A patient message about water-based lube
By Sara Twogood, MD
Message sent by a patient :
“Can you please recommend a lubricant for sexual activity? I have heard that baby oil may cause infections. You and I discussed coconut oil but I think oils may be too messy. How about something water based like KY Jelly classic? But I also read that water based lubricants may cause infections more than silicone or oil based, and that water based lubricants actually require reapplication and can dry out tissues”.
Yes, patients send these types of messages! And yes, I answered with the right lubricant for her.
Let’s go through her message and see if everything she “heard” / “read” (translation: what the internet says) is correct!
“Can you please recommend a lubricant for sexual activity?”
I left out a few details related to her specific medical diagnoses in the quote above – which is why she was more concerned than others may be about lubricant use.
In general though, I absolutely recommend lubricant use for sexual activity … but there is not a one size fits all approach. Here’s our post about different types of lubricants if you want to get a broad overview.
“I have heard that baby oil may cause infections.”
Baby oil typically contains mineral oil plus perfume (which gives it that particular “baby oil” smell).
Mineral oil coats the cells with a barrier. Placed inside the vagina means it coats the vaginal cells. It’s also very difficult to wash off completely.
For most people mineral oil is a great choice and will not cause irritation or infection. However, for people who are prone to vaginal infections like BV, any lubricant can increase the chance of an infection. And one that does not wash off easily so lingers? Even more so.
However, the main issue I have with baby oil is the perfume. The chemicals in perfumes are a huge cause of vulvar and vaginal irritation and inflammation. Perfumes may disrupt the vaginal pH and microbiome, causing symptoms like abnormal discharge, dermatitis, and generalized inflammation, and infections like yeast and BV. We can’t say this enough – don’t put perfumed products inside the vagina!
Bottom line: if basic mineral oil works for you, great! But don’t use mineral oil with additives like perfumes.
“You and I discussed coconut oil but I think oils may be too messy.”
I like coconut oil as a vaginal moisturizer and sexual lubricant. For this patient in particular it was a good option – but yes, any of these oils can be messy and stain clothes.
“How about something water based like KY Jelly classic? But I also read that water based lubricants may cause infections more than silicone or oil based, and that water based lubricants actually require reapplication and can dry out tissues.”
Check the packaging to know what “type” of lubricant you’re buying – for this specific KY Jelly, it says right there: water-based. And water-based lubricants are great!
The pros: Water based lubricants tend to feel more natural and light weight. They wash off quickly and easily with water (so not the best option for shower or water-based sex!). Being able to wash off quickly after sex may help decrease irritation if the skin is very sensitive.
However, certain ingredients in water-based lubes (in all lubes, really) can increase the risk of infections:
Glycerin is a vaginal moisturizer and often a primary ingredient in lubes – using glycerin in the vagina has been shown to increase the risk of yeast infections, especially when someone is prone to them in the first place. There are many glycerin-free options, but you have to check the ingredient label!
Artificial flavors, “warming” agents, and colors can all disrupt the vaginal microbiome the same way perfumes can – so best to avoid these ingredients in water-based lubes as well.
Chlorhexidine is sometimes an ingredient in lubes too (such as the “surgilube” used in many medical offices for paps). Chlorhexidine is an antiseptic, meaning it helps kills bacteria. It can kill the good kind of bacteria in the vagina called lactobacillus. So steer clear of this on the ingredient label for sexual lubes too!
TLDR: For someone without a predisposition to vaginal infections and vulvar / vaginal irritation – most lubes are just fine! Experiment and see what feels best!
Additional tips for someone prone to vaginal infections like BV or yeast, or with particularly sensitive skin:
Read the entire ingredient label. The fewer ingredients the better in general, but it really needs to be individualized.
Pay attention to ALL ingredients for potential irritants – even something that seems like a filler or is at the bottom of the list may be the culprit.
Steer clear of products with “perfume”, “parfum”, or artificial coloring – all are unnecessary for sex.
“Unscented” can be a tricky descriptor: it might mean perfumes are added to make it not smell. Fragrance free means no fragrance – so look for this instead!