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Understanding Estrogen Cream for Labial Adhesion
When you or your daughter face problems with your sensitive, intimate regions, a doctor may recommend the use of best estrogen cream like Biestro Cream. If the problem is labial adhesions you might be confused and not sure what to do. Read on to understand more of you need to know about labial adhesions. Before we start, rest easy because it is a very common problem that can usually be easily resolved.
What Is Labial Adhesion?
Labia is another name used for female genitalia in medical terms. The basic function of the labia is to protect and cover the opening of the urethra (passageway to the bladder)) and the vagina. The labia majora is composed of two outer lips. Two inner lips, the labia minora, also exist on the opening.
Sparse pubic hairs cover the labia majora and are considered as part of the skin structure. The labia look like flaps or wings, and it can be a few millimeters to several centimeters in length.
Labial adhesion is the term used when the labia minora are stuck together or fused. Adhesion sometimes results in complete labial fusion but more often is just partial. This may also be called bridging, as the right and left sides of the vulva are joined together. Labial adhesion in some cases also refers to the fusion of labia minora with labia majora.
A secondary type of labial adhesion usually occurs after menopause. Labial adhesion in prepubertal girls is mostly present from birth and is known as primary labial adhesion.
How Common Is Labial Adhesion?
A frequently asked question is how common is labial adhesion? It is estimated that about 2 out of every 1,000 girls will develop labial adhesions before they reach puberty.
Causes of Labial Adhesions
Labial adhesions are more common during the early nappy years. Poor hygiene is the main reason for older women. Low estrogen levels are also thought to contribute to the development of labial adhesions. This condition may resolve itself during puberty because the effect of the female hormone estrogen changes the cells that line the genitals.
The exact cause for this is still unknown, but it is strongly believed that labial adhesions are caused by irritation to the external genitals. The range of possible irritants includes:
- Feces
- Urine
- Strongly perfumed soaps
- Bubble baths
- Inflammatory conditions such as vulvitis
- Atopic dermatitis
- Pinworms
- Labial injuries
- Sexual abuse
People often think that labial adhesion and food allergies are co-related, which is not true. Labial adhesion and food allergies are unrelated or at least there is not enough evidence to substantiate it.
Many physicians have concluded that labial adhesions develop from a combination of inflammation, trauma, or infection that occurs due to a low-level estrogen environment. Newborns usually have estrogen in their bodies from their mothers, and it takes several months for the hormone to decrease. Adhesions commonly first appear between the ages of 13 and 23 months, when the leftover estrogen has disappeared and most babies are becoming more physically active.
Symptoms of Labial Adhesions
The symptoms of labial adhesions can include:
- Joining of inner lips
- Painful irritation
- Vulvar irritation
- Urine dribbling
- Vulvar soreness after urination
- In some cases, the inability to pass urine
Children will have few or no symptoms, but some children may complain of vulvar pain, itching, or irritation, or sometimes they will have trouble emptying their bladder. In many cases, children with labial adhesions also experience recurrent urinary tract infections or vaginal discharge.
Why does Labial Adhesion Need Immediate Attention?
In most cases, labial adhesions are harmless and resolve by themselves once puberty begins (from about 10 years of age). If the adhesions are severe and interfere with urination, medical treatment is needed. If left untreated labial adhesion can cause difficulty using tampons and painful sexual experience (apareunia).
Tackling Labial Adhesions
Most physicians will adopt three-step strategies to alleviate or rectify the symptoms of labial adhesions.
Monitoring
If the case is not serious, then a doctor will wait and see if the problem naturally resolves itself. The labia can become separated during puberty on its own, when the body begins producing its own estrogen.
Estrogen Cream
If adhesions are significantly blocking urine flow or causing recurring vaginal or bladder infections, physicians may prescribe an estrogen or steroid cream to put on the labia. Estrogen cream for labial adhesion is generally applied to the area once or twice every day for between two to eight weeks. This is successful in about 90 percent of cases. Any hormonal side effects are short-lived and resolve by themselves once the cream is no longer used. Using natural estriol oil or cream ensures that the hormone will leave the body each day as estriol does not leave behind any residual within 24 hrs. 1 mg applications were used in the studies.
Surgery
Though it is best to start out with a non surgical approach, such as a topical estrogen cream for labial adhesion, there are times it doesn’t work, and then the labia must be separated by surgery. This option is considered as a last resort. The surgery is performed by a trained surgeon under local or general anesthetic to prevent any discomfort for your child or you. Separation of the labia is performed by gently pulling the labia laterally with a lubricated probe, or cotton-tipped swab. The process is quick and the recovery period is short.
However, labial adhesion surgery recovery may be significantly longer.
During the labial adhesion surgery recovery, antibiotic cream or topical estrogen cream for labial adhesion must be applied to the labial edges to stop them from sticking together while they heal after the surgery. If even after surgery the discomfort and irritation caused by labial adhesions continue, it is best to contact the pediatric gynecologist or urologist.
It is important to mention here that in some cases the process of the separation can also be performed in a doctor’s office and not in an operating theater. The decision to perform the procedure in an office or OT is based on factors such as:
- The density of the adhesion
- The patients’ ability to tolerate the procedure
- The child’s level of maturity
It Can Even Come Back, Look out for it!
Sadly, it is very common for adhesions to return before the child enters puberty and begins to make their own estrogen. But some things that may help avoid this can be changing the nappy of the child frequently, wiping the child’s genitals front to back after they urinate or poop, using creams to separate the labia such as calendula cream, Vitamin A and D ointment, and avoiding perfumed soaps or bubble baths. It is important to respond in a timely manner if any of the conditions return.