Materiały źródłowe

• #1 Labial Adhesion: Causes, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/16435-labial-adhesions

  Labial adhesions may relate to low estrogen levels. […] Healthcare experts don’t know the exact cause of labial adhesions. […] In adults, labial adhesions may develop shortly after childbirth or after menopause. […] After childbirth, estrogen levels decrease. […] After menopause, the ovaries stop releasing eggs (ova) and estrogen levels drop.

• #2 Labial fusion

  https://www.nhs.uk/conditions/labial-fusion/

  Labial fusion, or labial adhesion, is when the small inner lips around the entrance to the vagina become sealed together. […] It’s not certain what causes labial fusion, but it may happen as a result of irritation or inflammation of the vaginal area, known as vaginitis. […] Without enough oestrogen in the body, which is quite normal before puberty, the lips can stay stuck together and gradually become firmly joined. […] Labial fusion can also sometimes happen after childbirth or after the menopause, when oestrogen levels are also low. […] There’s a high chance the fusion will return after treatment, whether it’s with oestrogen cream or surgery.

• #3 Labial Adhesions – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK470461/

  Labial adhesion is the fusion of the labia minora or majora, and it is mostly located near the clitoris. The exact cause for labial adhesions remains unknown. However, it is believed that a state of low estrogen may be a contributing cause. […] The exact cause of labial fusion remains unknown. However, it is believed to occur in a low estrogen state. It is rare in the reproductive age group due to the sufficient levels of estrogen found in this population. […] For those who do develop labial adhesions during the reproductive age, there is usually a history of some sort of genital trauma or irritation to the genitalia. […] It is believed that a possibility may be due to breastfeeding along with the irritation and trauma that occurs during vaginal delivery. […] Labial adhesions also may be found during another low estrogen stage, the postmenopausal stage. In this stage, due to the low estrogen, the genital area is susceptible to irritation and inflammation, which may lead to adhesion.

• #4 Labial Fusion in Childhood: Management and Treatment Strategies – Bezmialem Science

  https://www.bezmialemscience.org/articles/labial-fusion-in-childhood-management-and-treatment-strategies/doi/bas.galenos.2024.25349

  Labial fusion (LF) is frequently an asymptomatic condition and hypoestrogenism plays an important role in the pathopysiology. […] Although the exact etiology of LF is not fully known, various risk factors related to its development will be discussed below. […] It has been thought that hypoestrogenemia plays an important role in the pathophysiology of LF, which occurs with low estrogen levels at the two extremes of a woman’s life; prepuberty and postmenopause. […] In the literature, it has been determined that among the etiological risk factors, in addition to hypoestrogenism, perineal cleaning is also performed excessively by families. […] Frequent and abrasive perineal cleaning in a hypoestrogenized environment results in local inflammation, desquamation of the epithelium and fusion during tissue healing.

• #5 Labial fusion – Wikipedia

  https://en.wikipedia.org/wiki/Labial_fusion

  Labial fusion is a medical condition of the vulva where the labia minora become fused together. It is generally a pediatric condition. […] Labial fusion is rarely present at birth, but rather acquired later in infancy, since it is caused by insufficient estrogen exposure and newborns have been exposed to maternal estrogen in utero. […] The primary contributing factor to labial fusion is low estrogen levels. […] Conditions causing irritation, such as infection, inflammation and trauma, cause the edges of the labia minora to fuse together. […] Most labial adhesions resolve spontaneously before puberty as estrogen levels increase and the vaginal epithelium becomes cornified. […] Labial fusion is not uncommon in infants and young girls. It is most common in infants between the ages of 13 and 23 months, and has an incidence of 3.3% in this age group. It is estimated that labial fusion occurs in 1.8% of all prepubertal girls.

• #6 Labial Adhesions: Symptoms, Causes, Treatment | Qwark

  https://qwarkhealth.com/conditions/labial-adhesions

  Labial adhesions, also known as labial fusion, occur when the inner lips of the female genitalia become stuck together. […] It is believed to be caused by a lack of estrogen, which makes this condition less common in adult women. […] Hormonal imbalances can cause labial adhesions, particularly those that affect estrogen levels. Estrogen helps to maintain the mucous membrane in the vagina and vulva, and low levels of estrogen can cause the tissues to become thin and dry. […] Environmental factors that can contribute to labial adhesions are mostly related to hygiene. Poor hygiene practices can lead to bacterial infections, which can inflame the tissues around the vulva, causing them to stick together. […] Urinary tract infections (UTIs) have been known to cause labial adhesions, although there is no consensus on how this occurs. Some believe that the inflammation caused by UTIs can cause the labia to fuse together.

• #7 Labial fusion – wikidoc

  https://www.wikidoc.org/index.php/Labial_fusion

  Labial fusion is never present at birth, but rather acquired later in infancy, since it is caused by insufficient estrogen exposure and newborns have been exposed to maternal estrogen in utero. […] The primary contributing factor to labial fusion is low estrogen levels. […] Conditions causing irritation, such as infection, inflammation and trauma, cause the edges of the labia minora to fuse together. […] Most labial adhesions resolve spontaneously before puberty as estrogen levels increase and the vaginal epithelium becomes cornified. […] Labial fusion can lead to urinary tract infection, vulvar vestibulitis and inflammation caused by chronic urine exposure. […] Labial fusion is not uncommon in infants and young girls. It is most common in infants between the ages of 13 and 23 months, and has an incidence of 3.3% in this age group. […] It is estimated that labial fusion occurs in 1.8% of all prepubertal girls.

• #8 Labial adhesions | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/labial-adhesions

  The cause of labial adhesions is thought to be irritation to the labia minora: for example, poor hygiene, strongly perfumed soaps and inflammatory conditions like vulvitis. […] The exact cause is unknown, but it is strongly suspected that labial adhesions are caused by irritation to the external genitals. […] Low oestrogen levels (hypo-oestrogenism) are also thought to contribute to the development of labial adhesions.

• #9 Labial Adhesions: Practice Essentials, Pathophysiology and Etiology, Epidemiology

  https://emedicine.medscape.com/article/953412-overview

  Labial adhesions are fibrous adhesions between the labia minora. Low estrogen levels have been thought to play a causative role in their formation, and the protective effect of maternal estrogen makes labial adhesions uncommon during the newborn period. […] Labial adhesions may also be caused by vaginal inflammation, local irritation, or tissue trauma. They have been reported to result from childhood sexual abuse and may be associated with lacerations or hematoma.

• #10 Labial Adhesions | Children’s Hospital Colorado

  https://www.childrenscolorado.org/conditions-and-advice/conditions-and-symptoms/conditions/labial-adhesion/

  What causes labial adhesions? Labial adhesion or labial agglutination occurs when the small, inner lips (labia minora) of the outside of the vagina (vulva) get stuck or fused together and cover the vaginal opening. Labial adhesions can range in severity from completely covering the vaginal opening to only partially covering it. […] Irritation from fecal soiling (commonly referred to as vulvovaginitis) is the most common cause of this condition. Irritation from soaps, wet diapers, diaper rash, infection or trauma can also cause this sensitive tissue to stick together. […] Preventing the underlying condition of vulvovaginitis often stops the recurrence of labial adhesion.

• #11 Labial Adhesions | Children’s Hospital of Philadelphia

  https://www.chop.edu/conditions-diseases/labial-adhesions

  Labial adhesions occur when the labia minora adhere together forming a shiny membrane of inflammatory tissue. […] The reasons why labial adhesions occur are not known, but we do believe that estrogen may play a role. […] A chronic inflammatory process as the result of fecal soiling, vulvovaginitis, eczema or dermatitis can also play a role in the development of the adhesion.

• #12 What Is a Labial Fusion?

  https://www.webmd.com/children/what-is-a-labial-fusion

  A labial fusion, also known as a labial adhesion, occurs when the inner lips (labia minor) of the vagina become sealed together. […] It is currently unclear what causes a labial fusion, but physicians have linked it to low estrogen levels in young girls and women. […] About 2% of female children are affected by labial fusions due to having low levels of estrogen before puberty. […] Although there is a link between labial fusions and low estrogen levels, there are also a few other known causes of the actual fusion, or sealing, of the labia in female children and women. […] Several different types of skin irritation can contribute to labial fusion. […] Vaginitis has also been linked to labial fusions, as it oftentimes accompanies inflammation of the vagina. […] Trauma to the vaginal area can also lead to labial fusions, as trauma often leads to inflammation of the affected area.

• #13 Labial Fusion – narikaa.com

  https://narikaa.com/article/gynaecology-disorders/vaginal-disorders/labial-fusion/

  Labial fusion is a condition where the two flaps of skin on either side of the opening to the vagina, also known as the labia minora are joined or fused together forming a shiny membrane of inflammatory tissue. […] It is thought to be caused by irritation to the delicate membranes of the external genitals. […] The exact cause is unknown, but it is strongly suspected that labial adhesions are caused by irritation to the external genitals, as it is common in the nappy years. […] Poor genital hygiene plays the most important role in chronic inflammation.

• #14

  https://www.healthychildren.org/English/health-issues/conditions/genitourinary-tract/Pages/Labial-Adhesions.aspx

  Ordinarily the lips of skin (labia) surrounding the entrance to the vagina and urethra are separated. Sometimes, they grow together to partially or completely block the opening. This condition, called labial adhesions (sticking together of labia), may occur in the early months of life. […] The problem is usually traceable to diaper irritation, contact with harsh detergents or underwear made with synthetic fabric. […] In general, if they are not having symptoms like dribbling incontinence after urination or urinary tract infections, no treatment is needed.

• #15 Labial adhesion | PPT

  https://www.slideshare.net/slideshow/labial-adhesion/168021134

  The most common causes of labial adhesion in adult women (PostPartum, PostMenopausal) include oestrogen deficiency associated with atrophic vaginitis, vulval lichen sclerosus, erosive lichen planus, mucous membrane pemphigoid, Behcet syndrome, Stevens-Johnson syndrome/toxic epidermal necrolysis, and vulval cancer. […] There is no clear-cut effective treatment for labial adhesion, and there is no reason to treat girls in the absence of symptoms. The condition resolves spontaneously in all, at puberty if not before. Any child with symptoms that may be due to the adhesion should be referred to a paediatrician.

• #15 Labial adhesion | PPT

  https://www.slideshare.net/slideshow/labial-adhesion/168021134

  Labia minora adhesions (LMA) are the partial or complete fusion of the labia minora. They occur in 0.6-3.3% of prepubertal girls and are usually asymptomatic, resolving spontaneously during adolescence. Potential causes include microtraumas from overcleaning or chronic irritation/inflammation. […] Labial fusion is almost never present at birth, usually develops around one to two years of age. Labial adhesions are usually an innocent finding and a trivial problem, are a common finding in the girls. Usually, this condition is asymptomatic spontaneously disappears during adolescence but its importance is that it is frequently misdiagnosed as congenital absence of the vagina. […] Causes Of labial adhesion in PrePubertal Girls Exact cause is uncertain. Microtraumas like overcleaning causing mechanical mucosal injury of the perineum lead to adhesion of labia minora.

• #16 Labial adhesion in a postmenopausal female

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7329012/

  Voiding difficulty is more common in males, although it is not uncommon in females. Female voiding difficulty can be caused by iatrogenic, anatomic, and neurogenic factors, and specifically urethra stricture, impaired detrusor contractility, primary bladder neck obstruction, and detrusor-external sphincter dyssynergia. Labial adhesion is a rare cause of female voiding difficulty. […] The etiology is thought to be chronic inflammation or irritation of the vulval area, and a lack of estrogen and constant friction during mobility which leads to superficial skin epithelium denudation and slow progressive fusion of the labia. […] The etiology of labial adhesion is unclear, although vulvovaginitis and mechanical irritation have been implicated as causative risk factors. In addition, chronic inflammation is thought to cause denudation of surface epithelium, thereby allowing the labia to adhere to each other and result in the obstruction of the introitus.

• #16 Labial adhesion in a postmenopausal female

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7329012/

  A possible explanation for this condition is believed to be due to a hypoestrogenic state. However, if a hypoestrogenic state is the only explanation, labial agglutination would be expected to be more prevalent in postmenopausal elderly females. […] The exact prevalence of labial adhesion in postmenopausal elderly females is unknown, and only a few case reports have documented this condition in postmenopausal women. […] Standard treatment for patients with labial fusion includes topical estrogen cream, manual separation, or surgery. However, the most common treatment for cases of adult labial adhesion is adhesiolysis. For adult patients, estrogen therapy is not always successful as a first-line treatment, and surgery may be necessary. […] A review of the literature revealed no treatment guidelines for labial adhesion in postmenopausal females, probably due to the rarity of the condition.

• #17 What Is a Labial Fusion?

  https://www.webmd.com/children/what-is-a-labial-fusion

  When a woman is breastfeeding, her body often experiences an increase in serum prolactin. This leads to a hypo-estrogenic state in the woman’s body, meaning she is experiencing lower levels of estrogen. After childbirth, this lower level of estrogen coupled with edema or trauma to the vaginal area can lead to labial fusions.

• #18 Obstetrics & Gynecology Science

  https://www.ogscience.org/journal/Table.php?xn=ogs-57-70.xml&id=

  Postpartum genital tract adhesions are unusual, and their cause has not been evaluated. However, severe dystocia and numerous pelvic examinations have been suggested as possible causes. […] The causes of postpartum genital tract adhesions have not been completely evaluated. Previous reports showed that genital tract trauma such as large vulvar edema, or vaginal or labial laceration is associated with postpartum labial adhesions. In our case, the patient reported dystocia and numerous pelvic examinations. We assumed that her difficult labor, even though it was not certain because it was not at our institution, resulted in numerous pelvic examinations by obstetricians and increased vaginal wall laceration. […] Another possible cause of postpartum labial adhesions is breastfeeding. Breastfeeding increases the level of prolactin, and it can cause a hypoestrogenic state associated with labial adhesions. However, there is a concern that a hypoestrogenic state may not be associated with postpartum labial adhesions because most postpartum labial adhesions do not respond to estrogen therapy. […] In conclusion, we hope that our case will increase concern about postpartum genital tract adhesions and postpartum perineal care. In addition, further research should attempt to establish the best method of prevention and management of this rare postpartum complication.

• #19 Understanding Labial Adhesion: Causes & Treatments

  https://myvagina.com/labial-adhesion-labial-agglutination/

  Labial adhesion, also called labial agglutination, is a condition whereby the labia majora (outer labia) fuse together. Labial agglutination is a reasonably common occurrence in girls prior to puberty. […] It is important to ensure other disorders are not present when faced with labial fusing. […] Labial adhesions are fibrous and occur between the labia majora, not the labia minora, which sit between the outer labia. Their occurrence in childhood is the period where girls don’t have any oestrogen, also making this rare in newborns (who still keep oestrogen from their mothers). […] Oestrogen levels, however, have been tested and there was no significant difference in oestradiol levels in girls with labial adhesions and those without. […] These adhesions can also be triggered by inflammation, irritation, or vaginal or vulvar trauma. Sexual abuse can result in labial adhesions due to trauma to the tissues.

• #20 Treatment of Prepubertal Labial Adhesions with Topical Estriol + Testosterone: A Case Report

  https://www.mdpi.com/2036-7503/16/3/47

  Labial adhesions, a frequent gynecological condition in prepubertal girls, occur when the labia minora adhere along the midline. The prevailing hypothesis about their etiology suggests that labial adhesion may occur when the delicate and non-estrogenized labia minora undergo an inflammatory response, triggered by exposure to an irritant environment. […] The etiology of this condition is not entirely clear, and the general theory is that labial fusion can occur when the vulnerable and thin non-estrogenized labia minora develop an inflammatory reaction due to the exposure to a local irritant setting. […] The physiopathological base of labial adhesions is not completely clear, and many authors postulated that they could develop in girls exposed to local irritants in a low-endogenous-estrogen setting, characterized by the thin and immature epithelium of the labia minora.

• #21 Reddit – The heart of the internet

  https://www.reddit.com/r/beyondthebump/comments/zgaggg/labial_adhesion_feeling_like_a_freak/

  At my 6 week pp appointment my doctor told me I had a labial adhesion. Apparently it happens in extremely rare cases when your estrogen is low, but it does happen. […] Im pretty sure Ive been having a thyroid issue that caused this, Im going to talk to the doctor about it when he gets in. […] I have an estrogen cream to use to make sure it heals correctly.

• #22 :: JMM :: Journal of Menopausal Medicine

  https://e-jmm.org/DOIx.php?id=10.6118/jmm.22020

  Labial adhesions in postmenopausal women are caused by various inflammatory processes in the context of estrogen deficiency. […] Predisposing factors include chronic inflammation secondary to poor hygiene, underlying skin conditions, recurrent urinary infections, and local trauma and estrogen deficiency, which ultimately causes denudation of the surface epithelium and fusion of the labia during the healing process. […] Among dermatologic conditions associated with labial adhesion are lichen sclerosus (LS) and lichen planus. […] The above case shows a striking clinical presentation of vulvar HHD that masked the diagnosis of LS and led to development of labial adhesion. […] Treatment for mild cases of labial adhesion includes treating the underlying condition together with TCS and topical estrogen creams. […] Obtaining a complete history, in addition to careful clinical examination and skin biopsy confirmation may facilitate early diagnosis of LS. […] Prevention of chronic complications of LS such as labial adhesion may improve the quality of life of patients affected by this condition.

• #23 Labial Fusion in a Postmenopausal Woman Presenting with Lower Urinary Tract Symptoms: A Case Report

  https://clinmedjournals.org/articles/jgmg/journal-of-geriatric-medicine-and-gerontology-jgmg-5-074.php

  Acute or chronic lower urinary tract symptoms (LUTS) may be secondary to labial fusion in menopause. […] The etiology is multifactorial, comprised of hypoestrogenism, vulvar inflammation secondary to local infection, irritation, trauma, genital herpes, lichen sclerosus, and lack of intercourse. […] Labial fusion mostly occurs in patients in a hypoestrogenic state. […] Concomitant genitourinary factors in adult women may play crucial roles in the development of labial fusion. […] In conclusion, labial fusion in postmenopausal women is a multifactorial condition.

• #24 Labial adhesions in adult women. Labial fusion

  https://dermnetnz.org/topics/labial-adhesion-adult-women

  Labial adhesion means that the labia minora are stuck together or fused. Adhesion rarely results in complete labial fusion; more often it is partial. […] Secondary labial adhesion may be due to oestrogen deficiency, particularly in non-sexually active women after the menopause. It may also be caused by scarring or fibrous tissue that forms after severe inflammatory skin disease, surgery or trauma. The most common causes of labial adhesion in adult women are listed below. […] Complete labial fusion means that urine and vaginal fluids including menstrual blood build up behind the fused labia; this is an emergency and urgent medical assistance should be sought.

• #25 Labial Fusion in Childhood: Management and Treatment Strategies – Bezmialem Science

  https://www.bezmialemscience.org/articles/labial-fusion-in-childhood-management-and-treatment-strategies/doi/bas.galenos.2024.25349

  Some chronic inflammatory diseases, especially lichen sclerosus, have been associated with LF. […] Other infectious agents that may cause LF, although not very common, include N. gonorrhae, C. trochomatis, and T. vaginalis. […] The risk of recurrence decreases with increasing age and increased endogenous estrogen production. Factors contributing to recurrence include poor genital hygiene, recurrent vulvovaginitis, and vulvar dermatoses.

• #26 An Unusual Cause of Urinary Pseudoincontinence: Two Rare Cases of Labial Fusion in Adolescent and Postmenopausal Women

  https://www.jsafog.com/abstractArticleContentBrowse/JSAFOG/21668/JPJ/fullText

  Labial adhesions are usually a pediatric condition and are asymptomatic. They can also occur in postmenopausal age group albeit uncommon due to hypoestrogenism causing senile vaginitis. […] The proposed factors for labial adhesion include hypoestrogenism, chronic irritation, infections of the vulva, and recurrent urinary tract infections. […] Estrogen deficiency plays a major role in the development of labial adhesion, thereby explaining its high incidence rate in the prepubertal females and it is the cause in the postmenopausal age. […] The reported causes in this age group include poor hygiene, dermatitis, nonspecific or candidal vaginitis, herpes simplex, trauma due to fall, female circumcision, and lichen sclerosis. […] Labial fusion is defined as the partial or complete fusion of the labia minora causing partial or complete occlusion of the vaginal and/or urethral opening. It can be congenital or acquired. […] Recurrent labial fusion is a difficult situation both for the patient and for the treating gynecologist. It is not uncommon reported to occur in 11-14%.

• #27 Endoscopic examination of labial fusion in a postmenopausal woman: a case report | Journal of Medical Case Reports | Full Text

  https://jmedicalcasereports.biomedcentral.com/articles/10.1186/s13256-018-1568-4

  Labial fusion is defined as adhesions of the labia minora or majora. Labial fusion may cause urinary retention. […] The etiology of labial fusion in the reproductive or postmenopausal age group is unknown. Labial fusion can be caused by infection, trauma to the genitalia, or chronic inflammation resulting in low serum estrogen levels. […] A low serum estrogen level is the basic cause of labial adhesions. Physiologic hypoestrogenism, together with chronic inflammation in the vulvar skin and mucosa, leads to labial adhesions with subsequent partial or total obstruction of the vagina and/or the urethra. Because our patient had received radiation therapy in our hospital, decreased general activity and lack of sexual intercourse were the major causative factors leading to labial fusion.

• #28

  https://journals.lww.com/jiag/fulltext/2022/18030/labial_fusion__a_rare_cause_of_obstructive_lower.13.aspx

  Labial fusion is a rare cause of female voiding difficulty. […] The etiology is thought to be chronic inflammation or irritation of the vulval area. […] A lack of estrogen due to menopause and constant friction during mobility leads to superficial skin epithelium denudation and slow progressive fusion of the labia. […] The etiology of labial adhesion in the absence of LS is unclear and limited literature is available for the same. […] However, recurrent vulvovaginitis and mechanical irritation have been implicated as causative risk factors. […] A possible explanation for this condition in our patients is uncontrolled diabetes mellitus along with a postmenopausal hypoestrogenic state. […] Cases of labial fusion in the absence of LS can be treated with a topical estrogen cream but surgical correction is necessary in case of complete and near total fusion as it gives symptom-free results.

• #29 Labial Fusion (Adhesion on Genital Lips)

  https://www.eserdag.com/en/labial-fusion-adhesion-on-genital-lips

  Among the diseases that can cause labial synechia; Frequent vaginal infections, Lichen sclerosus disease, Lichen planus disease, Behet’s syndrome, Genital area cancers, Radiotherapy for cancer treatment, Female genital mutilation, Vulvectomy operations (removal of this region due to external genital region cancers), Vulvar psoriasis (psoriasis in the genital area), Genital eczema, Stevens-Johnson syndrome. […] Lichen sclerosis is an autoimmune disease which can cause itching in the genital area, thinning of the skin, sometimes bleeding, and serious adhesions over time. […] Early diagnosis and treatment of patients with labial fusion and genital adhesions are important.

• #30 How Do Labial Adhesions Impact Sexual Health and Intimacy?

  https://www.icliniq.com/articles/sexual-health/the-impact-of-labial-adhesions-on-sexual-health-and-intimacy

  Labial adhesion in adults caused by estrogen deficiency, inflammatory conditions, trauma, infections, irritation, and autoimmune disorders affect sexual health. […] Adults with labial adhesions may have a variety of root causes, all of which contribute to the fusion of the labia minora, the inner vulvar lips. […] A major factor contributing to adult labial adhesions is a lack of estrogen, a hormone that is essential for vulvar tissue flexibility and health. […] Chronic inflammatory skin disorders can contribute to the development of labial adhesions. […] Any type of injury or trauma to the vaginal region has the potential to cause tissue disruption, scarring, and adhesions. […] Repeated infections in the genital area can lead to inflammation, discomfort, and eventually adhesions.

• #31 Labial Fusing and Vulvar Lichen Sclerosus – Lichen Sclerosus Support Network

  https://lssupportnetwork.org/labial-fusing-and-vulvar-lichen-sclerosus/

  Labial fusing is something that many of us (though certainly not all) experience with vulvar lichen sclerosus (VLS). […] Fusing in the context of VLS means one part of the vulva sticking to another part of the vulva. […] As fusing progresses, it can become increasingly stuck to another part of the vulva; the result for some of us can be resorption. […] If you do not yet have fusing or have some fusing, you may want to know if you can do anything to decrease your chances of fusing. […] You may be wondering what interventions are recommended for labial fusing and if there is a surgery to unfuse labial fusing. […] Many VLS doctors do not operate unless a functional issue is present, and many do not consider labial fusion to pose a functional issue. […] The BSSVD position statement adds: If home treatments don’t work, some patients may need surgery to separate the fused skin around the clitoris. […] In sum, labial fusing can happen to some of us with vulvar lichen sclerosus.

• #32 Labial adhesions – Resource Library – Sheffield Children’s NHS Foundation Trust

  https://library.sheffieldchildrens.nhs.uk/labial-adhesions/

  Labial adhesions means that the labia are stuck together. […] This usually refers to the labia minora (the inner lips) and is also known as labial fusion. […] Primary labial adhesions happen in girls before puberty, commonly aged 3 months to 8 years of age. This is thought to be because of a low level of oestrogen (the main female hormone). […] Secondary labial adhesions are much less common in children, and usually happens because of ongoing scarring or inflammation. This could be associated with skin conditions such as lichen sclerosis or dermatitis. […] Other disorders also need to be ruled out. These include: scarring due to trauma, including sexual abuse; structural abnormalities where the genitalia have developed differently; female genital mutilation (FGM) can also occasionally be mistaken for labial adhesions.

• #33 Treatment of Prepubertal Labial Adhesions with Topical Estriol + Testosterone: A Case Report

  https://www.mdpi.com/2036-7503/16/3/47

  Recognizing the key role played by topical medical therapies in the treatment of labial adhesions, it is important to try to understand their physiological rationale. As we reported before, the etiology of labial agglutination is usually attributed to a chronic inflammatory process acting on the thin non-estrogenized epithelium of the labia minora. […] In our opinion, neither of these two theories fully explains the etiology of labial adhesions, and the role of androgens should also be taken into consideration. […] The low serum estradiol levels detected in infants between 3 months and 5 years old can potentially explain the higher frequency of labial fusion during these age ranges. […] However, in 2003, Papagianni et al. reported the co-occurrence of isolated premature thelarche and labial adhesions.

• #34 Labial Adhesion in a Pubertal Girl—A Commonly Misdiagnosed Entity: A Case Report

  https://www.jsafog.com/abstractArticleContentBrowse/JSAFOG/23933/JPJ/fullText

  The patient had recurrence after using estrogen cream, ruling out hypoestrogenism as a cause and the condition improved after personal hygiene and avoidance of local irritants like soap and steroid application to handle the local inflammation, which could have been the etiology. […] Recurrence rates range between 11% and 14%.

• #34 Labial Adhesion in a Pubertal Girl—A Commonly Misdiagnosed Entity: A Case Report

  https://www.jsafog.com/abstractArticleContentBrowse/JSAFOG/23933/JPJ/fullText

  Labial adhesion is a gynecological condition where adhesion of labia minora occurs in the midline. […] Hypoestrogenism and inflammation are usually considered as a cause of labial adhesion. […] Labial adhesion is thought to develop during the re-epithelization of microtraumatized hypoestrogenism labial skin, vulvovaginitis, and poor local hygiene. […] In pre-pubertal girls, hypoestrogenism, sexual abuse/genital trauma are suggested predisposing factors. […] Hypoestrogenism may also not be the cause in our case as she had attained menarche and had her secondary sexual characters developed. […] The indications for surgical treatment of labial adhesions include failed medical therapy dense adhesions without a visible transparent raphe accompanied by symptoms. […] In contrast to the recorded findings where there were no recurrences among the pubertal age group.

• #35 Labial Adhesions | Riley Children’s Health

  https://www.rileychildrens.org/health-info/labial-adhesions-vaginitis

  Labial adhesions occur when the inner lips (labia minora) of the vulva (outside of the vagina) stick together. This occurs most often in girls between 3 months and 6 years of age. […] There is no definite cause of labial adhesions other than low levels of estrogen, which is normal for girls in early childhood, particularly prior to puberty. […] Due to a lack of estrogen, labial adhesions can occur more than once until a child reaches puberty. […] Until a girl reaches puberty and estrogen levels increase, labial adhesions may occur more than once, and daily ointment application for 6 to 12 months may decrease recurrence.

• #36 Labial Adhesions: Causes, Symptoms, Diagnosis and Treatment | Nationwide Children’s Hospital

  https://www.nationwidechildrens.org/conditions/labial-adhesions

  Labial adhesions typically do not cause any symptoms. […] Young girls have very low levels of estrogen causing the labial tissue to be very fragile. Any irritant against this tissue (diapers or pull-ups) can cause the tissue to become inflamed and lead to labial adhesions. […] The vast majority of girls with labial adhesions have no symptoms and do not require treatment as the adhesions will resolve on their own once the irritant is removed and girls start making estrogen from their ovaries.

• #37 Labial Adhesions: Symptoms, Causes, Treatment | Qwark

  https://qwarkhealth.com/conditions/labial-adhesions

  The common treatments for labial adhesions include topical estrogen creams, surgical intervention, and non-surgical interventions like dietary changes, estrogen creams, or hygiene measures. […] Topical estrogen creams have proven to be effective in managing labial adhesions in many cases. […] Not all cases of labial adhesions require surgical procedures. […] The likelihood of spontaneous resolution of labial adhesions without treatment varies depending on the individual case. […] Labial adhesions may recur after successful treatment. […] The prognosis of labial adhesions may change based on the age of the patient. […] The long-term outcomes for patients with untreated labial adhesions can be variable.

• #38 Labial Adhesions | United Urology

  https://www.unitedurology.com/conditions-treatments/pediatric-urology/labial-adhesions/

  In some cases, labial adhesion occurs when your daughters labia becomes irritated. This can happen from prolonged exposure to wet or soiled diapers or even from a skin reaction to certain detergents. A lack of the female hormone estrogen, which diminishes in babies after three months of age, can also play a role in the development of adhesion. […] If the adhesion is trapping urine in the genital area and there is significant irritation or discharge, we may prescribe treatment with: Estrogen cream This is the most common treatment for labial adhesion. The cream is applied directly to the affected labia minora for two to three weeks. After this time, the hormone will separate the tissues and open the labia. […] In very rare cases, the labial adhesion will be thick and tightly fused. In these cases, your doctor will attempt to separate the labia under appropriate anesthesia. The majority of cases of labial adhesion do not cause pain or problems for your child and will resolve and reopen on its own with the onset of puberty.

• #39 Treatment of Prepubertal Labial Adhesions with Topical Estriol + Testosterone: A Case Report

  https://www.mdpi.com/2036-7503/16/3/47

  These findings can suggest the involvement of other factors besides hypoestrogenism in the etiology of labial adhesions and even other reasons for their apparent efficacy in therapy. […] According to other authors, chronic inflammation is the major determinant in the etiology of labial adhesion; therefore, they propose topical steroids as a treatment option. […] In our opinion, an ointment containing both estrogens and androgens should be considered for the treatment of labial adhesions. Further studies are needed to assess if the addition of topical testosterone can enhance the efficacy and reduce the recurrence of labial adhesions without significant side-effects.

• #40 Labial fusion

  https://www.rch.org.au/kidsinfo/fact_sheets/Labial_fusion/

  Labial fusion is a condition where the two flaps of skin on either side of the opening to the vagina (the labia minora) are joined together. It is also sometimes called labial adhesion or agglutination. Labial fusion is a common condition, and there is no need for concern in most cases. […] The exact cause of labial fusion is not known, but sometimes it occurs after an inflammation of the labial area (e.g. after a simple infection such as vulvovaginitis, or after mild trauma to the area). […] There is no relationship between labial fusion and any other medical conditions. Labial fusion will not have any effect on your child’s future ability to have sexual intercourse or have babies. […] While doctors are not sure exactly how labial fusion occurs, it often seems to happen following an infection in the vulval area, such as vulvovaginitis, or after minor trauma, like a injury from horse riding.

• #41 Labial fusion or labial adhesion | Raising Children Network

  https://raisingchildren.net.au/guides/a-z-health-reference/fused-labia

  Labial fusion is when the skin of the inner lips joins together. […] We dont really know what causes labial fusion. We think it happens after the skin around the vulva gets irritated. […] Labial fusion doesnt affect fertility, sexual function or menstruation.

• #42

  https://111.wales.nhs.uk/labialfusion/

  Labial fusion, or labial adhesion, is when the small inner lips around the entrance to the vagina become sealed together. […] It’s not certain what causes labial fusion, but it may happen as a result of irritation or inflammation of the vaginal area, known as vaginitis. […] Without enough oestrogen in the body, which is quite normal before puberty, the lips can stay stuck together and gradually become firmly joined. […] Labial fusion can also sometimes happen after childbirth or after the menopause, when oestrogen levels are also low. […] Labial fusion is not linked to any medical condition and has no long-term implications for your child. […] It will not affect her future fertility or sexual life.

• #43 Labial Fusion in Girls: Causes, Symptoms, and Treatment Options for Parents

  https://www.dremilmammadov.com/post/labial-fusion-in-girls-causes-symptoms-and-treatment-options-for-parents

  Treatment is only recommended if labial fusion is causing significant problems or symptoms. […] No, labial fusion will not have any impact on your daughter’s future sexual health or fertility. Labial fusion does not affect the development of the uterus (womb), ovaries or fallopian tubes, which are responsible for reproduction.

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