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vaginal synechiae, labial adhesions

"Doctor, my baby's vagina has closed up!" No, the labia minora are just stuck together (labial adhesions). This happens because 1) the female infant and toddler has very low levels of female hormones that keep the tissue non-sticky 2) parents forget to gently spread the vaginal lips properly during baths (all you really need to do is just part them for a second). Once the vaginal opening is stuck together, nothing bad happens*. If you did nothing about it, in a few years the opening would open back up without any problem.

If you really are nervous about it, your doctor could prescribe some Premarin® hormone cream to put on the area to soften up the tissue and open the orifice. The pediatric endocrinologists I have talked to about it don't think that's necessary or particularly advisable, but opinions differ. A one week course of treatment with the topical estrogen cream is said to be effective in 9 out of 10 cases in my textbook, but my experience has never been that good. In any event, once the labia are separated again, particular attention should be payed to hygeine (soaking cross-legged in the tub in clear water is always a good idea) and some petroleum jelly or zinc oxide should be smeared on the area where the adhesions occurred for a couple of months. This will help prevent reappearance of the adhesions.

*OK, well actually, rarely the girls urinary stream will partially deflect into the vaginal and lead to dribbling after voiding. This, along with recurrent UTI's is the only real reason to do anything about it. The procedure ("pop it open") can be done in the office under local EMLA cream anesthesia.

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