You Think You’re Slick? Lubricants and Their Role in Sexual Wellness

How often do you talk about sex with your patients? If this question makes you stop and think, it may not be often enough. Sexual health is often an overlooked yet crucial component of the health exam. Sexual well-being includes the patient’s ability to have satisfying sexual encounters that are both enjoyable and safe¹. When performing a physical exam, we should be asking our patients about their sexual health. Does sex bring them pleasure? Is there any discomfort or pain associated with sex? Pain during intercourse may indicate the need for lubricants to help ensure enjoyability and safety during sex¹. The use of lubrication during sexual activity may increase sexual well-being and may help individuals who experience dyspareunia, vaginal dryness as a result of menopause, pharmacological side effects, or individuals engaging in anal intercourse². However, not all lubricants are the same…. they can be water-based, oil-based, or silicone-based. With the multiple lubricant options available to patients, how do we know which ones to recommend?

Water-based lubricants are the most frequently used as they are safe options to reach for when your patient needs help with a little dryness during sexual activity³. This may be a great fix for perimenopause dryness or vaginal dryness secondary to medications / medical treatments⁴. It is a great option when skin sensitivities are a factor or when utilizing sex toys or vibrators³.

Oil-based lubricants are the better option for non-penetrating activities such as sexual stroking or massage as these lubricants stay slick for a longer period of time3. Nevertheless, these should not be used inside the vagina as they can affect the pH level of the vagina³. This can serve as a good option for anal intercourse; however, patients must be mindful to avoid the use with condoms as oil-based lubricants can damage the integrity of the latex³.

Silicone-based lubricants are excellent options when your patient desires a lubricant that stays slippery for a longer period of time yet is safe to use during vaginal or anal intercourse³. Silicon-based lubricants will not affect the pH levels of the vagina or the urinary tract making these the best option for women who develop frequent urinary tract infections, yeast infections, or have sensitive skin³. While silicone-based lubricants are safe to use with condoms, they should not be used with sex toys, or any silicone-based product as they may damage the material of the sex toy³.

All individuals deserve sexual wellness. This involves providing the education and resources available to help them make well informed decisions to better achieve that wellness. Lubricants are a key component that may help in achieving a more fulfilling intimate well-being.

References:
1. Sexual health. World Health Organization. https://www.who.int/health-topics/sexual-health#tab=tab_3.
2. Kennedy CE, Yeh PT, Li J, Gonsalves L, Narasimhan M. Lubricants for the promotion of sexual health and well-being: A systematic review. Sexual and reproductive health matters. 2021. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8942543/.
3. Young K, McCabe L. Know how to use vaginal moisturizers and lubricants. https://www.uhn.ca/PatientsFamilies/Health_Information/Health_Topics/Documents/Know_How_to_Use_Vaginal_Moisturizers_Lubricants.pdf.