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Moisturizer vs. Lubricant:

What's the difference & is it okay to use both?

Angela writes:

My husband sent me your recent article on vaginal dryness. Our question is: now that I am using your vaginal moisturizer, is it okay to still use a lubricant? What is the difference between a moisturizer and a lubricant? And is it okay to use both?

Dear Angela:

I’m all about helping women get as informed as they possible can and then make the health choices that are best for them, so thank you for these great questions. I just know these are questions other women/couples are wondering too.

Moisturizer versus lubricant—what is the difference?

Yes, it is okay (recommended, in fact!) to use BOTH a lubricant AND a hyaluronic acid vaginal moisturizer.

  1. Apply the moisturizer as part of your daily routine to restore natural moisture to the cells of the vulva and vagina wall.

  2. And use lubricants adjacent to sexual activity.

That is the key difference—moisturizers are an investment in lifelong vaginal health (and recommended as the first line of treatment by both the International Society of Gynecologists and the North American Menopause Society), and lubricants are temporary catalysts that reduce friction, ease sexual activity (with or without a partner) and they promote fun and pleasure.

The reason I’m glad you asked this question is that it is important for women—especially those experiencing vaginal dryness—to understand the difference.

We already know that vaginal dryness is common, but also under-treated. Too many women are told to use coconut oil or other lubrication—which is okay for sexual activity (although coconut oil has never been researched and I find it very messy!) but lubricants do not address the root cause of the vaginal dryness: which is primarily from a decline in estrogen and hyaluronic acid in postmenopause, hormone fluctuation in perimenopause or post-partum, or from taking the birth control pill, overuse of pantyliners, cancer treatments or other medications or health conditions.

Moisturize (whether you are sexually active or not)—the same way you moisturize your hands and face. It is so important to a woman’s overall wellbeing, as vaginal health influences how we sit, move and exercise comfortably--for the rest of our lives. It also helps promote urinary health and prevent infection and incontinence.

I love that you asked about how to discern the best products amidst a sea of great marketing. I have learned that established brands, and prominent positioning in the drug store aisle does not always equal great ingredients.

Make sure you choose a lubricant that won't alter the pH of your vagina.

Generally, I advise women—with any purchase—to turn the package around and read the list of ingredients. However, when it comes to lubricants, this is not such an easy task.

That’s because—even though in 2012, the World Health Organization (WHO) issued an advisory highlighting concerns about pH levels and the osmolality of certain lubricants—pH and osmolality levels are not included on lubricant package design. It takes a well-informed consumer to know which product is less likely to disrupt the natural pH level of their vagina.

The WHO recommends a lubricant with a pH of, or close to, 4.5 and osmolality of less than 1200 mOsm/kg. These levels are the same as the vaginal tissue naturally.

This is important because if a lubricant has a higher osmolality than the cells of the body, the vaginal tissue releases its own moisture in an attempt to reach homeostasis with the lubricant. So instead of lubricating the vaginal tissue, it actually dries it out. This can put women at greater risk of infection, and present a challenge for women who are already dealing with dryness.

The biggest culprits are any “warming” lubricant, so avoid those. For example, KY Warming Jelly registers at 10,300 in osmolality, which is 30 times higher than the body’s normal level.

Read the ingredient list. Ideally the list will be short, include only natural ingredients and no harsh chemicals. Choose water-based, especially if using condoms, as oil-based lubricants are twice as likely to cause condoms to break.

Or ask your pharmacist for a recommendation, or visit the manufacturer’s website for more information.


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