Moisturizers, Lubricants, and Vulvar Hygiene Products: Issues, Answers, and Clinical Implications


Genitourinary syndrome of menopause (GSM) is a group of symptoms that encompasses vulvovaginal atrophy (VVA), and affects more than half of all postmenopausal females. There are many etiologies that may cause GSM-like symptoms including declining hormone levels, post partum lactation, medications, and certain medical illnesses. GSM is often under-recognized by both the woman and her health care professional. VVA can cause a constellation of signs and symptoms including irritation, pain burning, and itchiness. Although systemic and local hormonal treatment is often recommended, many women may decline their use or opt for a more conservative approach. Numerous women are opting for over-the-counter products for their dryness solutions, including moisturizers, lubricants, and vulvar washes to help manage these symptoms. There is a lot of consumer confusion concerning these products, and with a plethora of varieties on the market, it is easy for the woman to get confused concerning type of products and the additives and chemical that maybe found within them. This review article summarizes the common characteristics of vaginal moisturizers, lubricants, washes, and dispels some of the misperceptions concerning common chemical/additives found in these products. It is important for the reader to note that trade names of several over-the-counter products are mentioned throughout the manuscript and this should not be interpreted as a specific product endorsement.

This is a preview of subscription content, access via your institution.


Papers of particular interest, published recently, have been highlighted as: • Of importance

  1. 1.

    Palacios S. Managing Urogenital Atrophy Maturitas. 2009;63:315–8.

    PubMed  Google Scholar 

  2. 2.

    Portman DJ, Gass ML. Vulvovaginal atrophy terminology consensus conference panel. Genitourinary syndrome of menopause: new terminology for vulvovaginal atrophy from the International Society for the Study of Women’s sexual health and the North American Menopause Society. Climateric. 2014;17:557–63.

    CAS  Article  Google Scholar 

  3. 3.

    Parish SJ, Nappi R, Kingsberg SA, et al. Impact of vulvovaginal health on postmenopausal women: a review of surveys on symptoms of vulvovaginal atrophy. Int J Women’s Health. 2013;5:437–47.

    Article  Google Scholar 

  4. 4.

    Wysocki S, Kingsberg S, Krychman M. Management of vaginal atrophy: implications from the REVIVE survey; clinical medicine insights. Reprod Health. 2014;8:23–30.

    Google Scholar 

  5. 5.

    Krychman ML. Vaginal estrogens for the treatment of dyspareunia. J Sex Med. 2011 Mar;8(3):666–74.

  6. 6.

    Herbenick D, Reece M, Hensel D, Sanders S, Jozkowski K, Fortenberry JD. Association of lubricant use with women’s sexual pleasure, sexual satisfaction, and genital symptoms: a prospective daily diary study. J Sex Med. 2011;8:202–12.

    Article  PubMed  Google Scholar 

  7. 7.

    Birnholtz JC. Sexual lubricants promoting health and pleasure. Medical Aspects of Human: Sexuality; 1998.

    Google Scholar 

  8. 8.

    Edwards D, N. P. Treating vulvovaginal atrophy/genitourinary syndrome of menopause: how important is vaginal lubricant and moisturizer composition? Climacteric. 2016;19(2):151–61. doi:10.3109/13697137.2015.1124259.

    CAS  Article  PubMed  Google Scholar 

  9. 9.

    Carter J, Goldrank D, Schover L. Simple strategies for vaginal health promotion in cancer survivors. Journal of Sexual Medicine. 2011;8:549–59.

  10. 10.

    Bygdeman M, Swahn ML. Replens versus dienoestrol cream in the symptomatic treatment of vaginal atrophy in postmenopausal women. Maturitas. 1996;23:259–63.

    CAS  Article  PubMed  Google Scholar 

  11. 11.

    Nachtigall LE. Comparative study: replens versus local estrogen in menopausal women. Fertility Sterility. 1994;61:178–80.

    CAS  Article  PubMed  Google Scholar 

  12. 12.

    Van der Laak JA, de Bie LM, de Leeuw H, et al. The effects of replens on vaginal cytology in the treatment of postmenopausal atrophy: cytomorphology versus computerized cytometry. J Clin Pathol. 2002;55(6):446–51.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  13. 13.

    Caswell M, Kane M. Comparison of the moisturization efficacy of two vaginal moisturizers: pectin versus polycarbophil technologies. J Cosmet Sci. 2002;53(2):81–7.

    CAS  PubMed  Google Scholar 

  14. 14.

    Loprinzi CL, Abu-Ghazaleh S, Sloan JA, et al. Phase III randomized double-blind study to evaluate the efficacy of a polycarbophil-based vaginal moisturizer in women with breast cancer. J Clin Oncol. 1997;15(3):969–73.

    CAS  PubMed  Google Scholar 

  15. 15.

    Ekin M, Yasar L, Savan K, Temur M, Uhri M, Gencer I, Kıvanç E. The comparison of hyaluronic acid vaginal tablets with estradiol vaginal tablets in the treatment of atrophic vaginitis: a randomized controlled trial. Arch Gynecol Obstet. 2010;283(3):539–43.

    Article  CAS  PubMed  Google Scholar 

  16. 16.

    Costantino D, Guaraldi C. Effectiveness and safety of vaginal suppositories for the treatment of the vaginal atrophy in postmenopausal women: an open, non-controlled clinical trial. Eur Rev Med Pharmacol Sci. 2008;12:411–6.

    CAS  PubMed  Google Scholar 

  17. 17.

    Fevola MJ, Gentner L, Ahmad N, Librizzi JJ. Getting intimate with polymers: personal lubricants. Cosmetics and Toiletries. 2008;123:59–68.

    CAS  Google Scholar 

  18. 18.

    Schmid-Wendtner M-H, Korting HC. The pH of the skin surface and its impact on the barrier function. Skin Pharmacol Appl Ski Physiol. 2006;19:296–302.

    Article  Google Scholar 

  19. 19.

    • Chen J, Geng L, Song X, H. L, Giordan N, O. L. Evaluation of the efficacy and safety of hyaluronic acid vaginal gel to ease vaginal dryness: a multicenter, randomized, controlled, open-label, parallel-group, clinical trial. J Sex Med. 2013;Volume 10(Issue 6):1575–84. This article is important as it illustrates that there are some important components that should be included in intimate vaginal products. Women must read labels to be aware what is included and what other potential caustic ingedients should be avoided.

  20. 20.

    Bailey AJ. Collagen and elastin fibres. J Clin Path. 31(Suppl. (Roy. Coll. Path.), 12):49–58.

  21. 21.

    Karpuzoglu E, Holladay SD, Gogal Jr RM. Parabens: potential impact of low-affinity estrogen receptor binding chemicals on human health. J Toxicol Environ Health B Crit Rev. 2013;16:321–35.

  22. 22.

    Nohynek GJ, Borgert CJ, Dietrich D, Rozman KK. Endocrine disruption: fact or urban legend? Toxicol Lett. 2013;223:295–305.

    CAS  Article  PubMed  Google Scholar 

  23. 23.

    Harvey PW, Everett DJ. Significance of the detection of esters of p-hydroxybenzoic acid (parabens) in human breast tumours. J Appl Toxicol. 2004;24:1–4.

    CAS  Article  PubMed  Google Scholar 

  24. 24.

    Accessed on August 4th 2016. Website:ACS:

  25. 25.

    Dezzutti CS, Brown ER, Moncla B, Russo J, Cost M, Wang L, et al. Is wetter better? An evaluation of over-the-counter personal lubricants for safety and anti-HIV-1 activity. PLoS One. 2012;7(11):e48328. doi:10.1371/journal.pone.0048328.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. 26.

    Cunha AR, Machado RM, Palmeira-de-Oliveira A, Martinez-de-Oliveira J, das Neves J, Palmeira-de-Oliveira R. Characterization of commercially available vaginal lubricants: a safety perspective. Pharmaceutics. 2014;6:530–42. doi:10.3390/pharmaceutics6030530.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  27. 27.

    Fashemi B, Delaney ML, Onderdonk AB, Fichorova RN. Effects of feminine hygiene products on the vaginal mucosal biome. Microb Ecol Health Dis. 2013;24. doi:10.3402/mehd.v24i0.19703 .eCollection 2013

  28. 28.

    Adriaens E, Remon JP. Mucosal irritation potential of personal lubricants relates to product osmolality as detected by the slug mucosal irritation assay. Sex Transm Dis. 2008;35:512–516. 14.

    CAS  Article  PubMed  Google Scholar 

  29. 29.

    Wang et al. Rectal microbicides: clinically relevant approach to the design of rectal specific placebo formulations. AIDS Res Ther. 2011;8:12.

    Article  PubMed  PubMed Central  Google Scholar 

  30. 30.

    Fuchs EJ, Lee LA, Torbenson MS, et al. Hyperosmolar sexual lubricant causes epithelial damage in the distal colon: potential implication for HIV transmission. Journal of Infectious Disease. 2007;195:703–10.

    Article  Google Scholar 

  31. 31.

    Begay O, Jean-Pierre N, Abraham CJ, et al. Identification of personal lubricants that can cause rectal epithelial cell damage and enhance HIV type 1 replication in vitro. AIDS Res Hum Retrovir. 2011;27(9):1019–24.

    Article  PubMed  PubMed Central  Google Scholar 

  32. 32.

    World Health Organization. Use and procurement of additional lubricants for male and female condoms: WHO/UNFPA/FHI360 advisory note 2012 [7 July 2015].

  33. 33.

    Moench TR, Mumper RJ, Hoen TE, Sun M, Cone RA. Microbicide excipients can greatly increase susceptibility to genital herpes transmission in the mouse. BMC Infect Dis. 2010;10:331.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  34. 34.

    Cunha AR, Machado RM, Palmeira-de-Oliveira A, Martinez de-Oliveira J, das Neves J, Palmeira-de-Oliveira R. Characterization of commercially available vaginal lubricants: a safety perspective. Pharmaceutics. 2014;6:530–42.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  35. 35.

    Steiner AZ, Long DL, Tanner C, Herring AH. Effect of vaginal lubricants on natural fertility. Obstet Gynecol. 2012;120:44–51.

    Article  PubMed  PubMed Central  Google Scholar 

  36. 36.

    Kutteh WH, Chao CH, Ritter JO, Byrd W. Vaginal lubricants for the infertile couple: effect on sperm activity. Int J Fertil Menopausal Stud. 1996;41:400–4.

    CAS  PubMed  Google Scholar 

  37. 37.

    Anderson L, Lewis SE, McClure N. The effects of coital lubricants on sperm motility in vitro. Hum Reprod. 1998;13:3351–6.

    CAS  Article  PubMed  Google Scholar 

  38. 38.

    Sandhu RS, Wong TH, Kling CA, Chohan KR. In vitro effects of coital lubricants and synthetic and natural oils on sperm motility. Fertil Steril. 2014;101:941–4.

    Article  PubMed  Google Scholar 

  39. 39.

    Ellington J, Daugherty S. Prevalence of vaginal dryness in trying to conceive couples. Fertil Steril. 2003;79(Supp 2):21–2.

    Article  Google Scholar 

  40. 40.

    Frishman GN, Luciano AA, Maier DB. Evaluation of Astroglide, a new vaginal lubricant: effects of length of exposure and concentration on sperm motility. Fertil Steril. 1992;58(2):630–59.

    CAS  Article  PubMed  Google Scholar 

  41. 41.

    Agarwal A, Deepinder F, Cocuzza M, Short RA, Evenson DP. Effect of vaginal lubricants on sperm motility and chromatin integrity: a prospective comparative study. Fertil Steril. 2008;89:375–9.

    Article  PubMed  Google Scholar 

  42. 42.

    Mowat A, Newton C, Boothroyd C, Demmers K, Fleming S. The effects of vaginal lubricants on sperm function: an in vitro analysis. J Assist Reprod Genet. 2014;31:333–9

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information



Corresponding author

Correspondence to M. L. Krychman.

Ethics declarations

Conflict of Interest

Jamie Patterson and Leah Millheiser declare that they have no conflict of interest. Michael L. Krychman reports grants from NERI and Evidera; has served as advisor and speaker for Shionogi and Sermonix; and has received fees as consultant for Uniderm, Rickett Benckiser, and Pfizer.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

This article is part of the Topical Collection on Female Sexual Dysfunction and Disorders

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Patterson, J., Millheiser, L. & Krychman, M.L. Moisturizers, Lubricants, and Vulvar Hygiene Products: Issues, Answers, and Clinical Implications. Curr Sex Health Rep 8, 213–221 (2016).

Download citation


  • Vulvar hygiene products
  • Genitourinary syndrome of menopause
  • Vulvovaginal atrophy
  • Moisturizers
  • Lubricants
  • Review