Sexual Health

TRANSCRIPT

Hello, and welcome to MenopauseWize. I am Dr. Sukhpreet Patel, an MD ObGyn, a Menopausal Health advocate, a Post Menopausal woman, and the founder of MenopauseWize. And this session is all about how to read the fine print on personal or vaginal lubricants so that you can choose the one that's right for you!

And before we get started on lubes please spend a few minutes reading the disclaimer by pausing this video.

Now, starting at perimenopause, declining levels of estrogen create some unfavorable changes in the vagina leading to vaginal dryness. And a decrease in natural vaginal secretions increases friction during intercourse leading to painful sex. And so, it sounds logical that using a lubricant during intercourse should take care of this problem. But the question is which one?

There are 3 types of vaginal lubricants - Water soluble, silicon-based, and oil-based and this information is available on the package. If you don't know which category your current lubricant falls under, please pause this video and check the box. And if it isn't written on it - please throw it away. All good quality products should have this information.

Coming to the first type - water soluble - they are less expensive, easily available, easy to wash off and they are latex safe which means you can use them with condoms. But on the flip side, they run out easily so they need multiple applications during intercourse, and they have something called high osmolality which

In the normal vagina is between 300 and 400 mOsm/kg but in common water-based lubricants, it is over 2000!

And from basic 8th-grade physics, we know how osmosis works. So, when a woman uses a water-soluble lubricant, water is actually sucked out of the vaginal tissue making it even dryer over time and can cause vaginal irritation.

Why should you know this? Because some of the most popular brands have sky-high osmolality - and you have perhaps used them in the past. These include water-soluble products from brands such as KY, Astroglide, and Durex. Another thing to beware of is products that mention things like Glycerin and Paraben free - just because they are free of 2 things doesn't make them safe. They can still have very high osmolality.

There are very few water-soluble lubricants that don't have high Osmolality but most won't mention that on their package. So how can you figure out which ones NOT to use - water-soluble lubricants that have glycols, glycerine, flavors or warming properties in general have high osmolality and can aggravate dryness over time. And please beware of products that say Natural - some very popular brands advertise their so-called Natural products without writing the ingredients on them. A rule of thumb to follow is NO Ingredients = No to using that lubricant

Coming to Silicon-based lubricants - they have a lot of advantages including the fact that they last much longer, don't dry up so they don't require to be reapplied as often as water-soluble ones, and don't have the problems that we see with water-based ones. In addition, they are latex-safe - so great to use along with condoms. And a fun fact about silicon-based lubricants is that they are also called shower lubes since they don't dissolve in water - But remember, they can make the shower slippery!

The problem with silicon-based lubricants is that they are less easily available and more expensive - BUT a small amount goes a long way. Another problem with silicon-based lubricants is that they erode silicon-based sex toys - and so aren't compatible with them. Once again, while looking for silicon-based products check the box - certain brands like Durex and KY manufacture both water and silicon-based products - so please read your package well before adding the product to your cart.

Coming to oil-based lubricants - like silicon-based they have no problems with osmolality but unlike silicon-based products, they do not erode silicon. But they do erode latex - and should not be used if one is looking for protection against pregnancy or STIs. Also, oil-based products can get messy and stain your sheets. In addition to that, one study has found that a type of fungus, candida, tends to colonize the vagina in women using oil-based products and there are some concerns about infection if the oil continues to stick in the area between your legs but there is no rock-solid research that indicates that it is unsafe. While there are a few commercially available oil-based products depending on where you live, a lot of women prefer natural oils such as coconut and vitamin E oil as lubricants as well.

So what's the bottom line on vaginal lubricants? In my opinion, water-based lubricants are best avoided. That brings us down to choosing between silicon and oil-based - If you are someone who needs protection, Silicon-based lubricants are a great option since oil-based ones are NOT latex compatible. Remember ladies, that one can get pregnant in the perimenopausal phase. Besides, protection against Sexually transmitted infections or STIs is super-important even after menopause. And after you have checked all the boxes, it finally boils down to personal preference. Your body, your choice! That's it on Lubes!

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