A recent UK survey discovered that out of 2000 women over the age of 55 who reported vaginal dryness or dyspareunia (painful intercourse), 33% of them did not seek professional advice (1). Surveys also suggest that there is a general lack of awareness among women about the availability of treatment options associated with these symptoms (1). Other studies have shown that the use of water or silicone based lubricants is associated with heightened female sexual pleasure and satisfaction for penetrative sex as well as solo sex compared with no lubricant use (2).
Lubricants are used during sexual intercourse to provide rapid, short-term relief from vaginal dryness. The extra moisture helps reduce friction or irritation of the vagina and penis when natural lubrication may be decreased. They are particularly beneficial for women whose vaginal dryness is a concern only or mainly during sex. The body’s ability to naturally lubricate can be affected due to hormonal shifts that occur during menopause, menstruation, pregnancy, postpartum, and while breastfeeding. Cancer treatments such as radiation therapy to the pelvis can cause the vagina to become narrower, shorter, less elastic, and drier (1). Medications and contraception methods may also have the side effect of influencing vaginal secretion levels. Emotional factors such as anxiety, depression, stress, fatigue, fear of pain, and lack of sufficient foreplay also play a role in production of vaginal lubrication. When there is a lack of arousal, the body’s natural ability to lubricate the vaginal walls is compromised. These unique scenarios can result in pain and discomfort during sexual intercourse and has been estimated to affect around half of all women at some point in their lives (1). The major take home point here is that vaginal lubricants are not just reserved for older women during menopause. Both men and women of any age may benefit from using lubricants during sexual intercourse at various times in their life. Having a well lubricated vagina and penis can enhance sensations and arousal during foreplay and intercourse. It is not only pleasurable but offers the benefit of preventing microtearing or abrasions to the delicate vaginal/rectal tissue and penis.
The plethora of lubricants available can create confusion as to each of their benefits. The following is an explanation of the types of lubricant available on the market.
Water based lubricants – Yes, Trojan H20, Sliquid Organic, Astroglide, Sliquid Oceanics (pH balanced for menopause), Yes But (pH balanced for rectal pH)
These lubricants are considered safe and compatible with all types of sex toys, dilators and condoms. They have a tendency to dry out a little more quickly than other lubricants. They may be used for oral sex as some are flavoured and others have no taste at all (do a taste test first as some may taste bad). These lubricants are easily accessible, generally inexpensive, non-staining, and wash off easily.
Oil based lubricants – olive oil, coconut oil
These lubricants are compatible with silicone, metal and glass sex toys only. They are not compatible with any latex toys or condoms. Benefits of oil based lubricants include long lasting, thicker texture to stay in place better, and waterproof (have fun in the shower!) Alternatively, there has been some evidence to suggest coconut oil/olive oil may alter the natural pH balance of the vagina, and could lead to yeast infections.
Silicone based lubricants – Uberlube, Sliquid Silver, Jo
These lubricants are completely tasteless and odourless. They are long lasting and waterproof just like their oil based counterparts. They have the added benefit of being deemed safe with all condoms and toys (except silicone). Silicone based lubricants don’t tend to absorb well. They stay on the surface of the vaginal walls for reduced friction. Any residual lubricant on the external tissues may need some warm water and a gentle soap to remove.
It is important always read the label on the lubricant you are interested in buying. Some companies include ingredients that have the potential to irritate the vagina and alter its natural pH level by adding chemicals that act as preservatives or promote warming/cooling effects. Although not widely reported, over 25% of women and men report genital itching and burning following personal lubricant use. Women should try and choose a product that is optimally balanced in terms of both osmolality and pH, and is physiologically most similar to natural vaginal secretions (1).
It may be worthwhile skipping the lubricants that include the following ingredients:
-Glycols –glycol concentration is the primary factor that determines osmolality levels. Increasing concentrations of glycerin/glycerol/propylene glycol increases the lubricants osmolality level. Hyperosmotic lubricants (greater than the normal physiological range of the female reproductive tract) have been shown to increase mucosal irritation and tissue damage in a slug mucosal irritation test (1). This test is used as measure of mucus membrane tolerance. The degree of irritation can predict genital burning, heat and itching in humans. Furthermore, low concentrations of glycerine/glycerol have been shown as a food source for Candida albicans and can trigger a yeast infection for those who may be prone.
-Parabens – this is a hot topic but the concern here is that parabens mimic estrogen and has been found in the tissue of cancerous breast tissue. Parabens have the potential to be irritating to the skin and induce an allergic response as well as disrupt hormonally regulated systems within the body
For those who are trying to conceive, there is evidence to suggest that lubricant osmolality and pH levels may be worth considering when choosing a personal lubricant. Brands such as KY Jelly, Astroglide, and Replens have been shows to greatly impair sperm motility, in vitro(1). Some associations have been made to the presence of glycerine as a factor that damages the sperm membrane. Furthermore, increases in osmolality (greater than 600 mOsm/kg) have been found to reduce sperm motility. The optimum pH level for sperm migration and survival is 7.2-8.5. Pre-Seed is a brand of lubricant that was found to have no effect on sperm motility and health.
In conclusion, personal lubricants may be a wonderful option for helping increase pleasurable sensation and enhance your sexual experiences. It is always recommended to test out your skin’s sensitivity to a product by first applying a small amount to the inside of your elbow. If after a day, there is no reaction, this is a good sign that this lubricant may be a good one for you. Be sure to experiment with various lubricants if one is not suiting your needs as everyone’s body and sensitivity levels are very unique.
If you are experiencing concerns with painful intercourse due to vaginal dryness, a pelvic health physiotherapist can help you navigate through the various options available to you. Book an appointment with Leeanna Maher today!
By Leeanna Maher
Pelvic Health Physiotherapist
- Edwards, D., Panay, N. Treating vulvovaginal atrophy/genitourinary syndrome of menopause: how important is vaginal lubricant and moisturizer composition? Climacteric, 2016. Vol. 19, No.2, 151-161
- Herbenick D, et al. Association of lubricant use with women’s sexual pleasure, sexual satisfaction, and genital symptoms: a prospective daily diary study. J Sex med 2011; 8:202-212.