelle on March 17, 2010:
I would like to tell you that I am a mother of two daughters, and a paediatric endocrinologist - the 'specialist' that labial adhesions generally get referred to, and I would like to make a few comments.
1. Thank you for writing this informative article - I believe the information is necessary, to prevent a lot of concern on behalf of parents and their daughters
2. One response mentioned this can occur after physical abuse - this is true but BY FAR the majority of girls have developed these adhesions without even obvious irritation or inflamation
3. The association with urinary tract infections and constipation is tenuous at best - LOTS of little girls are constipated for various reason, and do not get adhesions, while the reverse is also true that lots of little girls get adhesions, without ever having been constipated. It is possible that the two can co-occur without causal association. Fungal infections are an extremely common cause of vaginal irritation, and it is rational to treat this as mentioned by some respondants.
4. When I council families on treatment of their little girls with adhesions, I point out that the function of the 'private parts' in the young girl is purely for urine voiding. If urination is not affected by the adhesions - and most little girls have no problems, since the urethra though which the urine is voided is more anterior than most adhesions - then there is no reason to treat the child. The 'introitus' (vaginal opening) is only needed for menstruation and later on, penetrative intercourse.
The human body is a wonderful thing - it oftentimes heals itself without any extra help, and this is true most often with adhesions - once the girl reaches puberty, her own body produces oestrogen, which then thins the adhesions, eventually leading to opening of the introitus.
Occasionally I will prescibe up to two weeks of an oestrogen cream to be applied twice daily, to demonstrate the adhesions do thin and that the opening does reappear - but I warn the parents that it may close up again before puberty reopens it. I also warn that the cream can be absorbed, and cause breast development so that is why I limit it to a two week course. I do not repeat the course as I explain the information above.
5. I DO NOT advocate holding down a terrified girl to apply the cream - if the child is in nappies, and is used to having cream applied, it is usually not traumatic. If the child is afraid, but can understand the application technique, I allow her to do the apllication herself, with mom's supervision. Otherwise, I DO NOT allow her to be traumatised when there is no medical need to create the vaginal opening prepubertally. I believe this is an attack on her personal space, and offends the trust she places in her parents and me as the doctor looking after her.
6. There is no place for surgically opening the vagina before puberty - again, as I explained above, it is not necessary. Also, the adhesions can re-occur along the scar line, if repeated application of cream is not done - and the girl is placed again in the position of someone frightening and potentially hurting her.
7. Obviously, in the rare case of urinary flow obstruction or diversion, an individualised treatment plan would be necessary, but in my experience these cases are by far the minority.
I apologise for such a long post, but I feel we 'over-medicalise' this condition. I think our mothers didn't know or speak about it, not because it didn't happen or was taboo, but because it was left alone and healed itself.
I fear we are harming our daughters by focusing on their vaginas at a time in their lives when they should be innocent. They should not have a continuous focus on the labia, which occurs with regular examinations and cream applications. The adhesions should be noted, the urinary stream should be seen as normal, and then they should be left alone. At puberty they should be reviewed (gently)to ascertain reopening of the introitus.
I hope this provides some reassurance to moms who want to leave their girls alone, and will assist others in being able to make the educated decision about not treating these adhesions.
regards to all.
Sherry Holland on March 13, 2010:
May I also say that I REALLY appreciated the picture! Wow! That's EXACTLY what she looks like. I'm relieved to know that I am not alone.
Sherry Holland on March 13, 2010:
Ladies... I completely understand what you are feeling. I find this extremely stressful. My daughter is six and we have been dealing with this on and off since she was a baby. It was all but normal until recently. I learned that she has not been wiping after urinating. The inflammation caused the condition to worsen. In fact, it's the worst I've seen it. I HATE having to manually deal with this. She screams and jerks as if I am killing her! I'm being very gentle! I feel horrible. I'll be glad when this issue finally resolves itself. I have a 2 year old boy and would you believe I'm dealing with the same thing! If you have a son also be sure to pull that skin back after each diaper change!!
Karen on February 25, 2010:
Thank you for your article and informing us parents on such a common problem with our little girls. I have a 2 yr old and we have been dealing with this since birth. The ped. suggested Premarin and it "kinda" worked but with it came the breast swelling and mood swings. We ended that and went to a Betamethasone Dipropionate Cream which is a topical corticosteroid. It works by depressing the formation, release, and activity of different cells and chemicals that cause swelling, redness, and itching. Ok that also helped but it also closed again and is now only a pinpoint opening
I just came back from the ped. urologist and he is going to preform the surgery. I don't want to wait until she reaches puberty, nor do I want to continue creams. I am afraid that all the "activity in her private parts" will cause some sexual disfunction as an adult. I will post in a few months to tell you all how the surgury went and how she is responding to it. Until then, GO SEE A SPECIALIST.
Kate on February 22, 2010:
One thing that is not added in this is that it can also be caused by molestation... It is caused by irritation... I suspect someone had molested my 1 1/2 year old because she had strange behavior after we had left someone to babysit.. about a week later, we noticed her labia had stuck together. I am NOT saying that it isn't caused by just a wet diaper, I am saying that it can ALSO be caused by someone touching her, irritating her, penetrating her with fingers etc. I am quite surprised that this isn't said to be a cause of the adhesion, because it is the most important one. If this has happened to your little girls, and you have suspicions of someone abusing her, please do add two and two together.
Beth L. on February 21, 2010:
My daughter is 3 and the ped has told me she had this for about a year but said it should correct itself. She just had a UTI so has has prescribed premarin. My problem is that I just don't know where it is and I can't really tell from the picture. Is it the vaginal opening? That is what I thought and that is where I thought the doctor pointed so that is where I was putting the creme. Today my MIL told me no. I was giving her an episiotomy. I feel really stupid. I really had the ped point it out last time and I thought that was the place.
sarah on February 18, 2010:
I also wanted to thank you for the article. I have just noticed that my second child has what appears to be labial adhesion. She is not quite 18 months, so I will bring this up with her doctor at her 18 month appointment. I do feel reassured having read both your article and the different posts.
Ree-Ree on February 17, 2010:
The comments and links were extremely helpful! My daughter is 4 years old and was complaining of pain in her vaginal area....I had taken her to see her primary care physician 6 times, the after hour clinic twice and the emergency room once all places asked me if there was a male living in the home and questioned me continuously, they told me maybe she wasn't wiping herself correctly after urinating, and that she wasn't taking a proper bath....I insisted that something else was wrong and finally they referred me to a specialist...the specialist noticed what it was immediately...they prescribed premarin and this is the 2nd day of use...now my question is that area is very very sore how do i apply a cream and it hurts so bad...also it took six months for them to give me a diagnosis so all that time my little girl was suffering and going through several wasted appointments that really upset me!
Judy on February 03, 2010:
These comments have helped so much. Thank you to everyone for sharing your experiences. My daughter is 2.5 and I noticed she had this quite some time ago, but her pediatrician said to just keep an eye on it and unless it causes more serious problems we'll hope it corrects itself. She has only complained of pain once.
It does some to be getting worse though, and we're going to visit her pediatrician this afternoon. I am dreading it - I feel guilty like I didn't keep her clean enough/should have done more to prevent it, etc. I know the exam will be so upsetting to her, so as you have all experienced, this will be a tough appointment.
After reading the posts I'm reluctant to try the estrogen cream route if it doesn't seem to help long-term.
For those who are concerned about a constipation link, from our experience, that hasn't been the case. Our daughter has never had constipation issues (thankfully!).
I think the yogurt option might be one to consider for us. When I was pregnant with her I constantly battled yeast infections so I took acidopholous capsules and it took care of the problem. I came across that recommendation from a Mom online and thought it wouldn't hurt to give it a try. My doctor had prescribed something to take orally, but I was concerned it would impact my baby while pregnant.
Thanks again! I wish labial adhesions would be discussed by doctors/pediatricians at the first visit, so parents would be aware. I had never heard of it either. Not that I discuss it with many people, but those close friends/family and daycare people I have told have never heard of it either.
Tampamom on January 27, 2010:
I just wanted to update: I am the one who said I would just try the BIO-K (since we weren't going to use the cremes anyway). We have been giving her BIO-K for am feeding and vaginally at every change. It has been two weeks and the area seems to have improved. I have seen more separation line in the lips, it seems to have gotten wider. and that is all. I have no expectations before 30 days considering its not a drug 'per se' ... her pooping has improved greatly! Still have death threats tho...
Ann on January 22, 2010:
My daughter was diagnosed with this a few weeks ago (3 months old) and we've started using the premarin daily and gently stretching the area in the evenings after bath.
I had this as a kid and it was my biggest fear when I found out I was having a girl. I have a lot of memories about it - going to different doctors, being pinned down by my older sister so my mom could apply the cream, not being allowed to take bubble baths, etc. It was extremely embarrasing and confusing. I never understood what was wrong with me and didn't understand why I kept having to have my privates examined. I hated having the cream and having mom stretch the area and I hated being threatened with surgery or the possibility of never having babies if I didn't let her do it.
I'm praying that my daughter will heal before she's old enough to remember any of this (unlikely, since mine lasted so long and so did my niece's). I'm glad that I have time to start planning on how we will explain this to her as she gets older. I think that it will be important to be very honest and open about the topic.
As for effects when you're older - I didn't have a physical problem being intimate (although I was terrified that it would hurt and so never slept with anyone until I met my husband) and I was able to have a natural, vaginal delivery without complications. Obviously there have been a lot of emotional effects for me and I'm hoping to find a way to prevent that from happening to my daughter.
Tampamom on January 15, 2010:
I have a 10 month old, my pedi has confirmed her labial adhesions today, but I noticed it maybe 3 months ago and forgot until 2 weeks ago. I feel after all this reading that it seems the younger they are, the more likely they are to close back up. Therefore, I will not use the creme, I plan to wait (despite death threats from mother-in-law) to see if it corrects itself. I read on one medical site that labial adhesions have 80% spontaneous resolution. Moms, that means it usually fixes itself. C'mon! Give nature a chance!! I feel there is no need to open this if urine flow is unaffected. I plan to keep the area lubricated with the coconut oil, I have always used it with the diaper changes anyway on the butt! My midwife taught me to use it with the first muconium poop diapers, and I love how it just keeps the area CLEAN!!! Now I will just go a little further with it!!
I too have been wary of her pooping schedule, since her birth. YES, (surprise, surprise, CONSTIPATION CAUSES CANDIDA!!) I read that constipation is associated with INTESTINAL YEAST INFECTIONS. And now I supplement (I breast feed, she WILL NOT TOLERATE FORMULA) with Aloe Vera Juice and raw food smoothies - my husband and 2 yr old drink these anyway. My 2 year olds favorite is a recipe I stole from Whole Foods: Kale (yes, I said kale), bananna, apple (contains quercitin which is the same stuff in garlic), apple juice and beet peeled (purifies the blood). This WILL help, and its fantastic tasting. Her pooping has improved. I also give BIO-K orally (and now vaginally, read below).
I have stumbled upon a couple of bloggs from parents of naturopathic physicians, I FEEL THEY ARE CORRECT IN THEIR SUPPOSITIONS: and to recap: their opinion is that it is the baby's inate defense mechanism against infection or some trauma to close in this way, and they also are very strongly of the opinion that it is an issue of YEAST. Yes, I said yeast. One phys. even prescribed that the mom simply apply BIO K (50 billion count yogurt you can get at most health stores, but cheapest at Whole Foods) to the area, and she reported success in re-opening. Think about it, what do they put a baby on after a surgery? Antibiotics. What does antibiotics do? It kills all flora, including friendly ones, clearing the path for overgrowth of yeast. Its a vicious cycle. I feel this is why they are closing back up. Your baby is fighting an infection the best way it knows how. Yeast has to be the number one subliminal criminal in disease and infection in our society.
I plan to give nature a chance even though I have to hold back my inate urge to 'fix' her right away. I would urge all moms to try this first...
Good luck to all
Concerned Momma on January 10, 2010:
My 4 year old daughter was just diagnosed with it, I noticed a couple of weeks before we went for her yearly check up that she would leak urine after going pee, I was after her to make sure she pushes it all out before getting off the potty, boy I feel bad now! When the doc told me she had this and assured me it was not big deal and very common I was SHOCKED! Common??? I've never heard of this and she is my 3rd child. So far so good no complaints from her on this as far as pain or infections but she does seem to have an issue w/ leaking and it bothers her. Tonight I offerred a pull up for bed as she was very concerned about this, she has been off of pull ups well over 1 1/2 years now, I did let it be her choice too.
As far as the picture, I can understand how some parents were upset of that being posted, however I do think it was good for parents that are concerned on whether or not their little girl has this.
My doctor prescribed her a cortisteroid cream to put on hers, its supposed to thin the skin, week 3 now and so far no changes. :-(
valeria harasim on January 05, 2010:
forgot to say this but i know putting your baby through surgery is a train wreck but i didn't know what else to do for her all the crying and pain she went through was more than enough to make me realize that she needed it things happen in this world and sometimes we don't know why i am just glad that she is better now there is a possibility that they may come back but i am praying that this problem stays at bay
valeria harasim on January 05, 2010:
my daughter just had surgery to correct her labial adhesions
she was having a lot of urinary infections and her last culture of urine had ecoli in it so the doctor suggested the surgery it was very quick she was very cranky for a day but now she is doing fine and i am glad we had it done for her she doesn't cry and tell me her pee pee hurts everyday like she did before the surgery
prekmom on December 07, 2009:
my 5 year old has also this recurring problem since infancy.. and I have half-heartedly been using the cream. But tonight she awoke from sleep to tell me she was sore 'down below'. As I apply the cream I understand I am supposed to be pulling (coaxing) the skin apart gently.. but how was never explained. And I didn't ask. Has anyone been told something useful that just made sense? I never really know if I'm doing it the best way.
Thanks for the original post and all the comments. This is a topic that rarely gets mentioned on Mom's day out meetings!@!
SRP on November 12, 2009:
This is a great article and info. My 5 year has been battling this for a couple years and it has just come back again. She doesn't seem to complain other than the dribbles - which are not convenient during school. Thanks to all the Moms who take the time to share their stories - it's really helpful!
mg1223 on November 05, 2009:
My daughter is five and was diagnosed with Libial adhession today, I feel terrible because she would complain about itchness and irritation, I thought she was not cleaning herself when she used the potty!! One other thing I'm shocked to see is that most of these girls have also suffered from chronic constipation (I would have never tied these two together), my daughter too has always had issues with constipation and a hard stool! There has to be more to this then what doctors say! They told me she had an adhession when she was younger but told me it was no big deal and that it would go away along with the constipation and brushed it off as being normal!! This makes me really upset one at the doctors and two at myself for not rearching and asking questions! She was given an estrogen cream that Im suppose to apply daily but other then that the doctor said it was no big deal!!! There has to be more research done on this!!
Tracey same as 5 wks ago on November 05, 2009:
My 2 1/2 year old just had the surg. to separate the adhesions yesterday 11/4/09. she's okay a little tender. It looks good after seeing it almost closed for so long they put her on Premarin cream for a few weeks.
Amber on November 03, 2009:
Thank you for posting this. I was told today my daughter didn't have a vaginal opening, and to use estrogen cream to open the adhesion. I didn't really understand, nor had I ever heard of the condition. I didn't ask questions because I was freaking out! (I had noticed it, but I was hoping I was wrong!) I am glad you posted the link for a picture, it made me feel better to recognize it in my own daughter. I am going to make sure I ask more questions next time though, I feel silly (and so should my doctor) that I didn't understand until I looked it up on the internet! What did mom's do before the web???
Amber on October 22, 2009:
I had this when I was young. I'm now 29 and have had no problems since I was 7 or 8. No side effects in later life either (intercourse,etc.) My mom didn't use the cream. I went to a specialist who told my mom to watch closely and pull slightly each day and I think he also worked with me that day showing her how to pull. My daughter is 2 1/2 and has this and I'm trying to decide what to do. She does seem to be bothered by it, but hasn't had a UTI. I don't want to use the cream and I plan to check for other natural options. Has anyone tried the coconut oil or flaxseed oil?
Tracey on October 02, 2009:
These are all good articles.My daughter was dignosed at 18 mo. Then she's been on Estrance since then she's 2 1/2 now. No change. I've breastfed her and just wonder if that had a part in this with low estrogen. Don't know Dr.'s don't seem to know much or even feel concerned. I have noticed a big change in her moods w/the cream. She' like an emotional roller coaster. Has anyone noticed this? She's is suppose to have surg. but is there anyone who has had pos.results with surg.? This is hard because you really feel alone and helpless for your child. I wish I had a quick fix. It does help a little to finally hear some similar stories.
Jenny on August 27, 2009:
My daughter is now five and has had two surgeries around 1 1/2 yrs and at 3 trying to correct this problem, yet the problem persists... She was diagnosed and given premarin at around 3 months. The doctor changed her to estrace (stronger) when that didn't work and then referred her to the urologist.... 4 years later I want to say it's hard to put medicine, or lubrication on your child daily that changes their attitude and violates their personal space. I want to encourage my child to be comfortable with her body and that that is her private area. So for the last year or so, during bath time I ask her to pull her vagina open. Telling her it's important. If it closes all the way ladies, these kids are going to have serious problems! After bath time she sits on the toilet and opens her legs and puts a little KY on her finger and then her little afflicted spot to lubricate. I feel KY is better than Vaseline (I was told I could use either by the urinologist).
BTW she has always had constipation.
There is no way I'm giving her any MORE hormones. I think there is nothing wrong with trying the hormones, but don't just keep applying them. If it's not working STOP. My five hear old is VERY moody and her nipple area is pooky. The side effects DON'T stop when you stop applying. I gave her the premarin and estrace for like 6 months straight when she was a baby following the pediatricans script to use it until it clears up. I will always wish I hadn't!
My plan is to keep having her lubricate and pull daily until puberty. After puberty and early check with obgyn will probably check with surgery again, maybe some kind of vaginal reconstruction.
Are there any grown girls or women who have had this that can give advise? I worry that intimacy will be uncomfortable when she is grown, unless there is drastic change naturally or we have another surgery. However, with 2 surgeries already and the same problem persisting, I think the wait and see approach is good now until puberty.
Tif on August 03, 2009:
My daughter has used cream 4x and already had two surgeries and we are still fighting the issue (she just turned 4). i have been researching the subject online as well, and found flaxseed oil was listed as a potential solution... at this point I am willing to try about anything. Also noticed that many references include a link between UTI & constipation... my daughter has sufferred from constipation since birth as well, and UTI's from the labial adhesions... am wondering if constipation may be a commonality for any of you as well - perhaps there is a link???
Holly on July 24, 2009:
I just discovered that my 6 month old has this condition. I had never heard of it before and, like all of you, was quite upset about the whole thing. Reading all of your comments certainly helped to ease my mind. My doctor prescribed the estrogen cream which we started yesterday. She said "as soon as the labia opens it will be fine and stay open". However, now I'm concerned as it sounds like several of you have indicated that the condition can recur over and over!
wendy on July 18, 2009:
its great to know your not alone ,weve been using the cream for about 4 weeks and no change but we shall wait and see
i find the first comment rather disturbing ,i looked up the subject because my daughter has one and was looking for something to compare with ,how did she stumble across it !
Michele on July 16, 2009:
My daughter is 5 yrs old and like many of the others we have been dealing with her fused labial since 6 months old. We have used premarin cream off and on since six months old. At first it worked fast to separate the adhesion, but it would always come back. Now the cream seems to not help at all even when used twice a day for two plus weeks. She is starting to grow pubic hair now.She only has a tiny opening left to the vaginal area. She complains of it hurting and she does have leaking from the urine pooling just above the fused area. She has not had a urinary tract infection so far even with the complaints. I keep reading that is ok to to wait until she hits puberty but I worry that she could get an infection in the future. I don't want her to go thru surgery if possible. I think we are going to use vaseline or a+d Oint from now on. I really think if the premarin was the solution for us it would have worked better by now. I am worried about the hormones too but was willing to try. I think we tried long enough. Your article was very helpful and the picture was also helpful to relate what I was seeing with my daughter. I was disappointed to read the first comment, obviously she does not understand how important the info is to families with concerns and questions.
Sheryl on July 14, 2009:
My 2.5 year old daughter was also just diagnoised with this. She also got a urinary tract infection and the adhestions seem to have gotten worse now. I hope this corrects itself. We see the Dr. again next week.
Michelle on July 09, 2009:
Thank you so much for the article. My daughter is almost 3 and we have been dealing with this off and on since her 3 month checkup. We are potty training and I haven't been as vigilant at checking the adhesion as I should have been and am now kicking myself because they are worse this time than last. So we are on the premarin again. This time is worse because she doesn't want me to put the cream on, so I have become the traumatizing mommy!! Usually takes about 2 weeks. I had never heard of this condition before I had her, but am glad to know it's fairly common. Good luck ladies!!! Also, glad to see the link for the photo. When they are little, it's hard to tell what you are looking at. It helped a lot!!
Shocked mommy on March 31, 2009:
I am furiously searching for information on this topic. I just noticed this today on my 3 month old and am very concerned. I didn't even know it had a name. I appreciate everyone's feedback and testimonies. I will take all of this with me to her pediatrician tomorrow. I feel somewhat comforted in knowing that others have had experience with labial adhesions and there may be some effective means to treat it.
Dada on March 30, 2009:
Thank you for this article, my daughter was complaining of pain and when diagnosed the docter explained us about this condition , and my wife was very much worried anou it .I can now happily show her this article and start with the treatment from tomorrow.
Diana on March 24, 2009:
Thank you for this article. My little one was diagnosed w/ this condition from her 1st well baby check up, days after she was bourn. She will be 16 months tomorrow & the area has still not opened. Though, her Pedi doesn't seem to be worried I've had a nagging feeling somehow I caused this. Your article, as the many responses, have eased my worry. Again, thank you.
Lucy on March 16, 2009:
Thank you for the article and the photo. My 2 girls never had this, but my granddaughter does, and it's the first time I've heard of it. She's 18 months now and on her 2nd treatment of Premarin. The 1st time was about 6 months ago, then it readhered. My concern is I'm not sure how much the area is to open up. There is a little circular hole/opening at the distal area and the labia is starting to part, but I am unsure how much it is supposed to open?
Dawn on March 09, 2009:
Well-written article, Lela. Just wanted to add - others have said it, but it's so important, it's worth repeating - any parent who has any doubts whatsoever regarding the safety of a medicine should talk it over with her doctor or pharmacist. Just because a medicine is a 'hormone' doesn't necessarily make it dangerous. Likewise, just because a medicine isn't a hormone and you can buy it from the supermarket doesn't make it safe! Example: common cold products, even those made for kids, could well be more dangerous to a young child than the hormone cream.
A lot of the known dangers associated with estrogen use was discovered through studies on women who had taken estrogens (normally contraceptives) orally, often for several years. A cream is less likely to be absorbed into the blood, and would probably be absorbed in much lower amounts. Since this treatment is usually only necessary till the child hits puberty, the duration of treatment is also probably lower than what you would find in the main studies conducted on estrogen use (women on contraceptive pills likely would have taken them for a much longer duration). While it's true that long-term estrogen use is known to increase the risk for a number of diseases, it's also important to bear in mind that this is a relatively tiny, tiny risk compared to other more common and serious risk factors like smoking, obesity, unhealthy diet, sedentary lifestyle, genetics etc. Compared to all these other risk factors, the risk from estrogen use alone is not likely to be very significant. So it's important to maintain a sense of perspective when considering the risks of using estrogen creams.
A note on urinary tract infections: this is not only painful (for both mother and child!) - it's potentially dangerous. An untreated urinary tract infection can lead to infection of the kidneys and/or reproductive organs.
By the way, Lela, you did exactly the right thing in linking to the picture. As others have noted above, it was useful to illustrate the condition. You couldn't have posted the picture straight here in any case, since you don't own copyright for the picture and you did not receive permission from that child's parents to use her picture (unlike the people who originally took the picture - since you found it on a responsible and reputable website, they would likely have had the parents' permission for taking and using the photo in the first place). Anyone who suggests that you are promoting child abuse by linking to a medical website, where a picture is shown for medical education purposes, is simply wrong-headed.
Jessica on February 19, 2009:
My daughter is 5 yrs old. She has been on Premarin cream on and off since she was 3 months old! She has seen a specialist in Boston several times. (Today was the latest) This has reacured 10-12 times in 5 yrs. Every time the Premarin takes longer and longer to work. This time 11days twice a day and no difference. She dribbles after urinating. The Dr said she will have to "deal with it" till it goes away once she hits puberty! (the average is 12 yrs old) She is in school and I am afraid she will be picked on. We are taking her to another DR. Also I am worried about the long term use of a hormone cream.
Lela Davidson (author) from Bentonville, Arkansas on January 27, 2009:
Ladies, you are definitely not alone! This is a very common issue in girls. Most likely there is absolutely nothing to worry about and whatever your doctor recommends is the right thing to do. You are correct though, that there are different opinions about when and if something needs to be done, or if it can be left alone to clear up beore puberty on its own. Talk to your doctor and get a second opinion if it makes you feel better. Also, most doctors' nurses are glad to discuss ongoing cases over phone if you have a particular concern.
amy on January 26, 2009:
My daughter was diagnosed when she was 3 months old, she is now 7 years old and is still sealed. The doctors I have talked to want to wait till she hits puberty. It doesn't bother her at all but I still do research to see if there is any new ideas out there. It helps to read I'm not the only one going through this and there are others that understand the situation.
Worried on January 24, 2009:
My daughter was diagnosed. I used Premarin for 10 days. It went away. I check routinely and when it came back, I did use my fingers to separate it. It separated very easily and my daughter seems fine, but now I am really concerned I hurt her. I just did this today. Please tell me what to do to be sure I did not hurt her.
cassandra on January 23, 2009:
Thank you for posting this. I just noticed this on my 19 month old daughter and thought something was seriously wrong with her. I was bawling freaking out!! i hated to actually look for pics to make sure thats what it was but pics did help even though it did feel wrong. it is necessary though and i doubt any child molester/pervert will be checking medical websites to get their kicks. she is starting estrogen cream tomorrow.
Laura on January 22, 2009:
Hello and thank you for this article. My 16 month old has been diagnosed with this... about five or six months ago. At first we were to just massage the area with A & D ointment but that didn't work so now we are using Premarin. Today is the first day but the doctor said it should take up to 3 weeks to work. If this doesnt' work than she will have to be sedated and have it slit open.. =( Here's hoping that the Premarin works. My 6 y/o had the same condition when she was an infant/toddler but hers opened up on it's own.
valerie on January 02, 2009:
My 16 month old developed this and we have no health insurance I was very comforted to know that this isn't something I need to rush her to the Doctor for!
Illinoisadoptee on December 21, 2008:
Hello! I didn't know treatment with cream was an option. My daughter had this and the urologist performed surgery. I wish I would have tried cream first!
starting to worry on November 01, 2008:
Our old pediatrician discovered my daughter's labial adhesion on her first thorough check up. He suggester the estrogen cream, which scared me ( i didn't want to put hormones on my newborn) or said it may"fix itself over time with normal activities". I opted for that course. It has not "fixed itself" and my daughter is almost ten now. What are my options at this point. I don't want to traumatize her by some big procedure or embarass her by having doctors spending too much time in her private area. Any help would be greatly appreciated. P.S. She has had NO problems due to the adhesion up to this point. I simply don't want to wait until she matures and it DOES become a problem.
mom3 on September 13, 2008:
I have 3 girls and all 3 have had this problem. Two of them have been fine, but my middle daughter is 4 and we are just starting the cream. She is having a hard time keeping herself dry at school all day. At home she changes panties a lot, and gets upset. Its only a "dribble", but it causes her to smell like she wet her pants. I pray this goes away for good after treatment this time!
beth_h on August 29, 2008:
After we noticed some complaining when she urinated, my 2.5 year old was diagnosed with labial adhesion, and her Dr. did prescribe premarin cream once a day at bedtime. I am just now noticing that it is starting to open up a little, after about three weeks of treatment. Also tonight we noticed her nipples are a little swollen, and I can feel little bumps underneath. This totally freaked me out. I guess I need some reassurance that this treatment will not hurt her, and it will go away once we stop treatment...yikes. I keep reading various articles, and of course I find contradicting info (one article said that estrogen cream should not be used for more that two weeks).
alaanag on August 21, 2008:
I just noticed that my 6 year old daughter has developed labial adhesions. The pediatrician is prescribing Premarin to be used. I was wondering if anyone has noticed if the child experiences any discomfort on the adhesions from the cream "thinning" the area and when it separates. I am also concerned with the possible breast enlargement because she is so much older than the norm. She is six and is very aware of her body and changes.
Any opinions or advice would be welcomed before I actually begin treatment on her.