The Best Drugstore Lube

In a previous post, The Best Lubes: Research and What to Avoid, I wrote about the importance of a lube’s pH, osmolality, and ingredients. In another previous post, The Best Lube: Bases and Textures I wrote about the different bases and textures lubes can have and provided some recommendations. Most of these recommendations are unfortunately unavailable in a drugstore or supermarket. Looking at the selection of lube available at drugstores like CVS and Walgreens, it is clear that most options are not ideal with respect to ingredients and osmolality.

In the past, there have been times where I needed lube and the only options  immediately available to me were at a drugstore or supermarket. Plenty of people will never look beyond drugstores or supermarkets, but many of those lubes can be irritating or harmful. Fortunately, there are good options at most drugstores and supermarkets.

Characteristics of Common Drugstore Lubes

Ingredients

Many water-based lubes, especially those found at drugstores, contain propylene glycol and/or glycerin. These ingredients are often among the first four ingredients, implying a relatively high concentration of propylene glycol or glycerin. In several studies, many lubes with a high concentration of propylene glycol and/or glycerin have been found to be hyperosmolal.

Other ingredients are less common, but have still been linked to irritation, increases susceptibility of infection, or potential harm, like polyquaternium-15 and chlorhexidine gluconate.

In general, drugstore companies seem to create new formulations that – for one reason or another – includes humectants or preservatives that have been linked to irritation or harm even while removing another.

Osmolality and pH

Astroglide and KY Jelly formulations tested in previous studies were shown to be hyperosmolal [1]. These formulations include most products by KY and Astroglide, including Astroglide’s Glycerin and Paraben-Free lube, which has an osmolality of 4806 mOsm/kg [2]. If you are interested in more details about the pH and osmolality of common lubes, I highly recommend looking at the Begay et al. study (which is available for free here).

Recommendations

Water-based lubes

The following lubes are free of chlorhexidine gluconate, polyquaternium, glycerin, propylene glycol, and parabens.

  • Good Clean Love Almost Naked Personal Lubricant – available at CVS, Walgreens, and Target
  • Good Clean Love Bio Nude Personal Lubricant – available at CVS and Target
  • Aloe Cadabra – available at CVS
  • LOLA Personal Lubricant made with 99% natural ingredients – available at Walmart
  • K-Y Natural Feeling with Aloe Vera – available at Target
  • Equate Liquid Personal Lubricant – available at Walmart
  • Wet Organics Organic Aloe Based Lubricant – available at CVS

Good Clean Love Almost Naked Personal Lubricant is iso-osmolar for vaginal use, hypo-osmolar for anal use. Its pH is on the higher end of the acceptable range for vaginal use, and its pH is acceptable for anal use. Good Clean Love is widely available at CVS, Walgreens, and Target, but it is also available at many regional and local grocery stores.

Good Clean Love Almost Naked

Aloe Cadabra is iso-osmolar for vaginal or anal use. It does contain citric acid, to which some people are sensitive.

The Equate Liquid Personal Lubricant listed is specifically this formulation is made with 99% natural ingredients. There are several different Equate Liquid Personal Lubricants, but only this one is free of glycerin and propylene glycol.

The Wet Organics Organic Aloe Based Lubricant is free of most problematic ingredients, but it does contain citric acid, to which some people are sensitive.

Fertility Lubes

The following water-based fertility lubes are free of chlorhexidine gluconate, polyquaternium, glycerin, and propylene glycol.

  • Pre-Seed Personal Lubricant – available at CVS, Walgreens, Walmart, and Target
  • Good Clean Love BioGenesis Fertility Lubricant – available at Walgreens

Pre-Seed is iso-osmolar for vaginal use. It does contain parabens, in case parabens are an ingredient that you want to avoid. It is also pricy, so it is probably not worth purchasing if you are not specifically in need of a fertility lube. In addition to these national chains, Pre-Seed can commonly be found at regional grocery stores and supermarkets.

Silicone Lubes

Silicone lubes are generally free of irritating ingredients, but the following lubes are free of fragrance, glycerin, and propylene glycol. Silicone lubes are generally not compatible with silicone toys but can safely be used with all types of condoms.

  • Astroglide X Premium Personal Lubricant – available at CVS, Walgreens, and Walmart
  • Astroglide X Silicone Gel – available at CVS and Walgreens
  • K-Y True Feel Deluxe Silicone Lubricant – available at Target
  • K-Y True Feel Premium Silicone Lubricant – available at CVS and Target
  • Lifestyles Skyn All Night Long Silicone Lube – available at Walgreens
  • One Move Deluxe Personal Lubricant – available at CVS and Walmart

In addition to being available at CVS, Walgreens, and Walmart, Astroglide X (in liquid and gel forms) is widely available at local and regional grocery stores across the United States.


[1] Charlene S. Dezzutti et al., “Is Wetter Better? An Evaluation of Over-the-Counter Personal Lubricants for Safety and Anti-HIV-1 Activity,” PLoS ONE 7, no. 11 (November 7, 2012), https://doi.org/10.1371/journal.pone.0048328.

[2] Othell Begay et al., “Identification of Personal Lubricants That Can Cause Rectal Epithelial Cell Damage and Enhance HIV Type 1 Replication in Vitro,” AIDS Research and Human Retroviruses 27, no. 9 (2011), https://doi.org/10.1089/aid.2010.0252.

The Best Lube: Bases and Textures

In my previous post, The Best Lube: Research and What to Avoid, I highlighted the research behind the ingredients, pH, and osmolality of lubes. If any of these terms are unfamiliar – or if you want to learn more – I recommend checking out the post.

While many lubes available in drugstores can be irritating or unsafe, there are safe lubes with different bases and textures. Lubes can be water-based, silicone-based, hybrid, or oil-based. In addition, there are lubes that have a more runny, liquid texture, and ones that are gel texture. Depending on how you are using lube, you might want to choose a particular base and texture.

What are you using lube for?

Vaginal sex? Anal sex? Oral sex? Masturbation?

Different uses have different considerations. Considerations for vaginal use include pH (3.8 – 4.5), osmolality, and potentially irritating or harmful ingredients.

Lube is particularly important for anal sex. It is possible to comfortably masturbate or have vaginal sex without lube, but anal is a different story. Anal sex without lube can result in anal tearing or increased risk of condom breakage[1]. Considerations for anal use include pH (5.5 – 7), osmolality, and potentially irritating or harmful ingredients.

Lubricants for oral sex may have different considerations than those for vaginal or anal sex, as flavored lubricants may be used either for fun or to change the taste of fluids. In this case, taste matters, and it’s difficult to recommend any particular flavor. When used vaginally, sugars and sugar derivatives in flavored lubes can be harmful to vaginal health, causing irritation or even yeast infections[2]. Some brands (like Sliquid’s Swirl) use non-sugar sweeteners.

For masturbation, the lube you choose may depend on whether you have a vagina or a penis. If you have a vagina, you should still follow the guidelines for vaginal sex.

If you are masturbating and have a penis, you might want something slick and thicker-textured. For this reason, silicone lubes and oil-based lubes may be your best choice.

Bases

Water-based Lubes

Water-based lubes are usually thinner than silicone-based, hybrid, or oil-based lubes. There are, however, thicker water-based lubes that can be used comfortably for anal use. Water-based lubes can be used safely with any toy material, including silicone.

Silicone-based Lubes

Silicone-based lubes are slicker and often thicker than ordinary water-based lubes. Silicone lubes avoid most of the potentially harmful or irritating ingredients that many water-based lubes include. On the other hand, silicone lubes are often not safe for use with silicone toys (in some cases toy manufacturers do suggest it is acceptable). Silicone lubes are excellent for anal sex due to their slickness and staying power. If you are not using a silicone toy, silicone-based lubes are also a good choice for masturbation.

Hybrid Lubes

Hybrid lubes are a mix of silicone and water. The addition of silicone enables these lubes to be thicker and longer-lasting than their water-based counterparts. However, unlike many silicone lubes, hybrid lubes can often be used with silicone toys without damaging the material. This varies by lube formulation and by individual toy, however, so spot-testing is still recommended. If you use hybrid lubes, you can check with the toy manufacturer, but a spot check can easily be performed by testing a small amount on a base or corner of a toy.

Oil-based Lubes

Oil-based lubes are free of the harmful additives present in many water-based lubes, but there are still caveats to using oil-based lubes. Oil-based lubes can raise vaginal pH, which is a potential concern for vaginal use[3]

While polyurethane condoms (e.g. FC2, Trojan Supra) can be safely used with oil-based lubes, both polyisoprene and latex condoms are sensitive to oil-based lubricants and should be avoided when oil-based lubricants are used. The World Health Organization lists a number of oil-based lubes that cannot be used with most condoms, including baby oil, vaseline, palm or coconut oil, cooking oil, mineral oil, and lotion[4].

Only certain oil-based lubes should be used, while others should be avoided. Many oil-based lubes designed for sexual use utilize plant-based oils including coconut, sunflower, argan, and almond oils.

Textures

Although water-based lubes are often thinner than silicone- or oil-based lubes, lubes are available in different textures. There are water-based lubes that are thicker than average or gel-textured, such as Sliquid Sassy or Good Clean Love, respectively.

 

Lubes on Dildo

From left to right: Sliquid Sassy, Sliquid Silk, Good Clean Love Almost Naked, and Wicked Simply Hybrid Jelle after 10 minutes

The picture above was taken after ten minutes to illustrate the differences between different bases and textures.

  • Sliquid Sassy and Good Clean Love are both water-based lubes, but Sliquid Sassy is more watery in comparison
  • Sliquid Sassy is thicker than the average water-based lube, but Good Clean Love Almost Naked has a true gel texture
  • Sliquid Silk and Wicked Simply Hybrid Jelle are both hybrid lubes, but Sliquid Silk – not being a gel – still slides down the surface
  • Wicked Simply Hybrid Jelle is a very thick lube, thicker than any non oil-based lube I have tried
  • After ten minutes, the gel textured lubes have hardly moved or evaporated
  • After ten minutes, Sliquid Silk has run down the dildo, but has not evaporated or run all the way down as Sliquid Sassy has
Wicked Simply Hybrid Jelle

Wicked Simply Hybrid Jelle

Wicked Simply Hybrid Jelle is very thick, as illustrated in the image above. Most gel textured lubes that I have tried are more comparable to Good Clean Love Almost Naked.

Current Recommendations

Water-based lubes

Thin texture:

Sliquids H20

Sliquids H20 is my favorite thinner water-based lube. It is pH-balanced (between 4.0 and 4.4) and free of many common ingredients that can be harmful or irritating. Sliquid lubes that are water-based contain citric acid. While citric acid is the last ingredient on the ingredient list, it can be irritating to some.

Ingredients: “Purified Water, Plant Cellulose (from Cotton), Cyamopsis (Guar Conditioners), Potassium Sorbate, Citric Acid (available on the Sliquids website)

Thick texture:

Sliquids Sassy

Sliquids Sassy is my favorite water-based lube. It is pH balanced (with a pH between 4.1 and 4.4) and a little thicker than average. For the most part, its ingredients list is free of irritating or harmful ingredients. Citric acid, the last ingredient on the list, can still be irritating to some.

Ingredients: Purified Water, Plant Cellulose (from Cotton), Cyamopsis (Guar Conditioners), Potassium Sorbate, Citric Acid (available on the the Sliquids website)

Gel Texture:

Good Clean Love Almost Naked

Good Clean Love’s Almost Naked is water-based, thickened with agar (derived from seaweed), and lightly flavored with lemon and vanilla. It lasts longer than many water-based lubes due to its thick texture. Good Clean Love’s Almost Naked is pH balanced (with a pH between 4.2 and 4.7) and is iso-osmolar (osmolality between 250 – 400 mOsmol/kg), making it a great choice for vaginal use. Personally, I am not a fan of the smell or flavor, but that is a matter of preference. Regardless of the smell and flavor, the formulation of Good Clean Love Almost Naked is among the best, and its osmolality is both known and appropriate for vaginal or anal sex.

Ingredients: Organic Aloe Barbadensis Leaf Juice, Xanthan Gum, Agar, Lactic Acid, Potassium Sorbate, Sodium Benzoate, Natural Flavor (available on the Good Clean Love website)

Hybrid lubes

Sliquid Silk

Sliquid Silk is a silky-smooth silicone lube that is pH-balanced (a pH between 4.1 and 4.4) and free of most harmful and irritating ingredients. Like most other Sliquid lubes, it does contain citric acid, which can be irritating for some people.

Ingredients: Purified Water, Plant Cellulose, Isopropyl Palmitate, Polysorbate 20, Dimethicone, Emollient Ester, Potassium Sorbate, Citric Acid (available on the Sliquids website)

[1] Anne Philpott, Wendy Knerr, and Vicky Boydell, “Pleasure and Prevention: When Good Sex Is Safer Sex,” Reproductive Health Matters 14, no. 28 (January 1, 2006): 23–31, https://doi.org/10.1016/S0968-8080(06)28254-5.

[2] Mantock, “Lube Can Alter Vaginal PH. Here’s What to Look for on the Label.”

[3] Mantock.

[4] World Health Organization, “Use and Procurement of Additional Lubricants for Male and Female Condoms: WHO/UNFPA/FHI360: Advisory Note.”

The Best Lube: Research and What to Avoid

When I first started having sex, my partner and I knew little about lube. We were lured in by warming lubes and other novelty lubes. Initially, I was only familiar with what was in the drugstore or shops in the mall; I never thought to look for lube at a sex shop.

Over time, I realized that I didn’t particularly like the lubes that I had tried, but I figured that there weren’t better options. I consider myself a smart consumer, but I thought that the drugstore gel lube was the best I was going to find.Years later, I realized that I was so wrong. Characteristics like osmolality, pH, and ingredients all affect the safety and comfort of lube.

This post is aimed at providing a detailed explanation and including research findings on the characteristics of lube. Future posts will be less technical, but I feel it is important to share this information and cite sources for further reading.

The Research

While I was wrong that there were no better options, most drugstore lubes are not ideal when pH and osmolality recommendations are considered. Manufacturers are usually not upfront about either of these metrics. In addition, some influencers and companies opportunistically sweep in to take advantage of disinformation and distrust, resulting in fearmongering. Most consumers don’t even know what lube is made of, but these ingredients matter.

Although most women use lube infrequently, it is generally used by women to decrease discomfort and pain and increase pleasure. Most women in the U.S. (65%) have used lube, and 20% have used it in the past 30 days[1]. Men who have sex with men also frequently use lube[2].

A healthy vagina is colonized by “good” bacteria called Lactobacilli. When the balance of bacteria is changed, and Lactobacilli are found in low numbers, the vagina becomes more prone to different infections, particularly bacterial vaginosis[3]. Bacterial vaginosis has been linked to increased susceptibility to a number of infections, including sexually transmitted infections.

Some lubes can disrupt the vaginal microbiome or damage vaginal or rectal tissue, resulting in irritation or even infections. If you wonder what lube you can use to avoid yeast infections or bacterial vaginosis (BV), and the information below can help you. If you’re unsure what is causing irritation, the information below can also help you figure out what lube ingredients you may want to avoid.

Ingredients

Water-based lubes can contain many ingredients, including preservatives, humectants (or moisturizers), and thickeners. Preservatives can include microbicides that prevent bacterial growth. Humectants can prevent the lube from drying out too quickly and can provide a slippery feel. Thickening ingredients can help change the texture to be thicker or gel-like.

Some of these ingredients can be harmful or irritating to vaginal or anal tissue. It’s possible that you won’t have a negative reaction to certain ingredients, but if you are experiencing irritation, discomfort, or vaginal infections, these ingredients could be the culprit.

Water-based lubes, which dry more quickly than silicone- or oil-based lubes, contain moisturizers or humectants to prevent evaporation. These humectants are used commonly in skincare products, but vaginal and anal tissue have different needs than ordinary facial or body skin.

Humectants

Humectants are moisturizers commonly used in personal care products such as skincare products.

Commonly used humectants in lube include glycerol/glycerin(e), and propylene glycol. Glycerol or glycerin(e) is a sugar byproduct (or sugar alcohol). Propylene glycol is a common ingredient in personal care products.

Glycerol and propylene glycol can be problematic particularly when found in large quantities in a water-based lube, making these lubes hyperosmolar (see below). Glycerine and propylene glycol in lube were also associated with an increase in HSV-2 (herpes) in an animal study[4]. In higher concentrations, propylene glycol has been associated with contact dermatitis and allergic reactions[5].

Hyaluronic acid is a humectant that naturally occurs in the skin and is frequently used in skincare products. Hyaluronic acid has been found to be safe and effective for resolving vulvar and vaginal pain in postmenopausal women and cancer survivors[6]. It is more commonly found in vaginal moisturizers, but it is also found in lubes such as Sutil Luxe and Sutil Rich. In some cases, hyaluronic acid can be found in its salt forms, sodium hyaluronate and potassium hyaluronate.

Preservatives

Polyquarternium

The World Health Organization (WHO) indicates that polyquarternium-containing lubes may allow HIV-1 to replicate more quickly. Specifically, researchers found a link between HIV-1 replication and the compounds polyquarternium-15 and MADQUAT[7]. Although polyquaternium compounds are different, the WHO recommends that lubes containing polyquarternium be avoided until further research is conducted[8].

Microbicides

Microbicides, like the spermicide nonoxynol-9 (commonly used in Trojan condoms), can be harmful to vaginal and anal tissue. Nonoxynol-9 is known to be associated with an increased risk of contracting HIV-1[9]. In an animal study, nonoxynol-9 was associated with increased risk of HSV-2 (herpes)[10]. Nonoxynol-9 has also been shown to reduce the growth of healthy Lactobacilli bacteria[11].

Chlorhexidine gluconate is commonly used in antiseptic mouthwashes and in surgical lubricants, but it is also occasionally used in lube (including some of the most common drugstore lubes). In a recent study, lubes containing chlorhexidine gluconate were found to diminish the growth of healthy Lactobacilli bacteria[12]. Chlorhexidine gluconate also can damage mucosal surfaces[13] and in an animal study, it both increased vaginal sensitivity and increased susceptibility to chlamydia[14].

Parabens

Parabens are preservatives commonly used in cosmetics and food. While it is not clear that parabens are harmful in small amounts, they resemble a weak estrogen. Currently, there is no evidence that parabens cause cancer or disrupt hormones in human beings[15]. Many women who are survivors of breast cancer avoid estrogens and may avoid parabens out of an abudance of caution. Parabens are relatively non-allergenic, but a small percentage of the population is allergic to parabens[16]. If you don’t feel comfortable using parabens, there are many lubes that are paraben-free.

Other Ingredients

Benzocaine

Benzocaine is used in desensitization and numbing lubes. While it can be used for penis desensitization to increase the length of intercourse, it should be avoided for anal sex. Anal numbing lubes are commonly sold at novelty stores and some sex shops to ease discomfort and pain with anal sex. These lubes can be harmful[17]! Pain during anal sex can indicate that something is wrong – for example, tearing or tissue damage. Instead, anal discomfort than be avoided by preparing for anal using toys and using lubes that are thicker, or silicone based.

Carrageenan

Carrageenan is a seaweed-derived ingredient commonly used to thicken foods and drinks. It is also a potent inhibitor of HPV[18], and some studies have found that a proprietary carrageenan lubes (Divine 9) can help prevent HPV transmission[19].

pH

pH, which you may remember from chemistry class, is the measure of how acidic of basic a water-based solution is. When shopping for lube, this means that only water-based (and hybrid) lubes will have a pH value. At the same time, lubes that aren’t water-based can still raise vaginal pH – oil-based lubes can raise vaginal pH[20].

A healthy pre-menopausal[21] vagina has an acidic pH of 3.8 to 4.5[22], while the rectum is closer to a neutral pH of 7. Unfortunately, some manufacturers don’t seem to take vaginal pH into consideration when producing lube. This is unfortunate, because an increase in vaginal pH can result in bacterial vaginosis and trichomoniasis infections[23]

The World Health Organization recommends that vaginal lube have a pH of around 4.5 or less, while anal lube should have a pH in the range of 5.5 to 7[24].

Osmolality

Osmolality refers to the concentration of particles in a solution. In this case, the concentration of lube is measured in milliosmoles per kilogram of water (mOsmol/kg).

Lube will first come into contact with the vagina or rectum through the epithelial layer – the uppermost layer that lines the vagina and rectum. Lubes that have a similar osmolality to vaginal fluid are called iso-osmolal. Other lubes may have a lower osmolality (hypo-osmolal) or a higher osmolality (hyperosmolal). In the case of vaginal use, use of a hyperosmotic lube can result in water being sucked out of vaginal tissues, resulting in a drying effect.

Hyperosmolal lubes have been found to cause damage to both rectal[25] [26] and vaginal[27] [28] [29] [30] tissue. This damage can result in both 1) increased susceptibility to sexually transmitted infections and 2) a decrease in the friendly lactobacilli bacteria that can help protect the vagina against infection.

In a review of studies that measured the osmolality of 44 common lubricants, researchers found that 86% were hyperosmolal[31]. Across these studies, only a few lubes were both at an appropriate pH and hypo-osmolal or iso-osmolal, particularly for vaginal use. Unfortunately, osmolality is not something that can be measured at home, and most manufacturers don’t provide osmolality values. Many hyperosmolar lubricants are hyperosmolar because they contain a large quantity of glycerin and/or propylene glycol[32], so the placement of these ingredients in a lube’s ingredient list could be a clue that it may be hyperosmolar.

Other resources

References:

[1] Debby Herbenick et al., “Women’s Use and Perceptions of Commercial Lubricants: Prevalence and Characteristics in a Nationally Representative Sample of American Adults,” Journal of Sexual Medicine 11, no. 3 (March 1, 2014): 642–52, https://doi.org/10.1111/jsm.12427.

[2] Marjan Javanbakht et al., “Preference and Practices Relating to Lubricant Use during Anal Intercourse: Implications for Rectal Microbicides,” Sexual Health 7, no. 2 (2010), https://doi.org/10.1071/SH09062.

[3] S. S. Witkin and I. M. Linhares, “Why Do Lactobacilli Dominate the Human Vaginal Microbiota?,” BJOG: An International Journal of Obstetrics and Gynaecology, 2017, https://doi.org/10.1111/1471-0528.14390.

[4] Thomas R. Moench et al., “Microbicide Excipients Can Greatly Increase Susceptibility to Genital Herpes Transmission in the Mouse,” BMC Infectious Diseases 10 (November 18, 2010), https://doi.org/10.1186/1471-2334-10-331.

[5] Soogan C Lalla et al., “Patch Testing to Propylene Glycol: The Mayo Clinic Experience,” Dermatitis 29, no. 4 (2018), https://journals.lww.com/dermatitis/Fulltext/2018/07000/Patch_Testing_to_Propylene_Glycol__The_Mayo_Clinic.6.aspx.

[6] Junya Chen et al., “Evaluation of the Efficacy and Safety of Hyaluronic Acid Vaginal Gel to Ease Vaginal Dryness: A Multicenter, Randomized, Controlled, Open-Label, Parallel-Group, Clinical Trial,” Journal of Sexual Medicine 10, no. 6 (2013), https://doi.org/10.1111/jsm.12125; Jeanne Carter et al., “A Single-Arm, Prospective Trial Investigating the Effectiveness of a Non-Hormonal Vaginal Moisturizer Containing Hyaluronic Acid in Postmenopausal Cancer Survivors,” Supportive Care in Cancer 29, no. 1 (2021), https://doi.org/10.1007/s00520-020-05472-3.

[7] Othell Begay et al., “Identification of Personal Lubricants That Can Cause Rectal Epithelial Cell Damage and Enhance HIV Type 1 Replication in Vitro,” AIDS Research and Human Retroviruses 27, no. 9 (2011), https://doi.org/10.1089/aid.2010.0252.

[8] World Health Organization, “Use and Procurement of Additional Lubricants for Male and Female Condoms: WHO/UNFPA/FHI360: Advisory Note” (World Health Organization, 2012), https://apps.who.int/iris/bitstream/handle/10665/76580/WHO_RHR_12.33_eng.pdf?sequence=1&isAllowed=y.

[9] Lut Van Damme et al., “Effectiveness of COL-1492, a Nonoxynol-9 Vaginal Gel, on HIV-1 Transmission in Female Sex Workers: A Randomised Controlled Trial,” Lancet 360, no. 9338 (September 28, 2002): 971–77, https://doi.org/10.1016/S0140-6736(02)11079-8.

[10] Moench et al., “Microbicide Excipients Can Greatly Increase Susceptibility to Genital Herpes Transmission in the Mouse.”

[11] Dong Wook Park et al., “The Effects of Vaginal Lubricants on the Human Vagina: An in Vitro Analysis,” Clinical and Experimental Obstetrics and Gynecology 46, no. 3 (2019), https://doi.org/10.12891/ceog4671.2019.

[12] Pawel Laniewski et al., “Clinical and Personal Lubricants Impact the Growth of Vaginal Lactobacillus Species and Colonization of Vaginal Epithelial Cells: An in Vitro Study,” Sexually Transmitted Diseases 48, no. 1 (2021), https://journals.lww.com/stdjournal/Fulltext/2021/01000/Clinical_and_Personal_Lubricants_Impact_the_Growth.11.aspx.

[13] Rebecca M. Brotman et al., “Rapid Fluctuation of the Vaginal Microbiota Measured by Gram Stain Analysis,” Sexually Transmitted Infections 86, no. 4 (2010): 297–302, https://doi.org/10.1136/sti.2009.040592.

[14] Sharon L. Achilles et al., “Microbicide Efficacy and Toxicity Tests in a Mouse Model for Vaginal Transmission of Chlamydia Trachomatis,” Sexually Transmitted Diseases 29, no. 11 (2002), https://doi.org/10.1097/00007435-200211000-00007.

[15] Raphael J. Witorsch and John A. Thomas, “Personal Care Products and Endocrine Disruption: A Critical Review of the Literature,” Critical Reviews in Toxicology, 2010, https://doi.org/10.3109/10408444.2010.515563; Mark G. Kirchhof and Gillian C. de Gannes, “The Health Controversies of Parabens.,” Skin Therapy Letter 18, no. 2 (2013).

[16] Anthony F Fransway et al., “Parabens,” Dermatitis 30, no. 1 (2019), https://journals.lww.com/dermatitis/Fulltext/2019/01000/Parabens.2.aspx.

[17] Kelli Acciardo, “4 Harmful Lube Ingredients You Should Avoid At All Costs | Prevention,” Prevention, 2016, https://www.prevention.com/sex/g20482085/personal-lubricant-ingredients-to-avoid/.

[18] Christopher B. Buck et al., “Carrageenan Is a Potent Inhibitor of Papillomavirus Infection,” PLoS Pathogens 2, no. 7 (2006): 0671–80, https://doi.org/10.1371/journal.ppat.0020069.

[19] Dianne Marais et al., “The Effectiveness of Carraguard, a Vaginal Microbicide, in Protecting Women against High-Risk Human Papillomavirus Infection,” Antiviral Therapy 16, no. 8 (2011): 1219—1226, https://doi.org/10.3851/imp1890; Aixa Rodríguez et al., “In Vitro and in Vivo Evaluation of Two Carrageenan-Based Formulations to Prevent HPV Acquisition,” Antiviral Research 108 (2014): 88–93, https://doi.org/https://doi.org/10.1016/j.antiviral.2014.05.018.

[20] Rachel Mantock, “Lube Can Alter Vaginal PH. Here’s What to Look for on the Label,” The Femedic, 2019, https://thefemedic.com/sexual-health/lube-can-alter-vaginal-ph-heres-what-to-look-for-on-the-label/.Mantock.

[21] Kelly M. Tucker et al., “Vaginal PH: A Simple Assessment Highly Correlated with Vaginal Morphology and Symptoms in Postmenopausal Women,” Menopause 25, no. 7 (2018), https://doi.org/10.1097/GME.0000000000001081.

[22] Stephanie Watson, “Vaginal PH Balance: Normal Levels, Correcting Unbalanced PH & More,” Healthline, 2019, https://www.healthline.com/health/womens-health/vaginal-ph-balance.

[23] Ana Raquel Cunha et al., “Characterization of Commercially Available Vaginal Lubricants: A Safety Perspective,” Pharmaceutics 6, no. 3 (2014), https://doi.org/10.3390/pharmaceutics6030530.

[24] World Health Organization, “Use and Procurement of Additional Lubricants for Male and Female Condoms: WHO/UNFPA/FHI360: Advisory Note.”

[25] Edward J. Fuchs et al., “Hyperosmolar Sexual Lubricant Causes Epithelial Damage in the Distal Colon: Potential Implication for HIV Transmission,” Journal of Infectious Diseases 195, no. 5 (March 1, 2007): 703–10, https://doi.org/10.1086/511279.

[26] Begay et al., “Identification of Personal Lubricants That Can Cause Rectal Epithelial Cell Damage and Enhance HIV Type 1 Replication in Vitro.”

[27]Els Adriaens and Jean Paul Remon, “Mucosal Irritation Potential of Personal Lubricants Relates to Product Osmolality as Detected by the Slug Mucosal Irritation Assay,” Sexually Transmitted Diseases 35, no. 5 (2008), https://doi.org/10.1097/OLQ.0b013e3181644669.

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