Labial Adhesions in Young Girls – Grand Rapids, Michigan Guide

Labial adhesions (also called “fused labia”) happen when the small inner lips of the vulva (labia minora) stick together. Normally, the labia minora sit on either side of the vaginal opening and urethra and only meet at the clitoris. With labial adhesions, part or all of the inner lips join in the middle.

This is a common and usually harmless condition in young girls, including here in Grand Rapids and across West Michigan.

How Common Are Labial Adhesions?

  • Affect up to 2% of girls between 3 months and 6 years
  • Most common between 1 and 2 years of age
  • Often noticed during diaper changes, baths, or routine checkups

Pediatricians at Grand Rapids clinics and hospitals such as Corewell Health (formerly Spectrum Health) Helen DeVos Children’s Hospital, Trinity Health Grand Rapids, Metro Health, and Mercy Health frequently diagnose and manage this condition.

Do Labial Adhesions Cause Long-Term Problems?

In most cases, no.

Labial adhesions:

  • Do not affect future fertility
  • Do not affect sexual function in adulthood
  • Do not affect menstrual cycles later in life

Most adhesions separate on their own as a child approaches puberty, when estrogen levels naturally rise.

Symptoms of Labial Adhesions

Many girls have no symptoms and the condition is found incidentally. When symptoms do occur, they may include:

  • Inner lips (labia minora) appear joined together in the middle
  • A smaller than usual or slit-like opening where the vagina and urethra should be visible
  • Dribbling urine after going to the toilet
  • Change in urine stream direction (for example, squirting sideways)
  • Mild vulval soreness, especially after urinating

In more severe cases:

  • Difficulty starting urination
  • Very weak urine stream
  • Rarely, inability to pass urine (this is an emergency and needs immediate care at an emergency department, such as at Helen DeVos Children’s Hospital or Trinity Health Grand Rapids).

What Causes Labial Adhesions?

The exact cause is not fully understood, but labial adhesions are strongly linked to irritation and inflammation of the delicate skin of the vulva in a low-estrogen environment (as in young girls before puberty).

Common Irritants and Triggers

  • Urine left on the skin
  • Stool (faeces) contact with the vulva (more common in diaper-wearing children)
  • Strongly perfumed soaps, bubble baths, or bath bombs
  • Harsh wipes or aggressive scrubbing
  • Inflammatory skin conditions, such as:
    • Vulvitis (inflammation of the vulva)
    • Atopic dermatitis (eczema)
  • Pinworms
  • Minor labial injuries or friction (tight clothing, rough wiping)

The skin of the labia minora is thin and delicate. When it becomes inflamed or raw, the two sides may heal together—similar to how two adjacent cuts on the skin can heal into one.

Note: Sexual abuse is sometimes listed as a possible cause of genital irritation in general, but most labial adhesions are not related to abuse. If you have any concerns about your child’s safety, speak to a trusted healthcare professional right away.

Why Are Labial Adhesions Common in Young Children?

Labial adhesions are more frequent during the “nappy/diaper years” and early childhood because:

  • The area is often moist (from urine, stool, wipes)
  • Irritants can sit on the skin under diapers or tight clothing
  • Low estrogen levels before puberty (hypo-estrogenism) make the tissues thinner and more easily irritated

As girls approach puberty, estrogen levels rise, which thickens and strengthens the genital skin. This usually causes existing adhesions to separate naturally without treatment.

Possible Complications

Most labial adhesions are mild and do not cause serious problems. However, complications can include:

Urination Problems

  • Changes in the direction of the urine stream
  • Dribbling urine after going to the toilet
  • Difficulty emptying the bladder fully

Urinary Tract Infections (UTIs)

  • About 20% of girls with labial adhesions develop asymptomatic bacteriuria (bacteria in the urine without obvious symptoms)
  • Up to 40% may experience UTIs

Watch for:

  • Fever without a clear cause
  • Pain or crying with urination
  • Needing to urinate more often
  • Foul-smelling or cloudy urine

If you notice these signs in Grand Rapids, contact your pediatrician, an urgent care clinic, or the Kent County Health Department for guidance.

Hydronephrosis (Rare but Serious)

If the adhesions completely block the urethra, the bladder cannot empty. Over time, this can cause:

  • Bladder distension (overfilling)
  • Back-up of urine to the kidneys
  • Hydronephrosis (abnormally enlarged kidneys due to urine build-up)

This is an emergency. If your child cannot urinate at all, go immediately to the nearest emergency department in Grand Rapids.

How Labial Adhesions Are Diagnosed

Labial adhesions are usually diagnosed by a simple physical examination.

Your child’s doctor may:

  • Gently examine the external genital area
  • Confirm that the inner lips are fused
  • Check for other conditions, such as:
    • Imperforate (closed) hymen
    • Other structural genital abnormalities

Additional tests may be ordered if there are concerns about urinary problems or kidney involvement:

  • Urine tests to check for infection
  • Voiding cystourethrogram (VCUG) to look at the bladder and urethra
  • Kidney imaging (ultrasound) if there are concerns about hydronephrosis

These tests are typically arranged through pediatric specialists at local centers such as Helen DeVos Children’s Hospital or Metro Health – University of Michigan Health.

Treatment Options in Grand Rapids

Treatment depends on the severity of symptoms, not just how the adhesions look.

1. Monitoring Only (Watchful Waiting)

For mild, symptom-free labial adhesions:

  • No immediate treatment is often needed
  • Your doctor may recommend:
    • Gentle hygiene
    • Avoiding irritants
    • Regular follow-up to monitor changes

Many adhesions slowly resolve on their own over months to years, especially as your child gets older.

2. Estrogen Cream

If adhesions are:

  • Causing urinary symptoms, OR
  • Recurrent UTIs, OR
  • Very extensive

Your child’s doctor may prescribe a topical estrogen cream.

How it is used:

  • Applied once or twice daily to the fused area
  • Typical course: 2–8 weeks
  • Gently massaged along the line of fusion as directed by your pediatrician or pediatric gynecologist

Effectiveness:

  • Successful in about 80% of cases

Possible (temporary) side effects:

  • Slight color changes to the labia (often a bit darker)
  • Mild breast budding or tenderness (uncommon and reversible)
  • Local irritation

These side effects usually go away after the cream is stopped. Pediatric specialists in Grand Rapids will review risks and benefits with you before starting treatment.

3. Surgical Separation (Last Resort)

Surgery is rarely needed and is reserved for:

  • Severe adhesions that block urination
  • Cases not responding to estrogen cream
  • Repeated infections or significant urinary problems

During the procedure:

  • A pediatric gynecologist or pediatric surgeon gently separates the labia
  • This is usually done under local or light general anesthesia, depending on the child’s age and comfort

After surgery:

  • An antibiotic or protective cream (such as petroleum jelly) is applied to the labial edges to prevent them from sticking together again while they heal
  • Good hygiene and follow-up are essential

Preventing Recurrence

Even after successful treatment, labial adhesions can recur. This is common and does not mean anything was done wrong.

To reduce the risk of recurrence:

  • Apply a barrier cream (such as petroleum jelly) to the separated labia as recommended by your doctor
  • If your child is still in diapers:
    • Change diapers frequently
    • Rinse the area with warm water during changes if skin is irritated
  • Teach older girls to:
    • Wipe front to back after urinating or bowel movements
    • Avoid scrubbing or using harsh wipes

Everyday Care and Hygiene Tips

Gentle Vulval Care

  • Wash the genital area once daily with warm water only or a very mild, fragrance-free cleanser
  • Avoid:
    • Strongly perfumed soaps
    • Bubble baths and bath bombs
    • Scented wipes or sprays
  • Pat dry with a soft towel—do not rub

Toilet Habits

  • Always wipe front to back to keep stool away from the vulva
  • Encourage your child to:
    • Take their time on the toilet
    • Empty the bladder fully
    • Tell you if peeing hurts or feels different

Local Considerations in Grand Rapids, MI

Living in West Michigan can bring some specific factors:

  • Cold, dry winters in Grand Rapids can dry out the skin, including the vulvar area. Using a gentle, fragrance-free moisturizer on nearby skin (not inside the vagina) and a barrier ointment on the labia can help protect delicate tissue.
  • Indoor heating during winter can worsen skin dryness and irritation; keep baths short and avoid hot water.
  • If your child attends daycare or preschool in the Grand Rapids area, ensure caregivers know to:
    • Change diapers promptly
    • Use gentle wipes or warm water
    • Avoid fragranced products

If you need additional support, Kent County Health Department and Grand Rapids Public Health resources can help connect your family with pediatric care, education, and follow-up services.

When to See a Doctor in Grand Rapids

Contact your pediatrician or family doctor if:

  • You notice the inner lips seem fused together
  • Your child has:
    • Pain or crying with urination
    • Frequent or urgent urination
    • Foul-smelling or cloudy urine
    • Recurrent diaper rash or vulval irritation
  • You are unsure how to clean or care for your child’s genital area

Seek urgent or emergency care if:

  • Your child cannot urinate
  • There is visible swelling of the lower abdomen
  • Your child has fever and appears very unwell

In Grand Rapids, you can seek care at:

  • Corewell Health Helen DeVos Children’s Hospital
  • Trinity Health Grand Rapids
  • Metro Health – University of Michigan Health
  • Mercy Health locations
  • Local urgent care centers and pediatric clinics

Key Points About Labial Adhesions

  • Labial adhesions are common in girls aged 3 months to 6 years, especially 1–2 years old.
  • They are usually caused by irritation and low estrogen in the delicate genital skin.
  • Most cases are painless and harmless and resolve on their own by puberty.
  • Symptoms can include:
    • Inner lips joined together
    • Changes in urine stream or dribbling
    • Occasional soreness or UTIs
  • Treatment ranges from watchful waiting and gentle care to estrogen cream; surgery is a last resort.
  • Recurrence is common, so ongoing gentle hygiene and barrier creams may be recommended.
  • Local Grand Rapids resources—including pediatricians, pediatric gynecologists, and the Kent County Health Department—are available to help diagnose, treat, and support your family.

If you’re in the Grand Rapids area and concerned about labial adhesions, start by calling your child’s primary care provider. Early evaluation and reassurance can prevent complications and ease worry.