Ordinarily the lips of skin (labia) surrounding the entrance to the vagina are separated. In rare cases, they grow together to block the opening, partially or completely. This condition, called labial adhesions (sticking together of labia), may occur in the early months of life or, less frequently, later on if there is constant irritation and inflammation in this area. In these latter cases, the problem is usually traceable to diaper irritation, contact with harsh detergents, or underwear made with synthetic fabric.
Usually labial adhesions do not cause symptoms, but they can lead to difficulty with urination and increase a girl’s susceptibility to urinary tract infections. If the vaginal opening is significantly blocked, urine and/or vaginal secretions will build up behind the obstruction.
If the opening of your daughter’s vagina appears to have closed or looks partially blocked, notify your pediatrician. He will examine your child and advise you whether any treatment is necessary. The majority of such adhesions resolve on their own as the child gets older and require no treatment.
At first, your doctor will attempt to spread the labia gently. If the connecting tissue is weak, this mild pressure may expose the opening. But if the connecting tissue is too strong, the doctor may prescribe a cream that contains the female hormone estrogen for you to apply to the area as you very gently and gradually spread the labia apart over a period of time.
Once the labia are separated, you will need to apply the cream for a short while (three to five days) until the skin on both sides heals completely. Occasionally some adhesions return once the cream is discontinued. However, they usually disappear permanently in early childhood.
In rare cases, the adhesions (scarlike tissue that grows between the labia and holds them together) are so thick that they block the flow of urine. In this situation, they will need to be separated by a physician, such as a pediatric urologist.