Last month, I had the honor of speaking to a wonderful group of women with cancer at Gibbs Cancer Center in Spartanburg, South Carolina. During that talk, an interesting question came up: What is the difference between vaginal lubrication, moisturizer, and estrogen cream? When and why would each be used? This is an important question for women with cancer because different types of cancer or cancer treatments can cause vaginal dryness, skin irritation, and estrogen sensitivity. In this post I will give a brief explanation of each of these products and when or why women might use them.
**This is not a substitution for medical advice for women with cancer. Please consult your doctor with any questions.**
The first myth to dispel about the use of vaginal lubricants is that if a woman is truly “turned on” she will be naturally lubricated. The second myth to get out-of-the-way is that only “old” women need lubricants. There are all sorts of reasons a woman, of any age, may not produce or support natural lubrication. Cancer and cancer treatments can be one contributing factor in vaginal dryness.
Vaginal lubricants are one helpful non-prescription, non-hormone solution. Personal lubricants are used by spreading a small amount on the clitoris and inner labia before vaginal penetration or manual stimulation or around the anus prior to anal penetration. Studies have found that women and their partners find greater pleasure and orgasm frequency when using personal lubricants during penetrative sex. There are a variety of water and silicone-based lubricants, many available in your local drugstore or grocery next to the birth control or feminine hygiene products. Before you go out and grab the first bottle of slippery stuff you find though, there are a few things to consider when selecting a personal lubricant.
These are probably the most popular. Silicone-based lubricants stay slippery even after extended sexual activity and are absolutely the best option for anal intercourse. They are generally well tolerated and non-irritating. On the other hand, these products are not for use with silicone sex toys.
These are closer to a woman’s natural chemistry. They are perfectly safe with latex condoms and silicone toys. However, they can dry out or become sticky with prolonged friction.
There are several brands of lubricants made with natural ingredients. They will typically not contain glycerin (a chemical which may cause problems for women prone to yeast inflections) or parabens (a preservative). Oil-based products mimic the benefits of silicone-based lubricant but also carry some down sides including breaking down latex condoms. In addition, “natural” does not necessarily make a product safe. Some of these products contain aloe or coconut and other natural oils that could be irritating to some women.
There are a also hybrid (water + a small amount of silicone) products that offer the staying power of silicone, the pH balance of water, and are safe with latex condoms and silicone toys.
Flavors and Heat:
Flavored or warming lubricants can be irritating especially for already dry and sensitive skin.
Many women have never heard of or considered using vaginal moisturizers. However, the same way we use moisturizing cream on our faces or lotion on our hands and legs, that delicate genital tissue needs a little help to stay supple and elastic too. Hand lotions and face creams are irritating and should never be used in this area. Vaginal moisturizers are safe, non-hormone, over-the-counter products that can be use 2 to 5 times per week to prevent dryness, cracking, and irritation and to support proper pH balance. Studies have shown that such a routine can be helpful in treating vaginal atrophy and discomfort.
Vaginal moisturizers aid in vaginal lubrication but should not be used for sex. These products are inserted via suppository or with a tampon-like applicator. Bedtime is the most effective time to apply moisturizers.
Moisturizers are an important part of maintaining vaginal health for all women. For women with estrogen sensitive cancers, Replens vaginal moisturizer has been shown to relieve vaginal symptoms as well as prescription estrogen creams.
Vaginal estrogens are topical or systemic treatments only available with a prescription from your doctor. These are typically used to treat vaginal atrophy (including symptoms like dryness) in post-menopausal women. Certain types of cancer and cancer treatments cause these same symptoms for many women.
Estrogens are a complicated issue because they are not tolerated well by some cancer patients and survivors and can worsen or even cause some types of cancer. For this reason, vaginal estrogens are not right for every woman. Talk to your oncologist for more information. NEVER use estrogen products that were not prescribed to you.
A few common brands of lubricants are K-Y Jelly, Astroglide, and Sliquid (they also make a hybrid product called Silk). K-Y Liquibeads and Replens are common moisturizers. Vitamin E gel caps can also be punctured and used as moisturizers. No specific products are being endorsed by this author or AMACF.org
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American Cancer Society. (2013). Vaginal dryness. Retrieved from http://www.cancer.org/treatment/treatmentsandsideeffects/physicalsideeffects/sexualsideeffectsinwomen/sexualityforthewoman/sexuality-for-women-with-cancer-vaginal-dryness
Biglia, N., Peano, E., Sgandurra, P., Moggio, G., Panuccio, E., Migliardi, M., & … Sismondi, P. (2010). Low-dose vaginal estrogens or vaginal moisturizer in breast cancer survivors with urogenital atrophy: A preliminary study. Gynecological Endocrinology, 26(6), 404-412. doi:10.3109/09513591003632258
Carter, J., Goldfrank, D., & Schover, L. (2011). Simple strategies for vaginal health promotion in cancer survivors. The Journal Of Sexual Medicine, 8(2), 549-559. doi:10.1111/j.1743-6109.2010.01988.x
Del Pup, L. (2012). Management of vaginal dryness and dyspareunia in estrogen sensitive cancer patients. Gynecological Endocrinology: The Official Journal Of The International Society Of Gynecological Endocrinology, 28(9), 740-745. doi:10.3109/09513590.2011.652717
Herbenick, D., Reece, M., Hensel, D., Sanders, S., Jozkowski, K., & Fortenberry, J. (2011). Association of lubricant use with women’s sexual pleasure, sexual satisfaction, and genital symptoms: A prospective daily diary study. The Journal Of Sexual Medicine, 8(1), 202-212. doi:10.1111/j.1743-6109.2010.02067.x
Jozkowski, K. N., Herbenick, D., Schick, V., Reece, M., Sanders, S. A., & Fortenberry, J. (2013). Women’s perceptions about lubricant use and vaginal wetness during sexual activities. Journal Of Sexual Medicine, 10(2), 484-492. doi:10.1111/jsm.12022
The Velvet Box. (n.d.) Education. Retrieved from http://www.thevelvetbox.com/education