Personal lubricants and cancer

Sex and cancer are always hot topics in my office. Whether I am sitting with one woman, a couple, or a group, we eventually get to this subject. I have written before about the common issues around libido arousal, but today’s subject is personal lubricants. One normal result of menopause is reduced vaginal lubrication; this can often be a problem for women who have not been treated for cancer. It is very often a problem for women who have had chemotherapy or who are taking anti-estrogen or hormone therapies (tamoxifen or one of the AIs). Although the basic problem is the same in both groups, women post cancer are often younger than their healthy menopausal counterparts, and the change has come more suddenly. Added to diminished libido, vaginal dryness and possible pain with intercourse are a major barrier to intimacy.

So what helps? The answer is personal lubricants, and there are many available. In addition to those that are easily available online or in stores, I will remind you here of two easily available and totally non-embarrassing options. The first is Albolene, a rather old-fashioned product that is sold primarily as a facial cleanser. You will find it on the shelves next to cold cream and various make-up removers. It comes in a tub and, at first glance, looks like melted candle wax. Once it comes into contact with the warmth of your skin, it gets very soft and is easily spread wherever you would like to put it. Humorous aside: When talking about the product once with one of my support groups, one woman became totally horrified and said: My grandmother always had that in her bathroom! We don't know whether Granny was sexually active or whether she was washing her face. And, as I always comment when I talk about Albolene, if you don’t like it for this purpose, it is an inexpensive and very good facial cleanser every evening. The second suggestion is canola oil or coconut oil. I heard about this possibility from a patient who had heard about it from her GYN. I called him to confirm, and he said he had been recommending it for years. He could not explain why his recommendation was canola vs. some other kind of oil, but that is what he had been told by a colleague, so he continued to pass it along. Second humorous aside: I once mentioned this to a patient who returned the next week absolutely furious with me. It turned out that she had used canola oil as a lubricant and then had sex on the beach. Sand and oil do not mix well.

There are some concerns about the safety of some products. If we worry about what we eat or breathe, it makes sense that we should also consider what we put on or in our bodies. One of my patients recently completed a course of radiation therapy for endometrial cancer. Towards the end of her treatment, she was given a set of dilators and instructions about how to use them. She was directed to use them or to have sex three times/week for the rest of her life. This seemed rather daunting, and she was concerned how best of follow directions to insure she could remain sexually active. She was also told to only use water-based products, and her personal choice is to try to avoid things full of unpronounceable ingredients. Silicone-based lubricants are not dangerous by definition, but should not be used with silicone sex toys as they could break down the toys.

Doing some exploration, she learned that many vaginal lubricants contain parabens, hormones, and artificial ingredients and that it can be difficult to get an complete list of ingredients. Reading various online comments, she found recommendations from other women for ASTROGLIDE Glycerin & Paraben Free, Yes, Good Clean Love ,and Sylk. I cannot personally vouch for any of these, and that sort of takes us back to the grocery aisle and canola oil.

Whatever you choose to use, do read the labels. Try to avoid parabens that can penetrate the skin and act like a weak estrogen. It is also probably smart to avoid products that have perfumes or flavors because we just don’t enough about them and others that produce a tingly sensation for the same reason. If you have concerns about a product's safety, it is better not to use it.