Updated March 24, 2026 — This post has been reviewed and expanded with current research and clinical guidance.
We as physical therapists think this is very subjective. You don’t technically need to use lubricant but it can help in making sex more comfortable, fun and decreasing any discomfort/pain.
In one study published in the Journal of Sexual Medicine, out of 1,000 participants, 65% of women had used lubricant in the past — and of those, only 20% had used it in the past 30 days. (Herbenick D, Reece M, Schick V, Sanders SA, Fortenberry JD. Women’s use and perceptions of commercial lubricants: prevalence and characteristics in a nationally representative sample of American adults. Journal of Sexual Medicine.)
Women’s perceptions about lubricant use and vaginal wetness during sexual activities
In another study, women felt positively about lubricant use, preferred sex to feel more “wet,” and were able to orgasm more easily when using it — a finding that is particularly helpful for women who have difficulty orgasming during sexual intercourse. (Jozkowski KN, Herbenick D, Schick V, Reece M, Sanders SA, Fortenberry JD. Women’s perceptions about lubricant use and vaginal wetness during sexual activities. Journal of Sexual Medicine.)
Many women do not produce enough natural lubrication — especially those taking hormonal contraceptives, those who are postmenopausal, and those who are breastfeeding. When a woman is aroused, increased blood flow to the vaginal walls stimulates the production of natural discharge. But even with adequate arousal, some women simply don’t produce enough lubrication on their own, and that’s completely normal.
This is particularly true for women experiencing Genitourinary Syndrome of Menopause (GSM) — the current clinical term for the constellation of symptoms that can include vaginal dryness, irritation, and pain with intercourse that often accompany the hormonal changes of perimenopause and menopause. For these women, lubricant can be an important part of comfortable, enjoyable sex.
Lubricants are also useful because they have been shown to help prevent membrane tearing in vaginal or anal tissue, which can reduce the risk of STI transmission. (And as always — use condoms when trying to prevent pregnancy and reduce STI risk!)
The Three Main Types of Lubricant
You can buy lubricants that are made of all types of things: petroleum, flavor additives, etc but there are generally three main types- water, oil, and silicone-based.
At 5 Point PT, we often recommend water-based lubricants as a first choice. Water-based lubricant is less likely to irritate vaginal tissue and is safe to use with condoms and most sex toys. It comes with or without glycerin — women who are prone to vaginal yeast infections may want to choose a glycerin-free formula. The main drawback is that it absorbs relatively quickly and may need to be reapplied.
Oil-based lubricants tend to last longer with less reapplication. However, they can degrade condoms and are harder to wash off after intercourse. Common examples include baby oil, mineral oil, vegetable oil, and coconut oil.
Silicone-based lubricants provide a longer-lasting, “wetter” feel and are safe to use with latex condoms. However, some people have sensitivities to silicone, and these lubricants will damage silicone sex toys — so keep that in mind.
There are also hybrid lubricants (water and silicone combined) that aim to offer the best of both — longer lasting than water-based alone, but easier to clean up than pure silicone. These have become increasingly popular and are worth considering if you find yourself constantly reapplying water-based lubricant.
What to Look for — and What to Avoid
This is an area where the clinical guidance has evolved significantly in recent years, and it’s worth paying attention to.
Two properties matter most when evaluating lubricant safety: pH and osmolality.
The vagina maintains a naturally acidic environment, with a healthy pH typically between 3.8 and 4.5. Many commercial lubricants have a much higher (less acidic) pH, which can disrupt the vaginal microbiome and increase susceptibility to bacterial vaginosis and other infections.
Osmolality refers to the concentration of particles dissolved in a fluid. When a lubricant’s osmolality is much higher than that of natural vaginal secretions, it can draw water out of the cells lining the vaginal walls, potentially damaging the tissue and compromising the body’s natural protective barrier. Research published in the Journal of Sexual Medicine (Palacios et al., 2023) found that lubricants formulated to meet the World Health Organization’s guidelines for osmolality and pH were both effective and safe for relieving vaginal dryness and improving sexual satisfaction. The WHO recommends water-based lubricants not exceed 1,200 mOsm/kg — yet many widely available over-the-counter products exceed this threshold significantly.
The practical takeaway: when choosing a lubricant, look for products that are pH-balanced (around 4.0–4.5) and low-osmolality. Ingredients to approach with caution include glycerol/glycerin in high concentrations, propylene glycol, parabens, chlorhexidine, nonoxynol-9, and added fragrances or flavors.
Some formulations that tend to score well on these criteria include Good Clean Love, Sliquid H2O, YES WB, and Überlube (silicone). That said, formulations change and new options continue to enter the market — when in doubt, look for products that specifically advertise pH-balanced and body-compatible osmolality, or ask your physical therapist or gynecologist for a current recommendation.
Vegan and/or organic options with fewer additives have been available for some time — YES and Sliquid remain solid choices in this category.
When trying any new lubricant, it’s always a good idea to do a small patch test on your forearm first to check for any skin sensitivity before using it in more sensitive areas.
A Note on Communication
Lubrication occurs naturally in a well-functioning system — but some women are simply more lubricated than others, and lubrication can also be a matter of personal preference. Many women find intercourse more pleasurable when they are more lubricated, regardless of whether dryness is a clinical concern. It’s worth having an open conversation with your partner so they understand the role lubricant can play in comfortable, enjoyable intimacy — including during foreplay.
If you’re experiencing persistent vaginal dryness, pain with intercourse, or discomfort that lubricant alone isn’t resolving, pelvic floor physical therapy may be able to help. These symptoms are often connected to pelvic floor tension, hormonal changes, or other treatable conditions — and you don’t have to just live with them.
In NYC? Learn more about pelvic floor PT at our NYC Flatiron clinic.
In New Jersey? Learn more about pelvic floor PT at our Millburn, NJ clinic.
Resources:
Palacios S, Hood S, Abakah-Phillips T, Savania N, Krychman M. A randomized trial on the effectiveness and safety of 5 water-based personal lubricants. The Journal of Sexual Medicine. 2023;20(4):498–506. https://doi.org/10.1093/jsxmed/qdad005
Herbenick D, Reece M, Schick V, Sanders SA, Fortenberry JD. Women’s use and perceptions of commercial lubricants: prevalence and characteristics in a nationally representative sample of American adults. Journal of Sexual Medicine.
Jozkowski KN, Herbenick D, Schick V, Reece M, Sanders SA, Fortenberry JD. Women’s perceptions about lubricant use and vaginal wetness during sexual activities. Journal of Sexual Medicine.
