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could your lube be hurting you

Have You Been Wondering Could Your Lube be Hurting You?

From alleviating vaginal dryness to improving anal play, choosing the right lube is important

Personal lubricant (lube) is something most people will use at least once during their sexual lifetimes, if not every time they are sexually active.

What are lubricants?

Lubricants are fluid or gel substances designed to offset genital dryness or inadequate natural lubrication which can be associated with discomfort or pain with sex or general activity. Lubes can be used for sexual activity, or just to alleviate dryness throughout the day.

Vaginal dryness is a common symptom during aging and menopause, breastfeeding, medical conditions including diabetes, and also a side effect of cancer treatment and some medications. Applying a thin layer of lubricant can help with dryness and irritation during the day.

For sexual activity, lubricants are a fantastic tool (if you find the right one)!

Lube can:

  • Be used for penetrative and non-penetrative sex, masturbation, and sex toy play
  • Improve lubrication, pleasure, and moisture
  • Decrease friction and discomfort
  • Decrease failure of sexual barriers (IF COMPATIBLE, more on that later)
  • Takes some pressure off the body to “perform” and create enough moisture
  • Makes sexual activities possible for many folks

Common types of lubricants: oil, water-based, and silicone

Water-based lube are ideal for people with sensitive skin or vaginal irritation and are safe to use with condoms and sex toys. However make sure your lube has proper osmolality and pH level (read below). Water-based lubes tend to get "sticky" and you may need to re-apply if you are engaging in sex for a long time.

Silicone-based lube is very slippery and long lasting and is safe to use with condoms. However, silicone-based lubes cannot be used with silicone sex toys, as they can damage the toy. Silicone-based lubes may be more difficult to wash off skin than water-based and may stain sheets, so keep that in mind.

Oil-based lube (we like to recommend organic coconut oil) is slippery and lasts longer than water-based lube. However, oil based lubes are not compatible with latex condoms, as they make the condoms easier to break. Like silicone-based lube, oil-based can stain sheets and be harder to wash off than water-based lube.

Problems with Lubricants

In 2012 the World Health Organization released an Advisory Note that underscored the importance of appropriate pH as well as osmolality of personal lubricant, it’s also important to be on the lookout for toxic chemicals in your lube as well.

The pH of a lubricant should match the area you’re using it with.

Vaginal: The pH of a lubricant to be used vaginally should be pH 3.8- 4.5. Lubricants with pH above 4.5 will increase risk of bacterial vaginosis. Unfortunately, many commercially available lubricants have pH levels far exceeding 4.5.

Anal: Lubricants to be used anally should have a pH level of 5.5 – pH 7.

High osmolality can damage tissue and increase risk of infection and disease transmission.

Many lubes on the market have a high osmolality, which is a high ability to draw moisture out of tissues and cells. Lubricant with a higher osmolality than normal vaginal secretions can damage vaginal tissue and breakdown mucous membranes which lead to irritation, reduced protection against infection, and increased transmission risk of sexually transmitted infections including HIV.

The World Health Organization (WHO) recommends osmolalities of less than 380 mOsm/kg, or at most 1200 mOsm/kg

Check out this chart by the World Health Organization, listing both the pH and the osmolality of popular lubricants on the market.

Stay away from toxic chemicals in your lubricants.

Chemical ingredients found in lubricants can be toxic to vaginal tissue and harm the microbiome.

Chlorhexidine gluconate – A disinfectant chemical that can kill strains of lactobacillus, which is a bacteria that is necessary for a healthy vagina.

Parabens (look for methylparaben and/or propylparaben) — Preservative chemicals that can irritate vaginal mucous membranes, contribute to genital rashes, and potentially cause fertility problems and endocrine disruption.[15][16]

Cyclomethicone, cyclopentasiloxane and cyclotetrasiloxane — Commonly found in silicone-based lubricants, these substances are linked to reproductive harm and uterine cancer in animal studies. Almost no research has ever been conducted to examine the long term impacts of vaginal exposure to these chemicals in women.[17]

Undisclosed flavors or fragrance — Be weary of ingredient lists that generically list “flavor”, “fragrance” or “aroma.” Flavors, fragrances, and aromas can include a mix of chemicals which can cause irritation and allergy. [18]

Lube and Fertility

There are some lubes on the market with pH levels that do not affect sperm motility (Pre-Seed and Yes Baby). Lubes with low pH and high osmolality decrease sperm motility. The best conditions for sperm survival is pH 7.2-8.5 and osmolality 270-360 mOsm/kg.

Takeaways: Picking the right lube for you

  • Make sure your lube matches what you want to use it for (vaginal vs anal, penetrative vs superficial skin contact, oral, etc.)
  • For Vaginal intercourse, pick a lube that is pH 3.8- 4.5 and osmolality under 380 mOsm/kg, or at most 1200 mOsm/kg
  • For Anal intercourse, pick a lube that is pH 5.5 –7 and osmolality under 380 mOsm/kg, or at most 1200 mOsm/kg
  • Check out this chart published by the World Health Organization (WHO) listing brand names of lubricants and the pH levels and osmolalities of each product.
  • Look at the ingredients list and avoid chemicals listed in this article.
  • Avoid unneeded smells, flavors, heating, or cooling chemicals.
  • Notice if you feel any stinging, burning, or irritation after using a lubricant and discontinue use if you notice any reactions

References

World Health Organization. Use and procurement of additional lubricants for male and female condoms: WHO/UNFPA/FHI (2012) https://apps.who.int/iris/bitstream/10665/76580/1/WHO_RHR_12.33_eng.pdf

World Health Organization (2012) Use and procurement of additional lubricants for male and female condoms: WHO/UNFPA/FHI360 Advisory note. Department of Reproductive Health and Research. 2012. Available at: https://apps.who.int/iris/bitstream/10665/76580/1/WHO_RHR_12.33_eng.pdf

Dezzutti CS, Brown ER, Moncla B, Russo J, Cost M, Wang L, Uranker K, Kunjara Na Ayudhya RP, Pryke K, Pickett J, Leblanc MA and Rohan LC. (2012) Is wetter better? An evaluation of over-the-counter personal lubricants for safety and anti-HIV-1 activity. PLoS One.7(11):e48328. 2012. Available at: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0048328

Fontaine, M. (2016). Slippery When Wet: Is Your Lubricant Causing Pelvic Pain, Infections, or Fertility Problems? Available at: https://pelvicpainrehab.com/female-pelvic-pain/3836/slippery-wet-lubricant-causing-pelvic-pain-infections-fertility-problems/

Smith, KW, Souter, I, Ehrlich,S, Williams, PL, Calafat, AM and Hauser, R. (2013) Urinary paraben concentrations and ovarian aging among women from a fertility center. Environmental Health Perspectives. Vol. 121, Issue 11-12, pp. 1299-1305. December 2013.

Women’s Voices for the Earth (2015). Slippery Slope: Potential Hazards of Lubricants for Women. Available at: https://www.womensvoices.org/lubricants-womens-health/

Women’s Voices for the Earth (2015) Fragrance Chemicals of Concern Present on the IFRA List 2015. Available at: https://www.womensvoices.org/fragrance-ingredients/fragrance-chemicals-of-concern-on-ifra-list/

What Our Patients Have to Say

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Testimonial by J.B.

My husband and I were having problems with painful intercourse. My therapist recommended that I go and get a pelvic floor evaluation from a physical therapist. Having never been treated by a physical therapist, I wondered how this really was going to help me. My husband who is a physician was very supportive and agreed that a PT evaluation would be a great idea. So i made the appointment and was blown away by what I learned. I had no idea that pelvic floor muscles could get tight and have trigger points just like any other muscle in the body. I'm a massage therapist and very familiar with tight muscles, and this new thought really amazed me. Heather's program to help relax and strengthen these muscles made such a difference. I can say that I am 100% pain free during intercourse now. Yippee! Going to the PT appointments and doing the at-home exercises was definitely a discipline, but it's 100% worth it! The rewards are amazing.

-- J.B.

Testimonial by P.M.

I was hopeful but frankly skeptical when the doctor treating me for Interstitial Cystitis recommended that I go to Heather for physical therapy. Medication and diet helped control my IC symptoms, but I had never heard of physical therapy being used to treat IC. The education and treatment I received from Heather was a revelation. She explained that the pain I experienced with IC had helped create a cycle of muscle guarding which affected the entire pelvic area. I had no idea of the amount of tension being held there. No wonder my husband and I had not been able to have sexual intercourse for years!

Read more: Testimonial by P.M.

Testimonial by J.H.

My last appointment with Heather was over 6 years ago but I still think of her every day. I don’t take for granted that I can easily get out of bed, care for my two active and busy young boys, run, play tennis, clean my house, or sit at a desk for several hours at a time. None of these tasks were easy for me before meeting Heather. Eight years ago my car was struck from behind by a tractor trailer that was estimated to have been speeding. I spent 3 years working with different PTs and Drs trying to heal and move on with my life. When I became pregnant and the hormone relaxin that “relaxes” all the joints of the body and the additional weight gain erased all my progress and I was suddenly in a lot of pain again. My OB sent me to Heather for one last try.

Read more: Testimonial by J.H.

Testimonial by Jackie W.

I was in multiple car accidents a decade ago, and I have been to many physical therapists through the years without success. They found the root of my lower back pain problems and after nearly a decade of barely being able to walk I finally can again without pain. They are also the best pelvic floor pts and the only ones who found the connection between my pelvic floor and lower back problems. If you need help with physical pain, they are your answer.

-- Jackie W., 1/19/17 via Yelp!

Testimonial by J.B.

My husband and I were having problems with painful intercourse. My therapist recommended that I go and get a pelvic floor evaluation from a physical therapist. Having never been treated by a physical therapist, I wondered how this really was going to help me. My husband who is a physician was very supportive and agreed that a PT evaluation would be a great idea. So i made the appointment and was blown away by what I learned. I had no idea that pelvic floor muscles could get tight and have trigger points just like any other muscle in the body. I'm a massage therapist and very familiar with tight muscles, and this new thought really amazed me. Heather's program to help relax and strengthen these muscles made such a difference. I can say that I am 100% pain free during intercourse now. Yippee! Going to the PT appointments and doing the at-home exercises was definitely a discipline, but it's 100% worth it! The rewards are amazing.

-- J.B.

Testimonial by Jamie M.

I have been going to see Heather for a while now, and I can't tell you enough how much she has improved my quality of life. Heather specializes in issues like pelvic floor, but I see her for other orthopedic issues.

I have a lot of chronic joint pain and dysfunction issues (back, hips, neck) that require that have ongoing physical therapy maintenance. The effects of my problem joints/areas overlap and interconnect with each other in complex ways, so helping me requires really having a complete understanding of the entire skeletal and muscular system. Pain does not always appear where the problem actually is, the human body is a twisty, many-layered puzzle. I have an exercise program I do at home and I am very functional, but there are just something things I need a PT to help me out with.

Read more: Testimonial by Jamie M.

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