Congratulations Dr. Ney on another excellent article!
Article originally published in Goop
A Q&A with Maggie Ney, N.D.
Q: Many commonly sold lubricants have parabens and other toxic ingredients in them—what sort of impact can inserting these types of ingredients into the body have on the female reproductive system?
A: Using lubricants with toxic ingredients has an effect on our reproductive system, as the vagina and anus are highly permeable areas and anything that is applied topically can be absorbed into the body. Parabens are a very common preservative in most cosmetics (moisturizers, face wash, lotions) that are used to prevent bacterial overgrowth. The problem is that parabens are endocrine disruptors, which means that they have an estrogenic effect in the body—they bind to the same cell receptors as our own estrogen but they interfere with our normal, rhythmic, hormonal process. Exposure to parabens has been associated with cancer and reproductive health issues and hormone imbalances like fibroids, endometriosis, infertility, and PMS.
Parabens have actually been found inside breast tumor cells. And while we cannot conclude that parabens cause breast cancer, we can certainly argue that our bodies do not efficiently metabolize and eliminate it from our bodies. So when the FDA (which does not even regulate what goes into our lubricants) claims that the amounts of parabens are too low to pose a toxic effect in the body, they may be correct if we’re talking about a single exposure. The problems is, parabens are in our moisturizers, makeup, shaving creams, and facial cleansers. With multiple, daily use of these products, parabens and other chemicals are accumulating in our bodies, being passed onto our children, and playing a significant role in the health of our reproductive system.
I could talk about endocrine disruptors all day. Standard lubricants also contain other potentially toxic ingredients like glycerin, which can contribute to yeast infections; propylene glycol, which can be irritating to the skin; chlorhexidine gluconate, an antibacterial that can kill healthy vaginal bacteria, which then makes a women more susceptible to yeast infections and bacterial vaginosis; and petroleum, which can alter vaginal pH and contribute to more vaginal infections.
Q: Any non-toxic alternatives to lube that you would recommend? I.e., would you suggest something simple like coconut oil, or are there ramifications to using anything at all?
A: When it comes to lube, if it is safe to eat, it is generally safe to apply. If a lubricant is needed, I recommend organic coconut oil, olive oil, aloe vera gel, or almond oil—they are free from preservatives and are safe alternatives to conventional lubricants. Oils, however, do compromise the integrity of latex, so don’t use oils with a latex condom. It is also important to note that lubricants can affect sperm motility, so I advise against lubrication while trying to conceive. I like to remind my patients that every body is unique and will respond differently to the products they use. Coconut oil—which has anti-microbial properties—could, potentially, disrupt vaginal flora. So I recommend taking a break from lubrication for women who experience recurrent yeast infections or chronic bacterial vaginosis. All that being said, if you are using a natural, organic, food-based lubricant without any side effects, continue and enjoy the benefits. But if you are experiencing any discomfort or an increase in infections, consider a trial of stopping your lubricant to see if it helps. Also, eat fermented foods and/or take a probiotic to support healthy vaginal flora.
Q: What about for men (gay and otherwise)? Would these ingredients affect the prostate?
A: Yes, the toxic ingredients and endocrine disruptors in lubricants are easily absorbed by the penis and anus and have an effect on men’s health. Parabens have anti-androgen (anti-testosterone) properties and may contribute to male-factor infertility by affecting sperm count and sperm motility. Parabens have also been associated with the rise in prostate cancer. Testosterone levels can also be reduced with exposure, which contributes to reduced libido, erectile disfunction, and loss of muscle mass.
Q: Why does vaginal dryness occur? Is it a natural symptom of aging, or can it be controlled and/or reversed?
A: Lacking lubrication in intimacy is very common and there are a number of different causes. Let’s start with aging. Vaginal dryness is a natural symptom of aging. As estrogen declines, the vaginal skin becomes thinner and natural lubrication is reduced. This can be controlled with natural lubricants like coconut oil, vitamin E oil, or aloe vera gel. Vaginal dryness due to aging can be reversed with vaginal estrogen. Vaginal estrogen, like vaginal estriol (estriol is the weakest form of estrogen and can reverse vaginal dryness), works locally (very little is absorbed by the body) to restore elasticity and integrity to the vaginal wall.
Childbirth and breastfeeding are also associated with vaginal dryness since postpartum estrogen levels are low. This is reversed the further postpartum a woman becomes and as the frequency of nursing is reduced.
Certain medications—like anti-histamines, anti-depressants, and anti-estrogen therapy—can cause vaginal dryness. Even birth control pills can contribute to dryness.
There is an autoimmune disease known as Sjogren’s syndrome that attacks cells in the body that produce moisture—these women frequently experience vaginal dryness.
Stress, fatigue, dehydration, and depression can all lower natural vaginal lubrication. When these issues are addressed, vaginal dryness resolves.
Douching, bubble baths, scented soups can worsen dryness for some women and once these products are discontinued dryness resolves.
And, of course, not enough foreplay can interfere with a woman’s production of their natural lubrication.
Q: Besides sexual discomfort, are there other implications from dryness?
A: Vaginal dryness makes intercourse uncomfortable and painful. On an emotional level, the anticipatory discomfort can contribute to a lower sex drive. Physically, natural lubrication is a primary signal of sexual arousal—without this lubrication, libido is reduced. Dryness can also contribute to vaginal irritation and itchiness—leading some women to feel they have a yeast infection. And, at the same time, dryness can cause the vaginal pH to increase which can actually contribute to more frequent infections—especially bacterial vaginosis.
Q: What are things women can do to increase lubrication?
A: First, it is really important to identify and treat the cause—that may be using vaginal estrogen, a change in medication, drinking more water, or addressing stress or depression. Avoid scented soaps, bubble baths, and vaginal douching. All can contribute to vaginal dryness and irritation in some women. Engage in long enough foreplay to become fully aroused. Stay well hydrated—drinking at least 8-10 glasses of water every day. Increase sources of omega-3 fatty acids, such as wild salmon, sardines, flaxseed oil, flaxseeds, pumpkin seeds, hemp seeds, or hemp milk. Any activity that increases blood flow to the pelvic region—like cycling—helps to increase natural lubrication over time. Topically you can apply Vitamin E oil or olive oil to the labia to help moisturize and strengthen the vaginal tissue.
Q: Are latex condoms bad for us?
A: Latex in its purest form is a fluid obtained from the rubber tree. Some people are allergic to latex, which can cause skin irritation, sneezing, runny nose, hives, flushing, and, in rare situations, an anaphylactic reaction. Besides being a potential allergen, natural latex really is not bad for us. The problem is that many companies use chemicals in the processing of the latex. Nitrosamine, for example, is a by-product of latex production. Nitrosamine is a known carcinogen, and while the amount in condoms is very small, we still need to be mindful of our total daily exposure to chemicals and toxins. There is much less exposure to nitrosamine in a condom than in a hot dog, but nitrosamines do not need to be in condoms—they can be removed without impacting safety or efficacy. Again, the vaginal walls are so permeable and chemicals are easily absorbed through the vaginal walls into our blood stream.
Also, latex is often treated with casein, a milk derivative. Casein is not toxic (so long as you don’t have a dairy allergy) but most people are surprised to learn that their condoms have dairy in them.
Q: What else (i.e. spermicide) can make a condom toxic?
A: Many condoms contain lubricants so we’re dealing with the same exposure of parabens, glycerin, and propylene glycol. Some condoms contain the spermicide Nonoxynol-9. Nonoxynol-9 is added to kill sperm and sexually transmitted infections. But it is not discriminative in its killing, so, with repeated use, it can also disrupt the good vaginal bacteria, which can lead to more bacterial vaginosis and yeast infections. Nonoxynol-9 can also be irritating to the skin of the vagina and rectum, causing more localized inflammation and a greater susceptibility to contracting sexually transmitted infections, like HIV.
Benzocaine and lidocaine are found in many condoms to provide a numbing sensation with the goal of delaying a man’s climax. There is no requirement to label this ingredient on condom packaging. These are not particularly toxic but people may have a localized reaction and not know they are added to condoms.
Q: Are there nontoxic, effective condom options?
A: Yes—read labels! Condoms are so important and I definitely feel that the benefits of condoms (protection against STIs and pregnancy at the same time) far outweigh the risk of being exposed to these chemicals and toxins. But even a good thing can be improved and understanding what’s in our condoms can help drive consumers and drive demand for even safer options. Ideally, you want to find a vegan, paraben-free, glycerin-free, Nonoxynal-9-free, and benzocaine- and lidocaine-free condom.