Treatment of Prepubertal Labial Adhesions with Topical Estriol + Testosterone: A Case Report

Background: Labial adhesions, a frequent gynecological condition in prepubertal girls, occur when the labia minora adhere along the midline. The prevailing hypothesis about their etiology suggests that labial adhesion may occur when the delicate and non-estrogenized labia minora undergo an inflammat...

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Main Authors: Filippo Murina, Cecilia Fochesato, Valeria Maria Savasi
Format: Article
Language:English
Published: MDPI AG 2024-07-01
Series:Pediatric Reports
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Online Access:https://www.mdpi.com/2036-7503/16/3/47
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author Filippo Murina
Cecilia Fochesato
Valeria Maria Savasi
author_facet Filippo Murina
Cecilia Fochesato
Valeria Maria Savasi
author_sort Filippo Murina
collection DOAJ
description Background: Labial adhesions, a frequent gynecological condition in prepubertal girls, occur when the labia minora adhere along the midline. The prevailing hypothesis about their etiology suggests that labial adhesion may occur when the delicate and non-estrogenized labia minora undergo an inflammatory response, triggered by exposure to an irritant environment. Therefore, conservative treatment involves the application of topical estrogen or betamethasone cream. The role of androgens has not been considered yet in the pathophysiology or therapy of this condition. However, some studies have shown that androgen receptors are prevalent in the labia minora and vulvar vestibule. Case summary: We present the case of a 29-month-old girl with symptomatic labial adhesions. She was first ineffectively treated with topical estriol, and then she was treated with a galenic cream containing both estriol and testosterone with complete recovery and without side-effects. Conclusions: Both androgens and estrogens play a significant role in maintaining the physiological trophic state of the vulva and vagina, even during childhood. Topical estriol+testosterone could be considered an alternative treatment for prepubertal labial adhesions refractory to standard topical therapy.
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spelling doaj-art-bbf7491d55014f04b0688045100c6bee2025-08-20T01:55:45ZengMDPI AGPediatric Reports2036-75032024-07-0116355856510.3390/pediatric16030047Treatment of Prepubertal Labial Adhesions with Topical Estriol + Testosterone: A Case ReportFilippo Murina0Cecilia Fochesato1Valeria Maria Savasi2Lower Genital Tract Disease Unit, V. Buzzi Hospital, University of the Study of Milan, 20124 Milan, ItalyLower Genital Tract Disease Unit, V. Buzzi Hospital, University of the Study of Milan, 20124 Milan, ItalyDepartment of Woman Mother and Neonate, V. Buzzi Hospital, University of the Study of Milan, 20124 Milan, ItalyBackground: Labial adhesions, a frequent gynecological condition in prepubertal girls, occur when the labia minora adhere along the midline. The prevailing hypothesis about their etiology suggests that labial adhesion may occur when the delicate and non-estrogenized labia minora undergo an inflammatory response, triggered by exposure to an irritant environment. Therefore, conservative treatment involves the application of topical estrogen or betamethasone cream. The role of androgens has not been considered yet in the pathophysiology or therapy of this condition. However, some studies have shown that androgen receptors are prevalent in the labia minora and vulvar vestibule. Case summary: We present the case of a 29-month-old girl with symptomatic labial adhesions. She was first ineffectively treated with topical estriol, and then she was treated with a galenic cream containing both estriol and testosterone with complete recovery and without side-effects. Conclusions: Both androgens and estrogens play a significant role in maintaining the physiological trophic state of the vulva and vagina, even during childhood. Topical estriol+testosterone could be considered an alternative treatment for prepubertal labial adhesions refractory to standard topical therapy.https://www.mdpi.com/2036-7503/16/3/47labial adhesionslabial agglutinationprepubertalestrogenbetamethasonetestosterone
spellingShingle Filippo Murina
Cecilia Fochesato
Valeria Maria Savasi
Treatment of Prepubertal Labial Adhesions with Topical Estriol + Testosterone: A Case Report
Pediatric Reports
labial adhesions
labial agglutination
prepubertal
estrogen
betamethasone
testosterone
title Treatment of Prepubertal Labial Adhesions with Topical Estriol + Testosterone: A Case Report
title_full Treatment of Prepubertal Labial Adhesions with Topical Estriol + Testosterone: A Case Report
title_fullStr Treatment of Prepubertal Labial Adhesions with Topical Estriol + Testosterone: A Case Report
title_full_unstemmed Treatment of Prepubertal Labial Adhesions with Topical Estriol + Testosterone: A Case Report
title_short Treatment of Prepubertal Labial Adhesions with Topical Estriol + Testosterone: A Case Report
title_sort treatment of prepubertal labial adhesions with topical estriol testosterone a case report
topic labial adhesions
labial agglutination
prepubertal
estrogen
betamethasone
testosterone
url https://www.mdpi.com/2036-7503/16/3/47
work_keys_str_mv AT filippomurina treatmentofprepubertallabialadhesionswithtopicalestrioltestosteroneacasereport
AT ceciliafochesato treatmentofprepubertallabialadhesionswithtopicalestrioltestosteroneacasereport
AT valeriamariasavasi treatmentofprepubertallabialadhesionswithtopicalestrioltestosteroneacasereport