As a women’s health specialist at Mayo Clinic, I’m baffled when I ask, “What lubricant do you use?” and the woman replies, “I don’t know, my husband buys it.”
If you’re using something on your body — and particularly in your vagina — you should be comfortable with the product and know its ingredients.
But choosing the right product can be complicated and confusing. Walk down the feminine products aisle of your local pharmacy or open the sexual health tab while online shopping and you’ll find a dizzying array of products with varying marketing claims. What’s the difference between a vaginal lubricant and a moisturizer? Do I need both? Are certain types or brands better than others?
Both lubricants and moisturizers can help women dealing with vaginal dryness, which can make sex painful. But they’re used in different ways and serve different purposes.
Causes of vaginal dryness
Menopause is a major culprit behind vaginal dryness for many women. With a change or loss of estrogen, surface (mucosal) cells change, often described as “thinning,” but this can be a reduced number of cells, loss of cell lubrication and decreased vaginal elasticity.
Other risk factors for vaginal dryness include:
- Breastfeeding. While you’re breastfeeding, you may need to use lubricants because of the hormonal changes affecting your vaginal lining.
- Smoking. If you’re looking for a reason to quit, this just might be it!
- History of sexual activity. If it’s been a while since you’ve had sex, your tissue will need time to respond and become more elastic. While it’s not quite “use it or lose it,” it’s important to listen to your body and be patient as the tissue responds to being stretched.
- History of cancer therapy. Especially if you’ve had chemotherapy or radiation, your vaginal tissue may have been affected. See the Women’s HealthSource post on “Sexual function after cancer.”
If you’re experiencing vaginal dryness for any of these reasons, a lubricant or moisturizer (or both!) may help.
Lubricants vs. moisturizers
Lubricants reduce friction. Friction is the resistance that one surface or object encounters when moving over another. Lubricants assist with high-friction sexual activity and can lessen pain or discomfort. A main reason to use these products is to make sex more comfortable, but they can also assist with arousal and pleasure. Lubricants are used when you need them — at the time of a sexual encounter.
Vaginal moisturizers are used regularly over time, not specifically in the moment of a sexual encounter. Over-the-counter moisturizers can be inserted into the vagina to add a protective barrier, coating the vulnerable lining. Improved moisture lessens discomfort, similar to using moisturizers on your face or legs.
With these products being so different, it’s important to read labels and know which one you are picking up. Moisturizer or lubricant should be clearly written on the package.
It’s unlikely that either of these products change the underlying cause of your symptoms, particularly the cellular changes in the vaginal tissue. Estrogen therapy and other Food and Drug Administration-approved medications can get at the root cause of the problem much more effectively. However, moisturizers and lubricants can still be very helpful and are worth trying.
Choosing and using: Lubricants
Lubricants can be water based, silicone based or oil based. I suggest glycerine-free and paraben-free options, while avoiding ones that are sticky. Some brands are Astroglide, K-Y jelly and Sliquid, and there are many others.
Many of the lubricants with additives that try to “stimulate or arouse,” can cause burning discomfort, so I would encourage you to avoid those products, especially if you are already dealing with vaginal discomfort.
Sometimes if male partners have erectile dysfunction, silicone lubricants can be too slick. The lack of friction can make it more difficult for these men to maintain an erection. But it is important for women to pick a lubricant that is “right” for them.
After purchasing a lubricant, use it on an as-needed basis. Apply it just prior to or during intimacy — especially any activity that causes friction. Lubricants can be applied to the outside (vulva) and into the vagina. How much to apply depends on what feels good to you and the product you’ve chosen.
Choosing and using: Moisturizers
There are many varieties of vaginal moisturizers available. Brand names are K-Y Liquibeads, Replens, Sliquid and others. Avoid common allergens that you are sensitive to (fragrances, parabens, benzyl alcohol, propylene glycol and lanolin to name a few). Those with hyaluronic acid are popular but can be expensive.
The key to moisturizer is how you use it. It can’t help if it is left in the tube unused. The product can be massaged into the vaginal walls with a clean finger, much like you would apply a moisturizer to your face.
Moisturizers require frequent — 3 to 7 times a week — and consistent use. Also, you must use moisturizers multiple times a week for many weeks to see results. If you stop, the symptoms of dryness or discomfort will likely return.
If pain persists
Bottom line: Sex should not be painful. If it is, many products and options exist to help with this. Navigating what’s available can be challenging, so consider talking to a knowledgeable provider who will listen. This could be your primary care provider, gynecologist, sex therapist or a women’s health specialist.
Jackie Thielen, M.D.
Dr. Thielen is a Women’s Health Internist in Jacksonville, Florida, and the medical director of the Women’s Health Specialty Clinic. Follow her on Twitter @JacquelineThie5.