You say that your wife suffers from lichen sclerosus, a condition that creates skin tissue that is thinner than usual (and is a higher risk for postmenopausal women). Warming oils and lubricants, unfortunately, create discomfort rather than arousal for her. I'm not aware of an option in that category that would work for her, since the ingredients that make them effective--usually something minty or peppery--will almost certainly cause an adverse reaction.
Plain lubricants won't cause that reaction; those we include in our product collection should be well-tolerated by lichen sclerosus patients.
There are a couple of other options you and your wife could explore for arousal. The use of testosterone has been beneficial for 50 to 60 percent of the women in my practice who've tried it. Testosterone is by prescription and off-label for women, which means a discussion with her health care provider is required.
Other prescription options include localized estrogen, Osphena, or Intrarosa (a recently available FDA-approved choice). Any of these would increase blood supply by "estrogenizing" the genitals, which can improve arousal and orgasm as well.
Congratulations on undertaking this exploration together! Good communication and mutual support are so important to shared intimacy.
Okay. We’ve talked about sexual lubricants before. Many times. And for good reason. Vaginal dryness and the associated pain with sex, penetration, and sometimes daily life is possibly the #1 issue I deal with in my practice.
Insufficient lubrication during sex isn’t just a problem of menopause—many women experience it at various times of life—during pregnancy, with insufficient foreplay, or while on certain medications, for example. Or just because.
Fortunately, sexual lubricants are an easy, safe way to make sex more comfortable and fun.
One critical distinction: Lubricants are for use during sex to increase comfort and reduce friction. They coat whatever surface they’re applied to (including the penis and sex toys) but they aren’t absorbed by the skin, thus, they have to be (or naturally are) washed off. Moisturizers, on the other hand, are specially formulated to soften and moisten vaginal tissue. Like any lotion, they should be used regularly and are absorbed into vaginal and vulvar tissue. Moisturizers are for maintenance; lubricants are for sexual comfort.
Basically, there are three types of sexual lubricants: water-based, silicone, and a newer hybrid formulation. Each has unique characteristics and limitations. Water-based lubes are thick, feel natural, don’t stain, and don’t damage silicone toys. They rinse off easily with water. However, they tend to dry out more quickly (although they can be re-activated with water) and don’t provide long-lasting lubrication. Water-based lubricants may contain glycerin, which tastes sweet but can exacerbate yeast infections.
Silicone lubes are the powerhouse of personal lubricants. They tend to feel slick and last three times as long as water-based options. They’re hypoallergenic, odorless, and tasteless. They may stain, and they will destroy silicone surfaces on other equipment, so you can’t use silicone lubes on your expensive silicone vibrator. They wash away with soap and water.
Hybrid lubes, as the name suggests, have some characteristics and benefits of both water-based and silicone.
At this life stage, you can put away your coupons and dispense with frugality. Your vagina deserves the best! Not only have those tissues become more delicate, your vagina also has a finely balanced pH level that (usually) protects against yeast and bacterial infections. Cheap or homemade lubricants can seriously mess with tender tissue and that natural acidity.
Some lubes contain “warming” ingredients, such as capsaicin, the ingredient that gives chili peppers their heat, or minty, or menthol-y oils. They’re intended to enhance sensation, increase blood flow to the genitals, and create a “tingly-warm” feeling. As such, they’re good for foreplay and use on vulva, clitoris, penis, nipples, external vaginal tissue, but not internally if they contain essential oil.
Use warming oils and lubricants with caution, however, since delicate or dry vulvar-vaginal tissue may respond with a fiery-hot rather than pleasantly warm sensation.
Use only products recommended for vaginal lubrication—not baby oil, vegetable or essential oils, petroleum jelly, or saliva. (Note: Oil destroys the latex in condoms and leaves behind a film that is a bacteria magnet.) Look for organic, natural, and high-quality ingredients (we look for these for our shop).
Each individual (and couple) ends up with one or more faves when it comes to lubricants. So make this a fun exploration for the products that work best, both for solo and couple play. If you don’t like one lube, a different type or brand might be just the ticket; don’t give up on lubes altogether.
Because the options for various lubricants are legion, we’ve tried to narrow the field in search of only the most effective and safest products for our shop. We examine the ingredients and opt for the most natural and organic brands possible. We also look at the philosophy of the company that makes them. We’ve been known to do quite a bit of research “in the field,” as well.
In the spirit of experimentation, we’ve put together a selection of seven sachets of water, hybrid, and silicone-based lubes in a handy sample kit. You can give them a whirl without the investment in a full bottle of lube that ends up in your sock drawer.
New lubricant options appear with some regularity, and we evaluate and add them periodically. If you’ve found something you love, let us know; other women may be happy to learn about the option!
The sexual arousal creams and gels are effective, and beneficial to most women who use them. Like our category of “warming lubricants and oils,” they typically use an ingredient like menthol, mint, or pepper to stimulate circulation, which increases responsiveness during intimacy. Read the instructions for the product you intend to use, to be sure you understand whether it’s for internal or only external use; lubricants are generally safe for internal tissues.
Arousal and warming products have the potential to cause some irritation for those women with significant atrophy, or thinning of the vulvovaginal tissues. I recommend applying a small amount to the genitals in advance of sex to make sure it’s comfortable and pleasurable.