Lubricant use can be a difficult conversation to bring with a patient. There are so many different brands and types of lubricants on the market that it can be overwhelming. Since personal lubricants are available over-the-counter, many users may end up taking home a product that does more harm than good.

Lubricant varieties include water-based, oil-based, organic or natural, silicone, fertility, and specialty lubricants. Each is made with different ingredients and can be utilized in different situations for personal and medical use.  When looking at lubricants, it is important to be mindful of components that can be harmful to pelvic health. These include preservatives, glycerin, petrolatum, warming agents, and osmolality.

Preservatives are commonly added to food and other products to increase shelf life and can affect the microflora of the gastrointestinal, vaginal, and rectal areas (similar to how changes in pH can affect microflora). When this balance becomes disrupted infections can occur.

Bacterial vaginosis, a common type of vaginal infection, is caused when there are less good vaginal bacteria and more bad vaginal bacteria. Some lubricants, KY Jelly specifically, contain Chlorhexidine Gluconate. This ingredient kills Lactobacillus, a good bacterium in the vaginal tract (and GI tract). Another lubricant, Gynol II, had a negative effect on Lactobacillus activity.

Chlorhexidine is another ingredient that can lead to irritation. Lubricants that contain glycerin, petrolatum, or warming additives may contribute to vaginitis. Many physicians recommend that patients who have chronic Candida infections not use lubricants that contain these ingredients.

Osmolality is the concentration of molecules in a product. Hyperosmolar lubricants contain large amounts of glycerin and propylene glycol. This assists in keeping the lubricant wet and does not allow it to evaporate quickly. The more hyperosmolar the lubricant, the more the cells along the vaginal and rectal walls shrivel up and come off, weakening the body’s defenses in that area. Astroglide, Gynol II, and KY Jelly (water-based) are not good at protecting the cells in the vaginal and rectal areas. Good Clean Love (water-based) and PRE (silicone-based) are good at keeping the epithelium intact.

It is important to do your research to select the best lubricant for the individual and intended purpose. Keep in mind that some people may be allergic to certain ingredients (such as parabens) when discussing options. While lubricants that contain artificial flavors, colors, sugars, essential oils, additional additives, or glycerine can generate reactions in different people. H&W does not endorse any lubricant brands over another, although the following brands advertise with us: Good Clean Love and Desert Harvest.

• This is not an exhaustive list of lubricants.

Dezzutti CS, Brown ER, Moncla B, Russo J, Cost M, et al. (2012) Is Wetter Better? An Evaluation of Over-the-Counter Personal Lubricants for Safety and Anti-HIV-1 Activity. 2012; 7(11).