LABIAL ADHESIONS
This is one of those small problems in childhood which may cause great
consternation when they are discovered but are in fact very minor and easily
solved.
Presentation:
The usual story is that a parent or other carer of a girl in the toddler
age group has suddenly noticed an odd appearance of her genitalia with
a fleshy membrane joining the labia minora (inner lips) of the vulva, completely
concealing the vaginal opening and leaving only a very small opening at
the front through which she passes urine. It looks as though she has no
vagina at all, nobody can remember for sure whether any such organ has
ever been seen and so naturally there is great concern.
Cause:
Many little girls at times have a minor degree of vulvitis, inflammation
of the vulva due to low-grade infection. This is seldom sufficiently severe
to cause any symptoms but there may have been some slight soreness or irritation.
The inner lips of the vulva become sticky and, in the absence of oestrogen
(the adult female hormone secreted from the ovaries at puberty, one of
its effects is to change the surface membrane of the vulva and vagina)
they adhere to each other and gradually become more firmly attached.
Treatment:
The treatment is to apply oestrogen cream to the membrane which then
dissolves away almost magically within a few days. This is most conveniently
done with Dienoestrol cream 0.01% (Ortho pharmaceuticals, 78g tube). There
may be some surprise from the pharmacist since this preparation is generally
used for old ladies (who may also have problems from oestrogen lack). Twice
a day place a small blob of the cream on a finger and rub it into the central
line on the membrane covering the vagina. As oestrogen is well absorbed
through skin this is a job for mothers not fathers! Within a few days the
membrane will start to dissolve and soon thereafter will separate completely.
When this has happened stop the treatment.
Outlook:
Sometimes there is a tendency for the adhesions to recur; if they are
just starting they can be separated painlessly but if they are more formed
a few applications of the cream will be needed. This condition has no long
term implications at all. Any tendency to recur usually ceases long before
puberty. |
