Do you know what to look for in a vaginal moisturiser or lube? Could some products do more harm than good? Find out what the science says.
Women’s intimate health is a big market – in fact by 2030 it’s expected to be worth a massive US$38bn. So it’s no wonder there are more and more products coming onto the market that claim to moisturise vaginal tissue or be great in bed. But, when you’re cruising your supermarket or social media feed looking to buy, how do you know which products are good and which could do you harm?
Surely, none would be harmful, you’d think – after all, if they’re on the market they must be safe? Well, the intimate health products fall through a regulatory gap – they aren’t regarded as medical products and they aren’t considered to be cosmetics and toiletries, so they aren’t closely regulated which means there’s a lot of room for poorly formulated products with potentially damaging ingredients to make their way into your shopping basket.
So, what should you look for and what should you avoid?
The first thing is the pH. Your vagina has a pH of around 4.2 (range 3.8-4.5) which is mildly acidic, but as menopause approaches the pH moves up a little toward the neutral level which may result in a rise in infections like thrush, urinary tract infections and bacterial vaginosis (BV).
Ideally, any products for use in the vagina should have a pH between 3.8-4.5. For anal sex the recommended pH is around 7.
Unfortunately, not all products state the pH on the packaging, and while some may say ‘pH Balanced’ – that’s not a guarantee that it’s between the recommended range.
In fact, a study by Edwards and Panay showed that very few of the popular products that they reviewed had the right range of pH. Two that did make it into the right range were certain Yes and Sylk products.
Take home message – if it doesn’t state the pH, put it back on the shelf or you could find yourself with an unwanted infection or irritation.
But pH isn’t the only thing that matters. Next is a thing called osmolality. Cast your mind back to chemistry and you may remember that it is the concentration of dissolved particles in a kilogram of fluid. So basically, how strong it is.
The World Health Organisation (WHO) recommends that anything that goes near a vulva or vagina should have an osmolality of less than 380 mOsm/kg. It does however recognise that that is hard to achieve so had set a maximum of 1200 mOsm/kg. You’d think that would be a wide enough berth but the Edwards and Panay study found again that very few products made it into that bandwidth – just 9 out of the 32 products they looked at were below 380 and 12 out of 32 were below 1200.
Why does that matter? If a product has too much of certain ingredients it can do damage to the skin and mucosa, causing irritation, burning and discomfort. So again, if the product doesn’t state its osmolality – give it a miss.
What about the ingredients?
The next important thing is what ingredients does it contain and could they be irritating?
Things to avoid according to the study are glycerine, propylene glycol, parfum (fragrance), sweeteners, warming agents, and parabens.
- These are often used as preservatives in skincare and intimate products and are said to have a mild estrogenic effect. They have been associated with breast cancer although there is no cause and effect show as yet. That said, probably best to avoid.
- Glycols – these often on appear on the ingredients list as glycerol/glycerine and propylene glycol. They are used as to help moisturise the area as they can bind water (humectant) or seal water in (emollient) which is great, but if there is too much they can also kill off the natural flora in the vagina, the lactobacillus in particular and in turn increase the risk of infections like BV. For that reason, WHO recommends that concentrations of glycerol shouldn’t exceed 9.9% and propylene glycol should not exceed 8.3%. In other words, it should be one of the last ingredients on the list, but even low concentrations have been associated with thrush infections if you’re prone to that. In addition, Edwards and Panay say mouse model studies showed that vaginal application of glycerol monolaurate, glycerine, propylene glycol and PEG-8 (another preservative) all significantly increased susceptibility to herpes simplex virus 2 (HSV-2).
- Alcohol – there are good and bad alcohols with it comes to skin care and alcohol denat falls into the undesirable category when it comes to vaginas in particular. It will ultimately things out and may damage delicate tissues as well.
Other ingredients to look out for include things like nonoxynol-9, a spermicide (ie it kills sperm) which has been shown to cause damage to the skin in the vagina and irritation. It can also damage the skin lining the rectum too. And, obviously if you’re trying to get pregnant, you don’t want to be using something that kills sperm.
What causes dryness and what can help?
It’s important to know what the cause of vaginal and labial dryness is – and there can be many – not just declining hormones and age. Post-pregnancy can see low levels of oestrogen which results in dryness and breastfeeding can also cause dryness. Stress and conditions like diabetes, inflammatory bowel disease, chronic heart failure and multiple sclerosis are other reasons. Certain medical treatments such as radiation and chemotherapy can be a cause, and medications like antidepressant and even antihistamines may also result in dryness and pain during or after sex.
Hormone replacement therapy (HRT) for women around the menopause can help and there is also local/topical vaginal oestrogen which can be used in conjunction with HRT but may be enough on it’s own for some women. The topical oestrogen can also be quite useful for women post pregnancy and while breastfeeding too.
If you’re thinking of raiding the kitchen cupboards for some relief, some doctors say coconut oil is their preferred option. Vaseline and heavy occlusive agents like beeswax are not a great idea for the vagina, they warn. Externally, fine, but internally – not so great. They tend to hang around too long and are occlusive.
Avoid soap or scented products in intimate regions and also – do not douche or clean your vagina in any way – it is a self-cleaning unit.
And one more thing to consider: if you’re using local vaginal oestrogen products like Vagifem or Ovestin, the Edwards and Panay study says it’s best to use moisturisers and lubes at different times of the day from the prescription products because “it is possible that estrogen absorption may be impeded if applied immediately after using a lubricant. It is also recommended to delay intercourse until at least 1 hour after the application of estrogen, in order to avoid any possibility of transmission to the partner.”