The external female genitals include the labia majora larger outer lips and the labia minora smaller inner lips. Generally, the two labia minora lie on either side of the vagina and urethra and only intersect at the clitoris. This common condition affects up to two per cent of girls aged three months to six years. It is most common in those aged one to two years. It is thought to be caused by irritation to the delicate membranes of the external genitals. In most cases, labial adhesions resolve by themselves during the onset of puberty without the need for medical treatment.
Medical treatment is then needed. The condition is also known as fused labia. The exact cause is unknown, but it is strongly suspected that labial adhesions are caused by irritation to the external genitals. The range of possible irritants include:. The outer skin surface squamous epithelial layer of the labia minora is thin and delicate.
Irritation and inflammation can cause the outer skin to become exposed and raw. The two raw lips then heal together in much the same way as any skin cut might heal. Usually, the labia start to fuse at the bottom end posterior fourchette , closest to the anus, and work up towards the clitoris.
Labial adhesions are more common during the nappy years. Poor hygiene is thought to be a common cause in older girls. Low oestrogen levels hypo-oestrogenism are also thought to contribute to the development of labial adhesions. The condition resolves during puberty because the effect of the female hormone oestrogen changes the cells that line the genitals.
Labial adhesions are diagnosed by physical examination. Additional tests may include:. In most cases, labial adhesions are harmless and resolve by themselves once puberty starts from about 10 years of age. If the adhesions are severe and interfere with urination, medical treatment is needed.
