Labia minora and labia majora adhesions

With the development of society, people are paying more and more attention to sex education for teenagers. However, in some backward areas, people's sexual awareness is very conservative and they don't know how to carry out reasonable sex education. Labia adhesion is a common disease among teenage girls, which seriously affects their married life. If it is not treated, it may cause unnecessary trouble and impact on their married life and prevent them from having normal sexual intercourse. So, how should adhesions of the labia minora and labia majora be treated?

1. What is the cause of labia adhesion?

The underlying cause is low estrogen levels before puberty. Low estrogen levels lead to less vulvar secretions, less protection for the genitals, and increased susceptibility to inflammation and adhesions.

The perineum was not kept clean and was not cleaned in time after defecation, leading to infection.

Various injuries, such as straddle injuries, and female circumcision which is still performed in some places.

2. Treatment of labia adhesions

Asymptomatic, no treatment required. When estrogen secretion increases during puberty, they will separate on their own.

Symptomatic – If it affects urine flow, causes recurring infections, or is painful, treatment may be needed. Treatment is divided into topical drug therapy and manual/surgical separation. Local drug therapy is the first choice, and separation is rarely required.

Topical medications include: estrogen, estradiol cream, or betamethasone cream.

Topical estrogen or estradiol

This method is the preferred method except for the following two situations: complete occlusion requires immediate separation, and repeated infection requires separation as soon as possible.

How to do it: Use a topical estrogen or estradiol ointment (for example, combined estrogen cream (Premarin) or 0.01% estradiol ointment) and apply the ointment to the adhesion area (do not apply it elsewhere) with your fingers, twice a day. Be careful when applying so as not to tear the adhesion. Stop taking the medicine after the adhesion has healed.

If done correctly, the adhesions will release in about 2-6 weeks. If not, you can continue to use it for several months.

After the adhesion is removed, the perineum should be kept clean, bathe every day, and apply a mild ointment for 6-12 months, such as white vaseline or A&D ointment (this is used to prevent diaper rash in foreign countries).

Side effects are rare and include local irritation, redness, swelling, vulvar pigmentation, minor vaginal bleeding, and breast development. Local side effects can be addressed by standardizing procedures and limiting the duration of estrogen and estradiol use. After the drug is stopped, breast development and vaginal bleeding stop. These side effects rarely occur if you apply the medication carefully, use a small amount, and apply it only to the adhesions. An experiment abroad showed that 109 girls aged 3 months to 10 years with labia adhesions were treated with local estrogen, with a success rate of 79% after an average of 4 months of treatment. Only 6 girls had breast development and 1 girl had vaginal bleeding.

The most likely reason for medication failure is incorrect placement or too little cream being used.