Hello friends! This week we are going to talk about intimacy—today’s topic is lubricants! There are many benefits to using lubricants, but using the wrong ones can increase your risk of infection or vaginal irritation. Regardless of any health factors, lubricants may also optimize sexual function, pleasure, and enjoyment for all genders (Kennedy, 2022; Potter, 2021).
Lubricants are great for individuals experiencing vaginal dryness due to menopause, pain with intercourse with vaginal penetration, or anal intercourse (Kennedy, 2022). Common causes of vaginal dryness and vulvovaginal atrophy include: breastfeeding, menopause, stress, chronic medical conditions (like diabetes, irritable bowel disease, chronic heart failure, hypothalamic amenorrhea, hyperprolactinemia), medications (anti-depressants or anti-estrogen), medical treatments like radiotherapy and chemotherapy, and advancing age (Potter, 2021).
Many of these common causes involve lower estrogen levels. Estrogen helps maintain good bacteria in the vagina and helps to maintain a lower pH which helps to prevents bacterial infections (Potter, 2021). When estrogen levels are lower, the vaginal walls begin to atrophy. This can cause less natural secretions and lubrication (Potter, 2021). It is estimated that 15% of premenopausal women and 57% of postmenopausal women suffer from vaginal dryness and vulvovaginal atrophy (Potter, 2021). Lubricants are safe to use when estrogen therapy is being used (Potter, 2021).
Lubricants are designed to decrease pain and discomfort by assisting with dryness during sexual intercourse. Lubricants work by reducing friction and therefore trauma to tissues and help to reduce pain and discomfort (Potter, 2021). On the other hand, vaginal moisturizers, although treating similar symptoms, are designed to maintain vaginal hydration day-to-day (Potter, 2021).
Aside from pain and improving vaginal dryness, lubricants have also been recommended to use with condoms to reduce condom breakage. This in turn, can help to prevent sexually transmitted infections (Kennedy, 2022)
Choosing the right lubricant is important. Lubricants have three main base types: oil, silicone, and water. It is important to remember that oil-based lubricants can damage condoms which increases the risk of sexually transmitted infections and unplanned pregnancies. Silicone-based lubricants can break down silicone products like toys or even some pelvic wands (used in pelvic floor therapy).
Try to find a lubricant with a pH and osmolality like that of natural vaginal secretions (Potter, 2021). The World Health Organization recommends that lubricant osmolality does not exceed 380 mOsm/kg—the higher the osmolality, the higher the risk of mucosal irritation and tissue damage while also impacting sperm motility and DNA integrity (Potter, 2021). If you are trying to conceive and osmolality of 270-360 mOsm is optimal for sperm motility and optimal function (Potter, 2021).
While osmolality of lubricants is often not advertised, some common brands that one study found to be significantly higher than the recommended limit include: KY Jelly (2,200 mOsm), Astroglide (4,500 mOsm), ID glide (2,900), and KY Warming Jelly (8,600 mOsm) (Ayehunie, 2018).
Lubricants with parabens, glycols, and preservatives (like chlorhexidine and polyquaternium-15) should also be avoided if possible as they can increase risk of infection and may contribute to cancer (Potter, 2021).
Some of our favorite lubricants within the recommended range include Aloe Cadabra (118 mOsm), Good Clean Love (194 mOsm), and Pre-Seed Fertility Lubricant (295 mOsm).
While lubricants can improve sexual function and pleasure, there may be other reasons for pain with intimacy including pelvic floor dysfunction. You can ask your provider for a referral to a pelvic therapist near you, or you can find one at www/mypfm.com/find-a-pt.
To learn more about your pelvic floor, check out these great resources:
Watch our YouTube playlist Pelvic Pain and Your Pelvic Floor
Watch Netflix for Your Pelvic Floor at Pelvic Flicks
Learn more about your pelvic floor on our Instagram
Visit our Amazon store for our favorite pelvic health products
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For providers, check out our online courses to help your clients. Consider joining our Ambassador Program and most of our courses are included with your membership!
Sexual Interviewing with Dr. Uchenna Ossai, PT
Female Sexual Function, Dysfunction, and Pain with Dr. Heather Jeffcoat, PT, DPT
An Overview of Female Sexual Function and Dysfunction with Dr. Heather Jeffcoat, PT, DPT
Written by Emily Reul, PT, DPT
References
Ayehunie S, Wang Y, Landry T, Bogojevic S, Cone RA. Hyperosmolal vaginal lubricants markedly reduce epithelial barrier properties in a three-dimensional vaginal epitherloum model.Toxicol Rep. 2018;15(5):134-140.
Kennedy CE, Yeh PT, Li J, Gonsalves L, Narasimhan M. Lubricants for the promotion of sexual health and well-being: a systematic review. Sex Reprod Health Matters. 2021;29(3):2044198.
Potter N, Panay N. Vaginal lubricants and moisturizers: a review into use, efficacy, and safety. Climacteric.2021;24(1):19-24.