All About Lube!
Let’s tackle another topic that doesn’t get talked about. Ladies and gentlemen, it’s time to talk about “lube.”
Personal lubricants, “lube,” can certainly be a useful tool to help improve comfort, increase pleasurability, and enhance the experience of sexual intercourse. As a pelvic floor physical therapist, helping people achieve pain free and healthy sexual experiences is just part of the job. Recommending use of lubricants is definitely part of the discussion for some of our patients. Commonly, women who are breastfeeding, experiencing menopause, or medically are experiencing vaginal dryness can have real benefits to the addition of lubricants to their sexual experiences.
Recently I attended a continuing education course that provided some GREAT information about lube. There truly is a lot to know about lube, and I learned some new things that are very important to the health of women’s vaginal tissue. So I’ll do my best to share that information and try to avoid geeking out on all the science stuff!
I think many people are aware that there are several different types of lubricant. There is water-based, oil-based, silicone-based, and even a silicone/water hybrid. There are important things to know about each of these, so here are a few points about each type of lube:
Water-based:
most affordable and widely distributed in stores
compatible with all types of toys, and safer sex barriers
tends to “dry out” easiest
tends to have preservatives that can be irritating to the tissues it is exposed to
Oil-based:
longer lasting lubricant compared to water-based
compatible with most sex toy materials
NOT compatible with some safer sex barriers including latex
takes longer to clear out of the body which may increase risk of infections or yeast overgrowth
Silicone-based:
doesn’t require any preservatives, so it may be less irritating to tissue it is exposed to
longest lasting lubricant, as it doesn’t “dry out”
compatible with all safer sex barriers
NOT compatible with silicone based toys
Hybrid (silicone/water based):
longer lasting than water based, but not as long as silicone based
compatible with all safer sex barriers, and sex toy materials
newer option and may be more difficult to find in stores, outside of sex toy stores or online options
Next, let me share a statement that really is “sciency” and we’ll break it down from there:
“The World Health Organization (WHO) recommends using a lubricant with a pH of 4.5 and an osmolality below 1200 mOsm/kg.”
pH
In regards to the pH of lube, we are talking about how acidic the lubricant is. Remember back to your chemistry days, that 7.0 is neutral on the pH scale, <7 is considered to be acidic, and >7 is alkaline (basic). Ideally when choosing a lube you want it to be as close to the environment where it will be used so that it doesn’t irritate the tissue. Typically, vaginal tissue is in the range of 3.5-5.5 pH in childbearing years and may increase to between 6-7 during menopause - so depending on your age and stage of life, your lubricant needs may change. Anal pH is 6-7, therefore the lubricant pH need may change depending on the tissue that will be involved with the sexual activity.
By introducing a lube that isn’t near the actual pH of the tissue, it can change the balance of normal bacteria in the area and create higher risk of bacterial infections, etc. Also, using a lube that is too acidic can cause burning/stinging of the tissue.
Osmolality
Just the word osmolality is too much science! This is the part that was pretty shocking to me in my continuing education course though. So hang in there…osmolality is talking about water crossing cell boundaries and moving into surrounding tissues. Basically, water wants to create equality between two items in contact with one another. In this case, if we are talking about vaginal/rectal tissue and the presence of lube, you want the osmolality of each of those to be very CLOSE to each other. Vaginal tissue is generally 260-290 mOsm/kg. Many common lubricants on the market are between 1,000-10,000 mOsm/kg. Wait, WHAT??!!! What does this mean?
If the lubricant you are using is hyper-osmotic (higher number) compared to vaginal/rectal tissue, it starts to draw water out of the tissue cells. That means it actually starts to destroy the outer layers of cells when they are exposed to the lube, which can lead to tissue damage and increased risk of infections (Sexually transmitted infections, bacterial vaginosis, urinary tract infections, etc.)
Finding a lube that is close to the tissue osmolality can be a challenge when many readily available products are WAY higher. The WHO researched many different lubricants and released information regarding their pH and osmolality levels. The original data can be found on page 7 at:
https://apps.who.int/iris/bitstream/handle/10665/76580/WHO_RHR_12.33_eng.pdf?sequence=1
There you have it, lots of science behind lube! Circling back to the purpose of lubrication, it is meant to improve the sexual experience. So, take some time to educate yourself about what you are using the lubrication for and learn about the right product for your needs so that it can be a safe and healthy addition to your sexual experience.
We love to be a resource to people for education and open discussion. I won’t necessarily know the pH and osmolality of each product, but I know how to guide you to places to get that information and make healthy decisions for your body!
Written by: Renee Hancock, Physical Therapists, Pelvic Floor Specialist
