This has become a very important topic to me! I am all about tissue repair and talking about how to deal with pain, inflammation, burning, itching, throbbing, and swelling, of the internal and external genitalia. My first message is cool the tissues, and for best therapeutic results, ice it. 12-15 minutes with a frozen She*Pak is great relief, and decreases inflammation, the way any ice pack would.
When your vagina is “off kilter” She*Pak goes in with greatest ease using lubricant, but does your lubricant improve your condition or make it worse? Does it increase your symptoms or not? Does it frankly sting and send you further into pain and suffering? If you bought a She*Pak with PDI packets throw them out. I have since learned that it is not healthy lubricant, especially for inflamed vaginas.
You may not use lubricant right now, but at some point in your lifetime or a friend’s, you will. Anyone who owns a vagina should really read the following content on what are the types of lubricant out there, what ingredients in lube can harm you, and what are the qualities you look for in good lube.
I am excited to partner with Smitten Kitten (Minneapolis, MN) a place where people of all backgrounds can get education and products that supports them in their sexual activity, in a friendly and dignified way. Sarah Mueller is their resident expert on lubricant, and she’s great at researching medical journals and more, so their customers can make informed and educated choices.
The next several paragraphs Sarah wrote for us, for which I am grateful. I think this should be in every OB/Gyn professional’s office. At the end, I will tell you how to get 10% off your next healthy lubricant purchase!
Personal lubricants can make any sexual activity safer, sexier, or simply possible for anyone, at any age, in any body; however, not all personal lubricants are created equally, not even close! Some lubricants reduce friction, which is great, but also dehydrate the body’s natural mucus and sometimes even the mucous membrane. Other lubricants are hydrating and can promote skin regeneration and elasticity. There are also many widely available lubricants, especially water based products, that contain potentially irritating ingredients. So how can you tell if your lube is helping or hurting? First, let’s figure out what type of lubricant works best for you!
There four basic types of personal lubricants: water based, silicone based, hybrids, and oil based. (See chart) Each type of lube has particular strengths and weaknesses which make it better suited for specific activities, uses, personal preferences, and bodies. You can figure out what lubes are best for you by using the following list of pros and cons. You may even find that you like to use different types of lubes on different body parts, or for different activities.
- The most common, affordable, and widely available type of personal lubricant
- Feels most like the body’s natural lubrication
- Available in a wide variety of consistencies, from thick gels to thinner liquids
- Compatible with all sex toy materials and safer sex barrier methods
- Will dry out quickest of any type of lube, as it evaporates and/or soaks into the skin
- Generally has the longest ingredients list and always contains preservatives, making it the most potentially irritating type of lube, especially for those with sensitive skin, compromised mucous membrane integrity, or compromised immune systems.
- Regarded as hypoallergenic, as it typically doesn’t soak into the skin and doesn’t need preservatives
- Lasts the longest of any type of lubricant and isn’t water-soluble, making it great for play in the shower or bath
- From brand to brand most silicone lubricants have very similar consistencies, although there are a few options available for thicker or thinner consistencies
- Compatible with all safer sex barrier methods; in fact, it is the lube used on almost all pre-lubricated condoms
- Few options available in convenience or grocery stores, but silicone lube is gaining in popularity with a variety of options available at sex toy stores or online
- Not always compatible with solid silicone sex toys
Hybrid (Silicone & Water)
- Less likely to cause irritation than water based lubes, but not regarded as hypoallergenic
- Lasts longer than water based lubricants, but not as long as silicone based
- Many brands feel similar, but there is some variance in available consistencies
- Compatible with all sex toy materials and safer sex barrier methods
- Newer product with less information available and less general availability outside of sex toy stores or online
Only plant oil based products are recommended for use as personal lubricants; petroleum based oils (like Vaseline) can breed bacteria inside of the body and should never be used internally.
- Hydrates and improves the elasticity of sensitive, fragile, and thinning skin and mucous membranes over time
- Lasts longer than water based lubricants, but not as long as silicone based
- The only type of lubricant that is actually 100% organic
- Compatible with all non-toxic sex toy materials
- NOT compatible with safer sex barriers made from latex or polyisoprene
- Takes longer to clear out of the body than other types of lubricants, therefore is not recommended for people who experience chronic, recurring bacterial vaginosis, urinary tract infections, or yeast overgrowth
There are two major characteristics particular to water based lubes that are more accurate predictors of their safety than any one ingredient, which are pH and osmolality. First, we’ll take a closer look at pH, which is the measure of a solution’s acidity or basicity on a scale from 0-14. A pH of 0 would be the most acidic, a pH of 14 would be most basic, and a pH of 7 would be neutral. Different parts of the body have different pH values, and some of them change over time. Using a water based lubricant with a drastically different pH than the body part it’s being used on can lead to irritation. There is a lot of information available on vaginal pH and its fluctuations over the lifespan, as well as throughout the menstrual cycle, but some of that information is misleading, or even harmful, so here’s a little more information on vaginal pH to put things in the proper context:
Vaginal pH plays an important role in the immune function of the vulvovaginal microbiome, as it helps maintain the balance of healthy bacteria and yeast, and acts as a defense against pathogen transmission.
Vaginal pH naturally changes throughout the menstrual cycle and is closely tied with estrogen and progesterone levels. As the body changes with menopause, or other causes of decreased estrogen, the pH of the vagina rises from 3.5-5.5 to closer to 6-7. This is a completely natural occurrence which doesn’t necessarily reflect poor health; however, it does leave the genitals more susceptible to Bacterial Vaginosis (BV), urinary tract infections, yeast overgrowth, or pathogen transmission.
When combined with other effects of low estrogen this raise in pH can create an environment where very acidic lubricants cause burning or stinging.
Smitten Kitten has also created this chart, to show the range in pH values of various body parts, body fluids, and various water based lubricants.
As I mentioned, there are two major characteristics particular to water based lubes that are more accurate predictors of their safety than any one ingredient. The first one was pH. Now we’ll take a look at the second one, osmolality. Osmolality, and how it functions in the context of lubricants on the mucous membranes of the genitals and rectum, also require a little bit more knowledge of how those mucous membranes function, so we’ll start there!
The body has mucous membranes of different structures and functions all over! When talking about lube I tend to focus on the genitals, but even when narrowing that focus there’s a lot going on! The vulvovaginal microbiome hosts 4 different kinds of mucous membranes, the recutum and anus host 2, and the penis hosts 2-3 depending on if it’s circumcised or not. They all function a little differently, but the important thing to know right now, is that the mucous membranes of the vulva, vagina, recutum, and penile urethra are all non-keratinized; this means that the cell membranes on these mucous membranes, as well as the mucus that coats them, allow water to flow freely in and out of the cell, making them susceptible to changes based on other water based products that contact them, which brings me to the details of osmolality.
What is Osmolality?
Osmolality is the measure of dissolved particles per unit of water, shown as mOsm/kg (milliosmoles per kilogram). More simply put, osmolality is the concentration of a water-based lubricant. The osmolality of a lubricant is important because the epithelial layer, the outermost layer of skin on a mucous membrane, and the body’s natural mucus are constantly trying to maintain an steady state of water pressure inside and outside of the cell.
When a lubricant has an osmolality similar to that of the mucus and mucous membranes of the genitals, the osmotic pressure is equalized and the cells’ integrity is not compromised. This is called iso-osmotic, and would be ideal for a water based lubricant. Most fluids of the body and mucous membranes have osmolalities between 260-280 mOsm/kg, and finding a lubricant with an osmolality between 200 and 380 mOsm/kg would be in the range of an iso-osmotic product.
When a lubricant has an osmolality far lower that of the mucus and mucous membranes of the genitals, the imbalance in water pressure can flood the cell and cause it to rupture. This is called hypo-osmotic, and is unlikely, as there are very few hypo-osmotic lubricants on the market. The research available on hypo-osmotic lubricants is also very limited, and what exists is often contradictory when it comes to mucous membrane health. One well documented effect of hypo-osmotic lubricants is that they can easily damage sperm.
But more often than not, water-based lubes are hyper-osmotic, meaning they have a higher osmolality than that of the body’s mucus. Hyper-osmotic lubricants dehydrate the body’s mucus and mucous membranes, and if they have a drastically higher osmolality this dehydration is so complete that the cells die and slough off, leaving the body irritated and more susceptible to infection.
Smitten Kitten has also compiled information on various lubricant’s osmolalities to give you context, and help you make safer lubricant purchases! Check out this chart:
If this seems like a potential health risk… that’s because it is! In 2012, the World Health Organization issued this advisory note: “Most commercial personal lubricants have high osmolalities (2000-6000 mOsm/kg)… the normal osmolality of female vaginal secretions is 260-290 mOsm/kg and in human semen it is 250-380 mOsm/kg… Ideally, the osmolality of a personal lubricant should not exceed 380 mOsm/kg to minimize any risk of epithelial damage…. It is therefore recommended on an interim basis that procurement agencies should source lubricants with osmolalities of not greater than 1200 mOsm/kg.” So far only a few brands have changed their formulas to comply with this, and information on a product’s osmolality is difficult to find, but there are some simple steps to follow to find a more body friendly osmolality product:
- The fewer ingredients the better!
- Avoid lubricants with glycerin(e) or propylene glycol in the first 3-5 ingredients listed, as these directly correspond to higher osmolality levels based on their concentration in a product, which is generally reflected by the order of ingredients listed on lubricant packaging.
- Avoid flavored lubricants or warming or stimulating products that use any sugars, maltodextrin, or honey.
Other Ingredients to Watch Out For
Glycerin(e) – a sugar alcohol that has anecdotally been linked with yeast overgrowth and directly corresponds with increased osmolality. Any water based lubricant that has glycerine in its first three ingredients is more likely to be significantly hyper-osmotic, and can dry you out.
Propylene Glycol – a chemical derived from petroleum (aka “petrochemical”) which has been linked with BV and is a sensitizer, meaning the more you’re exposed to it the more likely you are to have allergic reactions to it. Any water based lubricant that has propylene glycol in its first three ingredients is more likely to be significantly hyper-osmotic, and can dry you out.
Nonoxynol 9 & Chlorhexidine Gluconate – both of these ingredients are surface acting agents (aka “surfactants”), which change the surface tension and permeability of cell membranes. Both are designed to kill microbes in an effort to make them sterile or antiseptic, but this also kills healthy bacteria and compromises epithelial cell integrity. These ingredients, as used in lubricants, can lead to a burning or stinging sensation, and leave the body more susceptible to STI and pathogen transmission for 24-27 hours.
Petroleum Oils – these oils are ideal breeding grounds for bacteria and take a long time to be cleared from inside of the body, so they’re never recommended for use as a personal lubricant.
Polyquaternium-15 – used as a preservative and skin adherent in a limited number of water based lubricants and spermicides. It can enhance viral activity and infectivity of HIV and potentially similar viruses, so it’s not advisable to use in situations where STI contraction or transmission is possible.
Benzocaine – a numbing ingredient that is a potential skin irritant. Numbing lubes can be used responsibly, but it’s important to remember to listen to the body’s pain responses. If penetration or friction is painful, numbing ingredients will not solve the problem, and the body will continue to react to pain or irritation even if the sensation has been dulled. Continuing painful activities, with or without numbing products, can actually lead to increased or chronic pain.
Sugars – some lubricants use sugars, like glucose, honey, or maltodextrin, for flavor. However, all of these ingredients can feed yeast, dry sticky or tacky, and throw off the natural balance of the vulvovaginal environment; therefore, they’re not recommended for internal use.
Other Types of Lubricants
Water-based lubes are by far the most complicated and have the highest potential for irritation of the four main types of lubricants. Other types of lube have less variety, less ingredients used, and are much easier to make generalizations about.
Silicone Based Lubes
Silicone based lubricants are generally regarded as hypo-allergenic, although some folks (estimated at around 1-2% of all people) may have an acquired allergy or experience urinary tract infection that coincides with their use of silicone based lubricants. Silicones also don’t penetrate the skin, so while they’re great for reducing friction and lasting forever, they’re not actually very moisturizing. Because they don’t soak into the skin or evaporate, and are not water soluble, some folks find they last too long and need to be washed off after use. Lastly, silicone based lubes are not always compatible with silicone sex toys as they can bond onto the surface of a toy and change the texture irreparably.
Hybrids are very much the happy medium between water based and silicone based lubes: they’re less potentially irritating and last longer than water based, but don’t last quite as long as silicone based, and are compatible with all toys and safer sex barrier materials. Hybrids also tend to have a creamy, silk texture that many folks really enjoy.
Oil Based Lubricants
If you chose an oil based lubricant make sure that it is a plant-based oil! Petroleum oils like mineral oil, baby oil, or Vaseline can promote bacterial growth and lead to bacterial vaginosis, urinary tract infections, or yeast overgrowth. Oil based lubricants have less irritation potential than water based or hybrid lubricants and are very easy to find (you can just use coconut oil from the grocery store!). It’s extremely important to remember that oil based lubricants will deteriorate and are NOT compatible with latex or polyisoprene safer sex barriers and condoms.
Some folks who experience recurrent bacterial vaginosis or urinary tract infections may find that plant oil based lubricants are not the best option, not because they would exacerbate these infections, but because oils are not naturally removed from the body as quickly as the other types of lubricants so they may cause bacteria or yeast to stay on the surfaces of the genital longer than usual. On the other hand, some folks find that naturally antimicrobial oils, like coconut oil, are helpful in decreasing the occurrence of BV.
Oil based lubricants are also great for folks with vaginas who experience chronic dryness, a decrease in skin thickness or elasticity, easily irritated vulvovaginal skin, or are going through/have gone through menopause, chemotherapy, radiation therapy, are taking anti-depressants, anti-anxiety medications, or estrogen blockers and/or aromatase inhibitors. Typically I would recommend using an oil based lube in these circumstances every day, once or twice a day, and then using a silicone based lube on top of that for friction inducing or penetrative play or therapies.
I wished I had learned this information a long time ago! When Sarah shared it with me, I went home and threw out all my standard lubricant. I now have healthy water-based and silicone lubricants (Good Clean Love – Almost Naked formula, Uberlube). In the winter, if I am dry and itchy, I use a little bit of organic coconut oil before getting dressed for the day.
If you expand the charts you can see some brand names of lubricants in healthy ranges that work for you, but know that Smitten Kitten only sells healthy lube in whatever type you decide to use. To get 10% off your next healthy lubricant,purchase (or any product on their website) go to smittenkittenonline.com and at checkout enter SHEPAK10 in the discount code section.
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