Vaginal Synechia – How Can I Tell if My Daughter Has It?

Vaginal synechia¹ is a small adhesion of the labia minora, and surprisingly, it is a common occurrence that affects on average 5% of girls between 3 months and 10 years old. Usually, it is the mother herself who notices something different in her daughter’s genitals during diaper changes, but it can also be detected during routine pediatric checkups.

An adhesion can be observed, meaning the labia minora of the vulva are “stuck together”, and the exact reason for this occurrence is still unknown, even if the girl was born with perfectly normal genitals. Experts affirm that the problem occurs due to low estrogen production, which leads to greater difficulty in local healing.

Friction from diapers or even simple underwear, poor hygiene, dermatitis² in the area, and even trauma can cause small wounds or injuries. Due to poor healing resulting from lack of the hormone, these wounds may create an adhesion, resulting in vaginal synechia. There are no reports of vaginal synechia causing a total adhesion and completely closing the vaginal opening; in every case, the small hole for urine to pass remains intact. However, it can lead to urinary tract infections, irritation, and itching, or even be noticed by urine residue in the underwear or diaper, which remains trapped in the folds of the adhesion and may cause unpleasant odor in the area.

How Is Vaginal Synechia Treated?

The treatment is simple but must be carried out rigorously and under medical supervision to achieve the expected result. The use of creams and ointments based on the hormone that is in low production, estrogen, is recommended. When used correctly and as prescribed, the ointment will cause the labia to separate naturally, solving the issue. Keep in mind that, since these ointments are hormone-based, they must be used with great care, as misuse or excessive use may result in precocious puberty, leading to the appearance of genital hair in the child and darkening of the area³.

If the ointment is used for less than the period prescribed by the pediatrician, even if the synechia issue is resolved, it may return. Therefore, both the dosage and the duration of treatment must be strictly followed. In very extreme cases where the child’s health is affected, surgery is recommended. But this is only advised in very severe cases, because in most cases, after surgery, the trauma is even greater, resulting in a synechia with a thicker and more noticeable scar.

Of course, whatever treatment is chosen, it should always be carried out as indicated by the child’s pediatrician or consulted specialist, who will evaluate the case and recommend the best treatment option. It’s also important to point out that gynecologists don’t only treat women and sexually active teenagers; this type of specialist can also be consulted for young girls.

See also: Childhood Phimosis – How to Solve It?

Photo: Mateus André, Eline Luz