From the Research
Local hormone applications are not typically effective for vulva formation or unburying a buried vaginal canal in intersex patients, and surgical intervention is usually required. These conditions generally require surgical intervention rather than topical hormone therapy. For vulva formation, surgical procedures such as vulvoplasty or labiaplasty are the standard approach, while vaginoplasty is typically needed to address a buried vaginal canal. While topical estrogen creams (such as estradiol cream 0.01%, applied once daily for 2-4 weeks) may be used post-surgically to promote tissue healing and maintain vaginal health, they cannot create new genital structures or significantly alter existing anatomy. In some cases of mild labial adhesions, estrogen cream might help separate fused tissues, but this is different from addressing congenital variations in intersex individuals.
The provided evidence does not directly address the effectiveness of local hormone applications for vulva formation or unburying a buried vaginal canal in intersex patients. However, studies such as 1 discuss the use of injectable estradiol in transgender and gender diverse adults, highlighting the importance of careful dosing and monitoring to achieve optimal hormone levels. This suggests that hormone therapy can be complex and requires individualized management, but it does not provide insight into the specific use of local hormone applications for genital structure formation or alteration in intersex patients.
Surgical interventions are generally performed by specialists in pediatric urology or gynecology, ideally within a multidisciplinary team that includes endocrinologists and mental health professionals. The timing of such procedures has become increasingly patient-centered, with many medical centers now recommending deferring genital surgeries until the individual can participate in decision-making, unless there is a clear medical necessity in infancy or childhood. Key considerations in the management of intersex conditions include:
- The need for a multidisciplinary approach to care
- Patient-centered decision-making
- The importance of addressing medical necessities in infancy or childhood
- The role of hormone therapy in promoting tissue healing and maintaining vaginal health post-surgically
In the context of intersex care, it is essential to prioritize patient well-being, autonomy, and quality of life. This involves careful consideration of the potential benefits and risks of any intervention, including surgical procedures and hormone therapies. By prioritizing patient-centered care and involving a multidisciplinary team of specialists, healthcare providers can work to optimize outcomes for intersex individuals.