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weir: just like your elbows, vaginas need moisturizing too

menopause expert shirley weir explains the difference between moisturizers and lubricants.

shirley weir is the founder of menopause chicks
dear shirley,
my husband sent me your recent article on vaginal dryness. our question is, now that i am using a vaginal moisturizer, is it okay to still use a lubricant? what is the difference and how do i navigate my way down that aisle in the drug store?
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 and couples are wondering too.

what’s the difference between moisturizer and lubricant?

yes, it is okay — recommended, in fact — to use a lubricant while using a vaginal moisturizer. apply the moisturizer as part of your daily routine to restore natural moisture to the cells of the vagina wall. and use lubricants adjacent to sexual activity.
that is the key difference — moisturizers are an investment in lifelong vaginal health, 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. it is also under-treated. too many women are told to use coconut oil or other lubrication — which is great for sexual activity, but doesn’t address the root causes of vaginal dryness: estrogen loss in post menopause, or hormone fluctuation in perimenopause, postpartum, from taking the birth control pill, cancer treatments or other medications or health conditions.

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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. it also helps promote urinary health and prevent infection and incontinence.

how to shop for a vaginal moisturizer

as i wrote about in a previous column on vaginal dryness, one way of restoring natural moisture to the vagina is localized estrogen therapy. this is a physician-prescribed form of hormone therapy — often in the form of a cream, suppository or ring — applied directly to the vagina to deliver estrogen back to the body.

another effective way of preventing or reversing vaginal dryness is by moisturizing with hyaluronic acid. there are many over-the-counter options, but many contain primarily water, wax, glycerin, additives and preservatives. and we know that water is drying, glycerin is derived from sugar — which can cause yeast — and discharge from wax has sent some women straight to their doctors believing something terrible to happening to them. so before you buy something that claims to moisturize your vagina, read the ingredients carefully. like lubricants, you are looking for a short list, with natural ingredients. warning: this is hard to find at your neighbourhood drugstore. this is why menopause chicks co-developed a hyaluronic acid vaginal moisturizer that only contains hyaluronic acid and vitamin e which thousands of women are now reporting to be effective.

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how to shop for a lubricant 

i love that you asked about how to discern the best products amidst a sea of great marketing and package design. i have learned that established brands, and prominent positioning in the drug store aisle does not always equal great ingredients.
generally, i advise women — with any purchase — to always 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. osmolality measures the concentration of dissolved particles per unit of water — basically, how hard your vagina has to work to maintain equilibrium with the lubricant. unfortunately, ph and osmolality levels are not included in 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, which 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 those 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. good clean love has a ph rating of 4.4 to 4.9 and an osmolality rating of 250-400 mosmol/kg , well within the who’s recommendations.

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the bottom line is that it’s critical to 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. and be wary of ingredients such as propylene glycol and glycerol as they drive high osmolality.

the best thing to do if you are unsure, is to ask your pharmacist for a recommendation, or visit the manufacturer’s website for more information.  

do you have a question about perimenopause, menopause or beyond?  post it in our private online community  or write to me shirley@menopausechicks.com

shirley weir is the founder of menopause chicks, an online facebook community that advocates for women in perimenopause, menopause & beyond! she is also the author of mokita: how to navigate perimenopause with confidence & ease@menopausechicks
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