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What You Need to Know About Lubricants
By Dr. Dolores Fernandez, ND, Menopause Society Certified Practitioner
The Science Behind Lubricants. Did you Know They’re Not all Made the Same?!
Personal lubricants are often associated with enhancing pleasure, but their role in vaginal health extends far beyond intimacy. For many, lubricants are essential for reducing discomfort and supporting overall vaginal wellness. However, not all lubricants are created equal. There is science behind their formulation—factors like pH, osmolarity, and ingredients—play a crucial role in their effectiveness and safety. Understanding these elements can help you make informed choices that suit your exact needs.
What is Vaginal Dryness and Who Should be Using a Lubricant?
Much like the skin on every other part of your body, vaginal and vulvar tissues thrive when adequately hydrated. Vaginal dryness is a common concern that can arise at any age, but is especially prevalent during hormonal shifts like perimenopause, menopause, postpartum, or during breastfeeding1. A condition known as genitourinary syndrome of menopause (GSM) affects many menopausal individuals, leading to vaginal dryness, irritation, and discomfort due to decreased estrogen levels1.
While hormones often play a role, other contributing factors include medications (such as certain antidepressants and oral contraceptives), stress and lifestyle habits. Dryness isn’t just uncomfortable—it can lead to itching, irritation, and an increased risk of infections. Hydrated tissue is more resilient and better protected against microtears, which is a common concern I see in clinical practice. These tiny tears can cause surprisingly intense pain despite their small size.
Anyone experiencing vaginal dryness—whether occasionally or regularly—can benefit from a well-formulated personal lubricant. It provides temporary relief by reducing friction and enhancing comfort during intimacy and other activities, such as tampon insertion or pelvic floor physiotherapy exercises. However, not all lubricants are suitable for long-term vaginal health. Choosing the right one is key.
Some Things to Consider When Choosing Products
Lubricants come in three main types: water-based, oil-based and silicone-based. Each has unique properties that impact its function and safety. Silicone-based lubricants are often a great choice for long-lasting glide, while water-based options are closer to body-similar lubrication and can suit a wide range of needs and preferences. The right product can enhance comfort and enjoyment while supporting your pelvic health.
A good water-based lubricant complements the natural environment of the vagina by respecting its pH and osmolarity. This is particularly important because an imbalance in these factors can disrupt the vaginal microbiome, leading to discomfort or infections.
When choosing a lubricant, look for options that are free of parabens, glycerin, and irritating fragrances. Avoid products that contain warming agents or numbing ingredients, as these can mask discomfort and potentially exacerbate issues. Prioritize lubricants labelled as “pH-balanced” or “osmolarity-safe”. These terms suggest the product has been formulated to align with the natural environment of the vagina, reducing the risk of irritation or microbiome disruption.
pH
The pH scale measures how acidic or basic a substance is, ranging from 0 (very acidic) to 14 (very basic), with 7 being neutral. The vaginal environment typically maintains a slightly acidic pH of 3.8 to 4.5, which helps support a healthy microbiome and ward off harmful bacteria and yeast2. Products with a pH close to this range can help maintain balance, reducing the risk of irritation and infections.
Osmolarity
Osmolarity refers to the concentration of particles in a solution and its effect on water movement in tissues. For vaginal health, lubricants and moisturizers should match the natural osmolarity of the vaginal environment to avoid drawing moisture out of tissues or overhydrating them, both of which can lead to discomfort or tissue damage2. Using products with balanced osmolarity ensures optimal hydration and tissue integrity.
*Think of osmolarity as the Goldilocks of hydration: not too much, not too little, but just right.
Commonly Irritating Ingredients:
1. Glycerin: Can increase the risk of yeast infections because it may feed yeast
2. Parabens (e.g., methylparaben, propylparaben): May disrupt hormone function and irritate sensitive skin or mucous membranes
3. Propylene Glycol: Can be drying and may cause burning sensations or allergic reactions in sensitive individuals
4. Fragrances and Flavours: Can disrupt the vaginal environment and cause irritation or allergic reactions
5. Alcohol (e.g., isopropyl alcohol, ethanol): Is drying and can irritate sensitive tissues, leading to discomfort
6. Petroleum-Based Ingredients (e.g., petroleum jelly, mineral oil): Can trap bacteria, disrupt the vaginal environment, and are incompatible with latex condoms, increasing the risk of breakage
Beyond Lubricants: What Else can Help with Dryness?
While lubricants provide temporary relief, other options offer more lasting benefits for vaginal dryness:
Vulvar and vaginal moisturizers: These are designed for regular use to hydrate and restore moisture to vaginal tissues, unlike lubricants, which are used as needed. As a non-hormonal ingredient, hyaluronic acid has been studied for its ability to improve vaginal hydration and tissue elasticity, making it a valuable option for those as an alternative or alongside vaginal hormone therapy3.
Vaginal hormone therapy: Low-dose estrogen therapy (available as creams, tablets, or rings) can help restore natural lubrication and improve vaginal tissue integrity, particularly for individuals in the menopause transition.
Moisturizers and hormone therapy are typically used consistently, much like a facial moisturizer, to maintain your own lubrication, while lubricants are applied as needed for specific moments of friction or discomfort.
Removing Stigma: A Vital Step
For me, breaking the silence around pelvic health challenges is empowering and allows us to be in service to our community. We’re here to remind you that vaginal dryness, painful intercourse and related conditions are common—and treatable. And let’s be real—we all deserve to feel comfortable and confident in our skin!
Lubricants are more than a quick fix—they’re a meaningful tool in maintaining vaginal and vulvar health. By understanding the role of pH, osmolarity, and safe ingredients, you’re better equipped to make choices that nurture your body. Empower yourself with knowledge, embrace your needs, and continue the conversation about pelvic health with your community and healthcare professionals. Together, we can normalize these discussions and create a culture of comfort and care.
Sharing experiences and seeking education fosters community and reduces isolation. Remember, prioritizing your comfort and well-being is self-care and self-respect.
References:
- N . WOODS, BSN, PhD, J SHAVER, PhD, RN & J. BERG, PhD, RN. (2024). GenitourinarySyndrome of menopause: Prevalence and Predictors. 67 (1) p 27-42.
- N. Potter & N. Panay (2020): Vaginal lubricants and moisturizers: a review into use, efficacy, and safety, Climacteric, DOI: 10.1080/13697137.2020.1820478
- S Agrawal MD, Z LaPier MD, S Nagpal MD,A Oot MD, S Friedman MS, E Hade PhD, L Nachtigall MD, MSCP, B Brucker MD, C EscobarMD. (2024). A randomized, pilot trial comparing vaginal hyaluronic acid to vaginal estrogen for the treatment of genitourinary syndrome of menopause. Menopause. 31(9):p 750-755.
