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Not enough estrogen, no opening in vagina. Labia adhesion. Prescribed premarin cream. Difficulties in future?

When my daughter was 2 years old, I noticed while I washing her one day there was no opening to her vagina . I made an appointment to go see a pediatrician and they told me it was quite normal for this to happen in girls because the body doesn t provide enough estrogen , and he called it a labia adhesion . He prescribed her premarin cream which is most often used by menopausal women. I had to use it on her for about 4 weeks before it worked completely. He then told me to use vaseline to keep the vagina from fusing back together. I did that, and about 2 months after, I noticed the vagina was fused together again. So we did the premarin cream again and once again it worked. She is now 2 months shy of turning 5 and is now having the same problem. Why does this keep happening? I was told that I shouldn t use this cream anymore since it contains steroids, and there are alot of side effects from prolonged use. I was also told to wait until she is older and see if her body will produce more estrogen, and if there is no change then the only other option is surgery. I am really scared and I can t help wondering if this is doing harm to her? What if she is a child who starts her menstrual period before we can do something about this? Is there any advice you can share with me, or should I go and see another doctor?
Asked On : Sat, 9 Jun 2012
Answers:  1 Views:  80
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OBGYN 's  Response
Hello and welcome to HCM,     
I am Dr Nilajkumar a consultant gynecologist and I will be helping you in your queries.
I understand your concern very well.

Estrogen levels are low in children and begin to increase after pubertal changes set up. But this should not lead to labial fusion. Normally there is enough estrogen in the body of children to prevent this.

I suggest that you get her ultrasound done to see if the uterus and ovaries are normal or not as many times there are associated vaginal septums or other minor problems.

If the labia are close by but the vagina is well developed, a minor surgery will correct the defect. Also another condition called imperforate hymen may also be a cause rather than labial fusion.

It is best if you see another gynecologist and have an examination and opinion rather than giving repeated estrogens at such a tender age.
Please do not worry. It may at the most require a minor surgery at an older age.

Hope this was helpful.
Feel free to ask any further queries and I will be happy to help.
Thanks for using HCM.
Have a good day.
Dr Nilajkumar Bagde          
Consultant Obstetrics and Gynecology
Answered: Sun, 30 Mar 2014
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