In honor of sexual health awareness month and this crazy heat wave where we could all use a little more hydration, let’s talk about keeping your vagina and vulva hydrated, happy, and healthy.
Sex is a serious quality of life issue. You should never experience painful sex. As pelvic floor physical therapists, we typically focus on the pelvic floor muscles.
Sensations of deep pain, inability to tolerate penetration with a partner, toy, finger ect., or pain with orgasm should be discussed and evaluated with your trusty gynecologist and pelvic floor physical therapist.
While overactive muscles, scar tissue, or prolapse may be part of the problem, the health of the vulvar and vaginal tissue is incredibly important.
So let’s talk about lube, moisturizers, and estrogen creams.
Who needs it: Lube makes sex better plain and simple. All vagina owners can benefit from a good lubricant during sexual activity.
The vagina has the ability to self lubricate but amount of lubrication can vary tremendously. In addition, the clitoris, anus, and penis do not have the ability to self lubricate so lube is your friend here.
What lube should I choose (source: shout out Pelvic Guru for this awesome article https://pelvicguru.com/how-to-choose-a-lubricant/#comments)
Water based lubricants
Compatible with toys and condoms
Easy to find, inexpensive
Absorbs into vaginal tissue and will require re-application
Thicker and can be sticky
Lubricants labeled iso osmolar have a hydrating effect so look for this on labels
Silicone based lubricants
Not compatible with toys or condoms
Thinner, less sticky
Does not absorb into tissue=longer lasting
Will need to be washed off
A hybrid lubricant (silicone/water) has a combination of silicone/water based qualities.
Widely available (ie coconut oil)
Better for massage and external use
Can alter vaginal microbiome with internal use
Cannot use with toys and condoms
What lubes do you recommend:
Slippery Stuff (we use this one in the office when working with patients)
Who needs it: While lubricant is great for sexual activity, lube is not the best choice for daily use to maintain vaginal hydration.
Vaginal moisturizers are readily available without a prescription and good for anyone with vaginal dryness.
Dry vaginal tissue becomes more delicate, irritated, uncomfortable, and has a greater risk for tissue injury.
Vaginal moisturizers are designed for daily use and are formulated to match the vaginal PH which helps the vagina and vulva receive the appropriate amount of hydration.
Some of our favorite vaginal moisturizers are here:
Honor: Everyday Balm
Who needs it: Decreased estrogen levels can result in vaginal irritation. Menopause is just one example of an event leading to a rapid decline of estrogen.
Estrogen creams are prescribed by physicians which means this topic is a bit out of our physical therapy scope of practice.
If you’ve tried lubricants and vaginal moisturizers, it may be time to talk to your physician to see if an estrogen cream may be the right choice for you.
Just to reiterate, sex should never be painful. If you are experiencing any type of painful sexual activity, don’t hesitate to reach out to our pelvic health specialists at Hudson Valley Physical Therapy.
Photo attribution: <a href=’https://www.freepik.com/photos/people’>People photo created by ArthurHidden – www.freepik.com</a>