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What Lube Should I Use?

Written by Dr. Brenda Heinecke, PT, DPT, CSCS

Have you ever walked down the Target aisle and wondered “what lube should I use”? Or started reading the ingredient labels of different lubes and found yourself overwhelmed with what to look for?

Yea, us too! With so many different types of lubricants and brands of lubricants on the market, it can be really overwhelming to know what lube you should use. In fact, there are several different things to consider when asking yourself, “what lube should I use”. Let’s talk more about each thing so you can feel confident in your decision.

Oh and if you are wondering if you even need to use a lubricant in the first place, let’s clear that up quickly! If you are experiencing any drynness issues that are leading to discomfort or irritation, then you should use a lubricant.

If you are having pain deeper inside or with penetration, it is likely that you have pelvic floor issues causing that. Using a lubricant can help temporarily alleviate some discomfort but ultimately it is best to get to the root cause and see a pelvic floor therapist. Even the best lubricant isn’t the solution for those issues and pushing through pain is oftentimes not helpful.

Why the ingredients matter

The vagina is a really fascinating place, and with a little attention, we can keep our vagina healthy and happy. The vagina actually has its own microbiome, made up of many different bacteria.

Dr. Frank Lipman writes: “The vagina, in particular, is home to a rich ecosystem of bacteria that, when balanced and healthy, helps to prevent infections — from routine yeast infections and bacterial vaginosis to HIV. A healthy vaginal microbiome also helps keep more minor irritations, like itching and pungent odor, at bay.”

A balanced vaginal ecosystem allows for the right types of bacteria to grow and also keeps the vaginal pH low. pH is a measure of how acidic or basic (aka alkaline) something is. The ideal range of pH in the vagina is 3.5 to 4.5. In this environment, good bacteria can thrive and bad bacteria can’t, allowing the vagina to defend itself against infection.

Oftentimes products contain harmful chemicals that can cause irritation of the tissue and increase risk for infection. They are also not typically balanced for the pH so it will make the environment more alkaline and ultimately more prone to infection.

Other ingredients can also impact the natural moisture within the vagina, leading to worsening drynness. So if you’re wondering “what lube should I use?”, it’s important that the one you choose doesn’t interfere with the natural microbiome and pH of the vagina. This will help prevent infections and irritation, keeping the vagina working as it should.

What’s in your lube?

When choosing a lubricant, there are a few ingredients to watch out for and avoid whenever possible.

  • Petroleum: increases risk of vaginal infections and can break down condoms. 

  • Parabens (methylparaben or propylparaben): preservative chemicals that can irritate the mucous membrane and can cause rashes. Some parabens have been linked to fertility issues and hormone disruption.

  • Chlorhexidine gluconate: disinfectant chemical that kills off lactobacillus (an important vaginal bacteria)

  • Cyclomethicone, cyclopentasiloxane, and cyclotetrasiloxane: commonly found in silicone lubricants that have been linked to reproductive harm and uterine cancer. 

It is also important to consider the osmolarity and pH of a lubricant. Osmolality is important because if the number of particles in the substance is higher than the particle number in the vaginal canal, this can lead to dryness and breakdown of the vaginal tissue.

As mentioned earlier, lubricants with too high of pH alter the vagina’s natural pH, leading to an increased risk for vaginal infections such as bacterial vaginosis. With most lubricants, you can find research studies that have been conducted for each of these properties. This can help you to know how the lubricant stands up in the areas of osmolarity and pH.

What lube should I use?

There are three major categories of lubricants: water-based, silicone-based, and oil-based. We’ve got the low-down here on each of these for you so you can decide based on your specific needs and how you use lubricant.

Water-Based:

PROS:

  • Safe to use with condoms and devices

  • More natural ingredients

  • Long shelf life

  • Minimal vaginal irritation

CONS:

  • If using a glycerin-based water lubricant there can be higher risk for yeast infections

PRODUCT RECOMMENDATIONS:

Silicone-Based:

PROS:

  • Safe with latex condoms

  • Lasts longer

  • Holds up against water

  • Hypoallergenic

CONS:

  • Don’t use with silicone devices/toys

  • Stay away from “warming” lubricants as they dry out quickly

PRODUCT RECOMMENDATIONS:

Oil-Based:

PROS:

  • Natural options such as coconut oil and olive oil, however, coconut oil can increase risk for infection with antimicrobial properties

CONS:

  • Destroys latex condoms

  • Stains fabrics

  • Can alter vaginal pH and good bacteria levels

  • Do not use synthetic oils (mineral oil, vaseline) internally

PRODUCT RECOMMENDATIONS:

What are the next steps?

If you are having discomfort during sex or drynness, the first step would be to use one of the above recommended lubricants. Finding one based on your circumstances is crucial (ie: if a water-based lubricant is soaking in, try a silicone lubricant). If you are still having issues, I would highly encourage you to seek help from a professional because pain and discomfort is not normal. There are several different causes for pain with sex (Read about them here) and a pelvic floor therapist can help resolve them and help you actually enjoy sex again!

If you are local to the Milwaukee area and looking for a pelvic floor therapist near Milwaukee, feel free to apply for an initial appointment with us here at Revitalize Physical Therapy. Apply here.