Labial adhesion in girls: causes, treatment & when it clears

Author: Jessica Lloyd
Senior Vulvovaginal Specialist Naturopath | BHSc(N) | ISSVD, ISSWSH, BSSM, ATMS

Last reviewed: July 1, 2026

Labial adhesion, also called labial agglutination, is a condition whereby the labia minora (inner labia) fuse together in the midline, and less commonly the labia majora (outer labia). Parents most often first notice it as the labia looking stuck together. It is a reasonably common occurrence in girls prior to puberty, affecting an estimated 0.6 to 5 per cent of prepubertal girls.^1,2

There are usually no other symptoms and treatment is often unnecessary, because many cases resolve on their own over time, with most settling by puberty.^1,3 It is still important to make sure other conditions are not present when the labia appear fused.

Other conditions that may need to be investigated include an imperforate hymen (a hymen that completely closes off the vaginal entrance) or a septate vagina (a vaginal septum, creating a ‘double vagina’).

The ages labial adhesions most commonly occur are between about three months and three years, with the peak around one to two years of age, but the labial fusing can linger on until puberty.¹

This is general information, not a substitute for personalised medical advice. If your child has labial fusion causing urinary symptoms, or you are unsure what you are seeing, please have them assessed by a doctor.

Signs and symptoms of labial adhesion

Urine may fill up the vagina because it’s trapped, and leak out over a period of time after urinating (called postvoid dribbling or vaginal voiding)
A secondary urinary tract infection may occur
Uncomfortable urination
A thin, pale, somewhat translucent membrane may cover the vaginal opening inside the labia minora, and may sometimes completely close over the vaginal opening, starting from the bottom of the vaginal opening and working its way up towards the clitoris
Some masses may grow on the labia or other genital abnormalities might be present
Signs of sexual abuse may occasionally be present, though labial adhesion on its own is not a sign of abuse

Diagnosing labial adhesion

Labial adhesions are most often found by parents or during an examination, and are more often found if there is inflammation of the vulva (vulvovaginitis). Labial adhesion is a clinical diagnosis, so no scans or blood tests are needed to confirm it.¹ When a doctor diagnoses labial adhesion, there are a few things they must rule out, including:

Hymen skin tags
Imperforate hymen (where the hymen completely blocks the vaginal entrance)
Introital cysts (paraurethral or Gartner duct cysts)
Ureterocele (a birth defect causing urine flow problems)
Urethral polyp
Urethral prolapse
Vaginal atresia or Müllerian agenesis (MRKH syndrome)
Vaginal rhabdomyosarcoma

If a girl has urinary symptoms, a urine culture may be requested to check for infection or inflammation.¹

Resolution and treatments for labial adhesion

The resolution of labial adhesions most often occurs during puberty when hormones shift, but can occur in a short time after the condition develops, for example a year later. Because most cases settle by themselves, watching and waiting is a reasonable first approach when there are no symptoms.^1,3

Where treatment is needed, the usual stepwise approach is to try oestrogen cream first, then to consider surgery. Steroid creams are sometimes prescribed as an alternative, with a similar success rate to oestrogen.¹

Oestrogen cream for labial adhesion

Oestrogen cream is applied once or twice a day for several weeks, until the labia start to come apart, at which point frequency is reduced and an emollient cream is begun. Treatment is generally kept to the shortest effective course.¹

Studies report success rates of up to 90 per cent with oestrogen cream, though results in everyday practice are often more modest.¹ In one randomised trial, oestrogen reduced the severity of adhesions more than a placebo (emollient) cream, although the difference in complete resolution was not statistically significant.⁴ Minor local side effects settle after treatment ends.¹

Surgery for labial adhesion

The surgery for labial fusion is uncomplicated and does not require stitches. The labia come apart quite easily, however it can be painful for the child, so local anaesthetic is recommended.

Sometimes a general anaesthetic will be warranted if the child is likely to become very distressed. How this is approached is decided on an individual basis. Adhesions can recur after any treatment – reported anywhere from about 11 per cent to over 40 per cent of cases depending on the method – so ongoing care to prevent reattachment matters.^1,5

Treatment notes for labial adhesion

Topical oestrogen cream may be prescribed, particularly if frequent UTIs are occurring
Manual or surgical separation may need to be considered if urinary problems are being encountered and unresolved, or if the adhesion is very fibrous
Avoid exposure to irritants like soaps, detergents, bubble baths, and laundry detergent (choose hypoallergenic)
Regularly visit with a doctor, paediatric urologist or gynaecologist to keep an eye on the issue
If oestrogen or surgery are used, emollient cream must be applied several times a day to keep the labia from reattaching
Manual separation should not be attempted at home, as it can cause pain and scarring

Note: Oestrogen cream may cause a temporary pigmentation change on the area applied, however this normally fades after treatment stops. Your child’s breasts may become temporarily tender or enlarge.

Why does the labia fuse?

Labial adhesions are fibrous and form in the midline between the labia minora, the inner labia that sit between the outer labia. They tend to appear in childhood, the period where girls have very little oestrogen, which also makes them rare in newborns (who still carry oestrogen from their mothers).^1,2

Interestingly, when oestradiol levels have been measured, there was no significant difference between girls with labial adhesions and those without.⁶ This suggests that a low-oestrogen environment makes the tissue vulnerable, but local irritation, inflammation or trauma is usually what actually triggers the fusing.

These adhesions can be triggered by inflammation, irritation, or vaginal or vulvar trauma. Sexual abuse can result in labial adhesions due to trauma to the tissues, though it is important to stress that an adhesion by itself is not evidence of abuse.¹

In older girls and adults, lichen sclerosus is another recognised cause of labial fusion. This chronic inflammatory skin condition thins and scars the vulval skin, and needs its own targeted treatment, so it is worth ruling out when adhesions appear outside the usual toddler age range.¹

How natural medicine approaches labial agglutination

Natural medicine practitioners and doctors take the same general approach to labial adhesions: it is not dangerous and, unless it is causing discomfort during urination, it should be left alone.

A natural medicine practitioner is likely to look at the rest of the child’s development and health to see if there are any clues pointing to another reason for labial agglutination, such as skin and food sensitivities, intolerances, and allergies.

These other problems can then be dealt with. There may be changes in the labial agglutination, or there may not – each child is different in this respect.

If separation is required, plant oestrogens work in much the same way as human oestrogens, but are far weaker. Incorporating more phyto-oestrogens into a young girl’s diet, or using topical applications, may help to naturally separate the labia, at least enough to allow normal urination.

It’s important to get professional help when using plant oestrogens as a treatment strategy, particularly by mouth. Their use would only be as temporary as using oestrogen cream, and only in place of it as necessary.

If the labia need to be separated for urination, it may be more useful to use regular oestrogen cream, as it will work faster than a weaker plant oestrogen.