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Get Slick. Let’s Talk Lube, Part 1

by Angie Stoehr, MD

When things get going in the bedroom, most women notice something happening down below. There’s tingling, warmth, sensitivity, and extra wetness. But, did you ever wonder where that wetness comes from? Or if it is important to be lubricated? And what if you don’t get wet? Ladies, let’s talk lube!

What’s The Purpose of Lubrication?

There are actually a few reasons why lubrication is important. First, in most cultures, lubrication is associated with increased pleasure during sex. The wetness of the vagina allows for easier penetration of the penis or sexual toy. It also prevents excess rubbing, and facilitates thrusting movements necessary for male climax. Thirdly, natural lubrication may help nourish sperm- providing proteins and sugars for the sperm to survive. Those little guys have a long way to travel from your vagina all the way to your tube where one lucky joe meets his lady love, and conception happens.

Your body’s natural lubrication comes from a few places, the vagina itself, the cervix, and a set of glands near the opening of your urethra. Each site makes lubrication in a different way, and with different variations in slickness. Some of this lubrication is only with sex, some you get all the time to prevent the sensation of “dry vagina”.

Where, Why, and How Natural Vaginal Lubrication Happens

At the beginning of most pleasurable sexual encounters, there’s something called the “Excitement Phase”. Yep, it’s exactly what it sounds like. It may be that you’re excited from kissing, touching, or suggestive comments from your partner. It could be that someone finally bothered to do the laundry for you, or you’re feeling a little more sexy than usual. This often is kicked off by reading or watching sexually suggestive media. It’s that, “why is my clitoris tingling?” sensation during the bedroom scene of your favorite rom-com. The “Excitement Phase” is marked by increasing blood flow to your genitals. The outside and inside of your vagina and clitoris get extra love from your vascular system, which in turn causes an increase in pressure in the vaginal walls. The pressure causes “sweating”, where natural fluids are pushed through the vaginal walls and into the vaginal space, creating increased wetness or lubrication. There’s a particular protein in the nerves of your vagina, called VIP, that seems to be responsible for this whole process.

A little lubrication actually comes from the cervix, because your cervix makes some amount of vaginal discharge all the time. During ovulation, the cervical discharge increases a bit and becomes a little more sticky, and slick. Some people use this as a way to predict ovulation for purposes of avoiding pregnancy, or even for timing sex when they’re wanting to get pregnant.

The last source of lubrication is from the Skene’s glands. They’re located right by the opening of your urethra (where your pee comes out). During orgasm, some women secrete extra fluid (squirting or female ejaculation). This fluid appears to be coming from the Skene’s glands, but we’re not really sure of its purpose. Some scientists think it might be anti-microbial, or a response to stimulation of the G-spot.

Common Causes of a Dry Vagina

“What if I don’t get wet during foreplay? Is something wrong with me?” I hear this on occasion in the office. Lack of natural lube is actually pretty common and can be related to many things. Psychological factors often play a role, as do medications and physical issues. Here’s a run-down of some of the most common causes of a dry vagina.

First, you just may not be ‘jazzed’ enough, for any number of reasons. There could be a pile of dishes in the sink, or a toddler playing outside your door. Or maybe you had a huge project due today, and didn’t get it turned in. Anxiety and mental preoccupation regularly lead to lack of desire and in turn, low lubrication. It’s also possible your partner is facing his/her own challenges, suffering from erectile dysfunction, premature ejaculation, or difficulty with arousal. When you’re not anticipating great sex, it can affect how much lubrication you make naturally.

Second, quite a few medications can cause issues with lubrication. For instance, many cold remedies contain antihistamines (Benadryl), or ephedrine (Sudafed). These kinds of medications dry up more than just your nose. Blood pressure meds can affect lubrication by reducing the pressure inside the vaginal walls, reducing the amount of “sweating” that happens. Antidepressants and anti-anxiety meds are notorious for reducing libido, and can affect lubrication as well. Scopolamine, which is often used for seasickness, unfortunately, can prevent you from slick nookie on your romantic cruise. Even marijuana can make things a little less than perfect in the lube department.

Last, although not least, are physical issues. I lump hormones into this category. Lack of estrogen is likely the biggest factor affecting vaginal dryness during the years around menopause. It’s also the reason for lubrication issues during breastfeeding. Estrogen is absolutely necessary for the plumpness of your vaginal cells. When you don’t have enough estrogen, you can’t make enough fluid for lubrication. You also lose the elasticity of the vagina causing more discomfort during sex which compounds the problem. Another physical issue that can cause low lubrication is vaginal and vulvar irritants, like soaps or vaginal douching. You really shouldn’t use any kind of chemical inside the vagina, because it offsets your natural pH. When the pH is off, it can cause overgrowth of normal microbes in your vagina. This leads to yeast infections or bacterial vaginosis. These make discharge that can be uncomfortable, itchy, or have a funky odor.

In a previous blog, I mentioned pain with sex being a cause for low libido. Pain with sex that is caused by vaginal and vulvar skin issues also leads to lube problems. Psoriasis and eczema can be found on the genitals as well as itching or painful immune skin reactions. When you’re not sure what’s going on down there, it’s hard to produce enough lubrication for sex. One last consideration is women who have had to undergo chemotherapy or pelvic radiation for cancers. Chemo and radiation can permanently damage the vaginal tissue causing lots of problems with sexual function, lubrication included.

As you can see, sexual lubrication is its own little world. There are many potential problems affecting it. When you are lacking lube, it may be something really obvious; it may not. When in doubt, ask your gynecologist. Many of the medical issues with lubrication can be diagnosed and treated in the doctor’s office. If you’re lucky, they may even have some lube samples to give out! What kind of lubrication samples might they have? Stayed tuned for Get Slick; Let’s talk Lube, Part 2, where we’ll discuss effective treatments for lubrication issues, as well as talk about all the available synthetic lubricants. There are a bunch of them, and picking which one is right for you can be pretty important.

More resources:

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Dr. Angie Stoehr is a chronic pelvic and sexual pain and sexual dysfunction specialist. She works out of Nurture Women’s Health in Frisco, Texas. Dr. Stoehr is a member of the International Social for the Study of Women’s Sexual Health and the International Pelvic Pain Society.