Sometimes a baby is born with ambiguous genitalia. This might include fused labia, which look like a scrotum. This article isn’t about this condition. Rather, the articles applies to girls whose labia minora (inner vaginal lips) are stuck together, but who have otherwise normal genitalia.
Causes
We don’t know exactly what causes fused labia. It usually occurs after 3-6 months of age and up to the age of about six years. Sometimes baby girls are born with it.
Labial fusion might occasionally follow an infection or irritation of the labia minora, although the precise cause is unknown. Babies are exposed to their mothers’ oestrogen inside the womb. A baby’s oestrogen levels slowly drop after birth and are low at 3-6 months of age. This might cause the labia to fuse in response to irritation.
Sources of irritation might also include soaps or bubble baths, nappy rash or poor hygiene.
Symptoms
Labial fusion appears as a thin membrane, which might start near the anus and extend to the opening of the bladder, although the length of the membrane varies. There’s usually an opening at the front from which urine can come out, and the opening of the vagina is sometimes covered over.
Sometimes, a child might have difficulty getting all her wee out, because some can get trapped behind the membrane. This can lead to leakage, wet pants and difficulties in toilet training. It might also lead to a urinary tract infection or irritation of the vaginal skin.
Treatment
Labial fusion will usually sort itself out when the irritation gets better, by about eight years of age or at the time of puberty when your daughter produces higher levels of her own oestrogen.
If you think your daughter has this problem, you should see your doctor to discuss its management. Uncomplicated fused labia, which aren’t causing any problems, won’t need separating.
But if there’s labial irritation or recurrent bladder infections, your doctor might consider separating the labia. This would be done under an anaesthetic.
Some doctors recommend putting oestrogen cream on the fused labia to encourage separation. Others think this isn’t necessary because it often doesn’t work, or the condition comes back.
Labial fusion does not affect your daughter’s fertility, sexual function or menstruation.
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