An In-Depth Look At Personal Lubricants: Safety, Science, and Lube Ingredients

Ask anyone on the street what type of lube they use, and the answer will probably be K-Y or Astroglide (and some raised eyebrows). Most don't realize these two lubes are risky for vaginas and butts, and can lead to infections, irritation, and increased STI susceptibility[1][6-13]

This guide will broaden your lube horizons beyond K-Y and show you the healthiest, safest, and best feeling lube for the sex-tivities you enjoy most.  You'll also learn about the science behind lube and how it works.

Who uses lube?

89% of MSM relationships in San Francisco use lube on a regular basis[2].  Lube is an absolute must for anal sex, where the body provides very little natural lubrication, without it, delicate rectal tissue is easily damaged and torn.

A survey of 1,021 women found that 20% had used lube within the last 30 days, and 65.5% had used it at least once in their lifetime[3].  For vaginas, lube can make sex more comfortable, fun, and pleasurable and decrease discomfort/pain.

A similar survey found 25% of men had used lube within the last 30 days, and 70% had used it at least once in their lifetime[4].

Chapter 1:

The Lube Families

There's four main types of lube: water-based, silicone-based, plant-based, and hybrid.  The 'base' is the main ingredient in the lube, other ingredients are added in to alter the thickness and add other properties like flavoring.

Water Family

These lubricants are around 95% water, and feel like the vagina's natural lubrication (also mostly water).

Since water is so cheap, so are water-based lubes, which helped this type make up 72.5% of all lube sales in 2015[5].

Other ingredients are added to water to make it thicker, giving it a slippery feeling we can swirl in our fingers.  You'll also find preservatives, humectants, and dispersants in most water-based lubes.

Some of these ingredients are very controversial.  Lubes like K-Y use petroleum derived ingredients like glycerin and preservatives like chlorahexide that recent studies have found can damage vaginal and anal tissues, leading to an increased risk of infections, STIs, and Irritation.  The companies stick with these ingredients because they are cheaper than healthy alternatives like seaweed extract and citric acid.

Pros

Inexpensive

Water soluble, easy to clean 

Feels similar to the vagina's natural lubrication

Cons

Some can contain risky ingredients

Evaporates quickly and needs frequent reapplication, especially for external use

Silicone Family

Meet the silicones.  A lube family with truly super-lubricant powers.

Unlike water, silicone ingredients don't evaporate or absorb into the skin.  The result? A lube that keeps going and going and going.  This lube can last your entire sex without needing reapplication.

It's also completely impervious to water.  This makes it a pain to get off your hands, but let's you reach a whole new level of shower sex possibilities.

Silicone lube is also inert, non-toxic, and hypoallergenic.  It doesn't need preservatives, and is shown to be one of the safest and gentlest lubes ever applied to delicate tissue[6].  

There's a dark-side to silicone lube, though.  It hates silicone rubber, a popular and expensive sex toy material.  I don't know why exactly, there's probably a good reason; what I do know, is that as soon as they touch, silicone lube will warp and mangle your sex toy, which hopefully is not your new $200 Fun Factory Stronic Surf (my situation 3 years ago, rip).  

You've been warned, keep these two rough-housers away from each other.

Pros

Very long lasting

Hypoallergenic, inert, and non-toxic; doesn't absorb into the skin

No smell

Compatible with condoms, and usually the type of lube that comes on pre-lubricated condoms.

Cons

Can warp and ruin sex toys made of silicone

Difficult to clean

Plant Family

Plant-based lubes contain natural ingredients like coconut oil, cocoa butter, shea butter, and aloe vera.  They are all usually 100% organic and some of the most gentle personal lubricants on the skin.

Unlike water-based lubricants, these do not need added ingredients like thickeners, humectants, and many are naturally self-preserving and don't need any added anti-microbial chemicals.

And because there is no water these lubricants have no pH and no osmolality (more about these terms in the next section) which makes them extra safe on vaginal and anal tissues.

They aren't compatible with latex condoms though, same goes for other oil-based lubricants.  The oil will cause the latex to warp and easily break.  However, they do work with condoms made of polyurethane.

Pros

Gentle and hydrating

Often 100% organic

Compatible with sex toys

Lasts longer than water-based lubes

Cons

Not compatible with latex condoms

Take longer to completely exit the body

Hybrids

When a water lube and a silicone lube meet, they make beautiful lube babies together called hybrid lubes.  

The most popular hybrid is Sliquid Silk which contains 12% silicone by volume.  These feel like water-based lubes, but last like silicone lubes.  They are also easier to clean up and can be used on silicone sex toys. 

Other Hybrid lubes include Good Vibrations Please Cream, and 'Pop! Lube'

Household Lubes

Lubes around the house deserve a special mention.  These aren't marketed for sex, but make good substitutes in a pinch.  It's important that you only use safe lubes.  The best options for vaginal use are pure coconut oil or shea butter.  I would not recommend trying anything besides these two because of the high absorption of vaginal tissue, whatever chemicals you put inside you can easily be absorbed into the blood stream[18].

These rules don't apply to the penis, which is less delicate and only has mucosa tissue in the urethra.  Using highly acidic makeshift lubes, or lubes with harsh preservatives have the potential to cause urethral irritation and burning.

Safe Household Lubes

Coconut oil

Shea butter

AVOID (Dangerous for vaginal and anal tissue)

Vaseline

Anything with sugar in it (honey, whipped-cream, etc)

Water-based gels

Risky Lubes - Recently, lubes like K-Y, Gynol, Durex Play, and Astroglide have come under scrutiny for using petroleum-derived ingredients and harsh preservatives[1].  In some studies these lubes were shown to damage tissue and increase the risk of B.V., Yeast Infections, and lower the body's natural STI defenses[7-13].  In light of the studies, the United Nations' world health organization made an announcement recommending people avoid many water-based lubricants on the market[1].

To understand the controversies around water-based lubes, it helps to know some sexy science.

Chapter 2:

Water Lube Science

You shouldn't need a chemistry degree to pick out a lube.  However, by understanding pH, osmolality, and how they interact with your delicate tissue, you'll be a much better judge of water lubes.

Osmolality - Explain It Like I'm Five

In 2012, the United Nations' World Health Organization announced that all water lubricants above an osmolality of 380 mOsm/kg are a potential health hazard and should be avoided[1].

Osmolality is the concentration of a solution, aka the amount of stuff in water besides H20.  Using scientific instruments call osmometers, scientists can measure a liquid's osmolality and get a number of mOsm/kg or milismoles per kilogram.

Here's some osmolality measurements of different liquids[14]:

  • Pure water - 0 mOsm/kg
  • Tap Water - 3 mOsm/kg
  • Peppermint Tea - 184 mOsm/kg
  • Cell Fluid - 285 mOsm/kg
  • Blood - 290 mOsm/kg
  • Sperm - 380 mOsm/kg
  • Fanta - 415 mOsm/kg
  • Carrot Juice - 561 mOsm/kg
  • Red Wine - 2573 mOsm/kg

Cell fluid, at 280-290 mOsm/kg, is also the osmolality of the vaginal and anal environment.  Safe lubricants are Iso-osmolar to cell fluid, meaning they are close to this 280-290 range, and like the United Nations recommends, we definitely want to avoid lubes above 380 mOsm/kg, aka the hyperosmolar.

Hyperosmolar

A hyperosmolar lube has a higher osmolality than the fluid in your cells, and when the two touch, osmosis happens, a reaction where natural forces attempt to balance the difference of water in two concentrations.  

This means lube will suck water out of your tissue causing cell death and tissue dehydration.  The long term affects of using hyperosmolar lubes include dryness, painful irritation, B.V., yeast infection risk, and lowered STI defenses[7-13].    

Some hyperosmolar lubes include K-Y Jelly, Astroglide Liquid, and Wild liquid[36].  The most hyperosmolar lube studied is K-Y warming jelly at 10,300 mOsm/kg, 36 times the bodies natural level.  A 2010 study showed that mice exposed to the KYWJ were 9 times more susceptible to herpes.[11]

Hypo-osmolar

These lubes have a lower osmolality than your tissue.  Now the tables are turned, and your cells suck the water out of lubricants, causing them to swell and eventually burst.

Hypo-osmolar lubes are more rare than hyper-osmolar lubricants, and there is only one study showing that a hypo-osmolar lubricant (Slippery Stuff) caused damage to vaginal tissue[6].  Slippery stuff had an osmolality of 13, about 22 times less than the your natural lubricant's osmolality.  Other lubes like Sliquid H20 have an osmolality of 103 (three times less), but didn't cause any damage to vaginal tissue.

Iso-osmolar

These lubes are closest to that sweet spot of 285-295 osmolality.  When an iso-osmolar lube and cell meet they respect each other's personal space and don't steal water from the other.  'Leave the vagina as you found it' is the motto of iso-osmolar personal lubricants.   Iso-osmolar lubes are the safest and have been shown to not only leave the epithelial layer unscathed, but also restore and rejuvenate cell growth[13].

Lube pH

The pH scale measures how acidic a liquid is.  0 pH is the most acidic, and 14 is the least acidic.  

The vagina is naturally acidic, with a pH of 3.5 - 4.5[15].  This acidity, created by lactic-acid producing lactobacilli, keeps the vagina clean, and prevents bad bacteria and pathogens from growing out of control[6][15][16].  A vaginal lube should have a pH in this 3.5 - 4.5 range.  If the pH is too high, the lube can lower your natural defenses against infections and STIs.

The anal environment is less acidic than the vagina, with a pH of 6-7.  The slight acidity acts as a buffer between alkaline fecal matter and the body.  Since most water-based lubes have a pH of 4-5, some people with sores or lesions can have burning when using these lubes anally.  If you experience any burning during anal play, try switching to a silicone-based or plant-based lube, which don't have pH levels.


Chapter 3:

Vaginal and Anal Tissue

The vagina is very skilled at taking care of itself and keeping things clean.  Vaginal fluids flush out anything that shouldn't be there, and healthy flora produce lactic acid to kill off attacking microbes.[15]

If the natural ecosystem is disrupted though, risks of infection increase.  To better understand how things get unbalanced, it helps to know a bit about the Epithelium, Mucosa, and Lactobacilli.

Epithelial Layer (Epithelium) 

Both the vagina and the rectum have epithelium, the outer most layer of skin and first line of defense against pathogens and STIs.  The epithelium in the rectum is only one cell layer thick and very delicate.  Epithelium in the vagina is several cell layers deep, making it more flexible and durable[17].

Epithelial layer cells are the first ones damaged by the hyperosmolar lubes we talked about in the previous section.  Damaged cells means the epithelium barrier is compromised and STIs can stroll right in[6][9][13].  Below are four images from a 2018 study comparing the effects of different lubricants on epithelium.  Iso-osmolar lubricants like Aloe Cadabra had no effect on barrier integrity, while hyperosmolar lubes like K-Y and Astroglide caused significant tearing.

The effects of different lubricants on vaginal epithelium[13]

Mucous Membrane (Mucosa)

Mucous membranes are moist skin inside orifices like the nose, mouth, vagina and rectum.  The mucous they produce washes away foreign matter and adds lubrication for things coming in and out of the body.  The epithelial layer we just talked about is the first layer of the mucosa.

The vaginal mucosa absorbs chemicals very easily[15].  Absorbtion is so effective, that scientists have even been experimenting delivering drugs vaginally instead of orally[18].  This is another reason why it's important to be careful of what you put inside your vagina.  No one knows the long term effects of absorbing risky ingredients like petrochemicals and xenoestrogens into the blood stream.

Lactobacilli - The Vagina's Little Gatekeepers

The vagina has its own ecosystem of bacteria called Flora.  In a healthy individual, the prevalent species is Lactobacilli and the Lactic acid they produce lowers vaginal pH and prevents infections.  Lactobacilli also attach themselves to the epithelial layer cells, preventing bad bacteria from having a place to set up shop[19].

If a lube with strong preservatives kills off the lactobacilli the gates to the vagina are left unguarded; pH increases and bad bacteria swoop in and take over, causing infections like B.V. and yeast infections[15].

K-Y Jelly kills all three species of Lactobacillus it's applied to, which researchers believed this was caused by the ingredient Chlorahexidine, a strong preservative.[6]  In the same study, silicone lubricants, plant-based lubricants, and water-based lubricants using citric acid as a preservative did not kill lactobacillus.

Chapter 4:

Lube Reactions

Unpleasant lube reactions either happen quickly, within a few minutes to a few hours after using them, or gradually, taking weeks of regular use to show up.

Sudden Lube Reactions

These happen after a few minutes of exposure and cause stinging, burning, and rashes.

Contact Dermatitis includes rashes, bumps, and redness, along with itchiness or pain. It's been known to be caused by lube chemicals like N9, Glycerin, and Chlorahexidine.  The risk of having a reaction depends on how sensitive your skin is, and how much lubricant you use.

Allergic reactions are when your body has an auto-immune response to a chemical.  These are rare and risk varies from person to person.  Some ingredients that are more likely to cause an allergic reaction are chlorhexidine and benzocaine. 

Gluten Intolerance -  If you suffer from celiacs disease, avoid ingesting lubes with oat beta gluten and vitamin E tocopherals, which can cause gluten intolerance symptoms.

Gradual Lube Reactions 

These happen after using a lubricant regularly for weeks.  Over constant exporsure, a harsh lube disrupts the vagina's natural environment leading to Bactera infections, yeast infections, and an increased chance of contracting STIs[13].  The worst part is that most people blame their body, diet, or their partner for infections and go right on using harmful lubricants.

Bacterial Vaginosis (BV)

If vaginal flora becomes unbalanced from Lactobacilli death, then harmful bacteria like Gardnerella Vaginalis and Mycoplasma multiply out of control and can reach 1000 times their normal level[20].

The heightened bad bacteria count causes discolored discharge, a strong fishy smell, itching, and burning after peeing, increased STI risk, and premature births.  Bacterial vaginosis has also been found to be associated with cervicitis, endometritis, salpingitis, and tubal factor infertility[20].  B.V. can go away on its own, but in serious situations requires anti-biotics for treatment.[21]

Vaginal Yeast Overgrowth (Candidiasis)

Another member of vaginal flora is a yeast called candida.  It's also kept in line by Lactobacilli, and it also, grows out of control if Lactobacilli is missing.  Too much candida growth leads to Candidiasis, a yeast infection that shows up as a visible white fungus and feels itchy and uncomfortable[15]. 

Candida can also have a grow out of control from feeding on water-based lubes containing glycerin, or maltodextrin, and on flavored lubes with sugar or honey.[7]

Increased STI Risk

Harsh Lubes increase the risk of STIs in more way than one.  First, when hyperosmolar lubes damage the epithelial layer, susceptibility to STIs like HIV and Herpes increases[6-13].  Second, Lactobacilli kill-off lowers vaginal acidity, a natural defense against pathogens. In addition, conditions caused by the lack of lactobacilli, like BV and Candidiasis, even further compromise defenses[15].

Other studies have found that polymer Ingredients like PQ15, can aid the viral infection processes by increasing viral attachment[22-25]  PQ15 is an artificial preservative found in Astroglide Liquid.

Chapter 5:

Lube Regulations & Animal Testing

It's been since 7 years since the United Nations' WHO announced that hyperosmolar lubes have big risks. So why are they still on the shelves in the USA?  It all comes down to the FDA approval process for personal lubricants, which some scientists aren't very happy with it[13].

For starters, a new lube is tested on rabbits and not people.  Not only is it cruel to put K-Y warming jelly on a rabbit, but their vaginal environment is very different than a person's[26].  Lube Researcher, Richard Cone, argues that this difference makes safety tests inaccurate.

A Rabbit Afraid of K-Y Warming Jelly

The FDA approval process tests new personal lubricants on rabbits.

Moreover, the FDA considers anal use an off-label application of personal lubricants and does not do any tests exposing them to tissue in the rectum[7]. Considering that 89% of MSM relationships use lubricant[1], and the damage of hyperosmolar lubes to colorectal tissue[13], a large group of at risk people are ignored.

The FDA also has GRAS, a list of chemicals that are "Generally Recognized as Safe" and products containing GRAS ingredients do not need to be tested.  Richard Cone argues that GRAS chemicals are tested on the skin, NOT vaginal tissue, which is a very different environment[13].  Once these not-so-safe lubes are approved, a company doesn't have to list the ingredients on the label, which makes self-regulation difficult.[7]  

Chapter 6:

Behind The Label: Lube Ingredients

Every lube ingredient falls into a category: some add thickness, some help disperse the ingredients evenly, and some are preservatives to prevent mold and bacteria from growing. 

Ingredient Purposes:

  • Base - makes up majority of a lube, other ingredients are added to the base to get the desired properties.
  • Preservatives - prevent mold and bacteria from growing and increases the lube shelf life.
  • Thickeners - keep the base from being too runny.
  • Dispersants - keep ingredients from separating.
  • Humectants - prevent a lubricant from evaporating.
  • Flavors - added to to oral lubricants for a better taste.

Chemical Categories

  • Petrochemicals - ingredients derived from crude oil.
  • Xenoestrogens - chemicals that mimic the effects of estrogen and can cause sexual development problems

What's In Your Lube?

Glycerin thickens water and works as a humectant to prevent K-Y from evaporating.

  • A sugar alcohol that can be derived from soybeans, petroleum, animal fats and palm trees.  
  • Glycerin greatly increases the osmolality of a lubricant[6], which can contribute to cell death, irritation, and yeast overgrowth[6-13].

Found In: K-Y Jelly, Astroglide Liquid

Carrageenan - A natural thickener derived from red seaweed. 

  • Can reduce and inhibit HIV, Herpes, and HPV transmission without causing damage to mucous membranes[29].

Found In: Waterslide

Chlorhexidine is a synthesized chemical used as a disinfectant and anti-septic.  

  • In lube, it is used as an inexpensive preservative.  
  • Chlorhexidine was found to kill three types of Lactobacillus it was exposed to.[6]  Lactobacilli creates lactic acid in the vagina, and helps prevents bacteria infections and STI transmission.

Found In: K-Y Jelly

Citric Acid - If your lubricant smells like lemons, it probably contains citric acid, the most common preservative used in organic water-based lubes.

  • Increases the acidity of a lubricant
  • Natural and mild preservative

Found In: Waterslide

Sodium Hydroxide is used in soap, detergents, and drain cleaning fluid.  Also known as caustic soda or lye.

  • Works as a preservative in personal lubricants
  • Caused epithelial cell damage when used at a concentration of 2.5%[28].

Found In: K-Y Jelly

Polyquaternium-15 - Polyquaternium, abbreviated PQ, is a family of synthesized chemicals that comes in 55 different numbers.  Each number is a a different variation of Polyquarternium, and shows the chronological order that it was registered with the International Nomenclature for Cosmetic Ingredients (INCI).  The newest at the time of this article's writing is PQ-55.

  • Works as a preservative and makes lube more gel like.
  • In tests it has been shown to increase the permeability of cell walls, and increase the risk of contracting HIV[12].
  • Causes inflammation to epithelial cells[27]
  • Can be absorbed into the body through open sores and damaged tissue.  Long term effects of repeated exposure are unknown.

Found In: Astroglide Liquid

Organic Aloe Barbadensis Leaf Juice is made from the aloe vera plant and also called aloe vera juice.  It's mostly water, but contains minerals that strengthen, soothe, and repair tissues, instead of harming them.  

  • Aloe Vera also has natural anti-fungal and anti-microbial properties[30] and requires less preservatives than water-based lubricants.

Found In: Good Clean Love

Methylparaben / Propylparaben - Parabens are synthetic preservatives and weak xenoestrogens.

  • Any chemical ending in -paraben belongs to the paraben family.  The strongest irritant is butylparaben, and others include methylparaben, propylparaben, and ethylparaben.
  • Weak xenoestrogens and shown to disrupt hormone dependent organs in gerbils[31], however no studies have determined potential effects of parabens applied directly to the genitals.

Found In: Astroglide Liquid

Potassium Sorbate - A potassium salt that occurs naturally in berries, but is usually created synthetically.  It works as a preservative and keeps mold and fungus from growing inside a lubricant.

  • Used in small amounts as a natural preservative in lube.
  • Lubes containing it were not shown to cause epithelial cell damage or Lactobacilli death[6].

Found In: Good Clean Love

Propylene Glycol - A substitute for glycerin that works as a humectant to prevent water from evaporating.

  • Can be made from petroleum or corn syrup.
  • Like glycerin, it greatly increases the osmolality of a lube[6] and puts you at risk for irritation, B.V., cell death,  and increased vulnerability to STIs[6-13].

Found In: Astroglide Liquid

Sodium Benzoate - This is a preservative produced by reacting sodium hydroxide and benzoic acid.

  • It's been shown cause contact dermatitis and epithelial damage when used in concentrations above 5%[32].
  • In lubes using less than 1% Sodium Benzoate, like Good Clean Love, was not shown to damage vaginal tissue or vaginal flora[6][13].

Found In: Good Clean Love

Propendiol (Natural)- Naturally derived propendiol is a clear viscous liquid and a natural humectant used to prevent water-based lubricants from evaporating.

  • Derived from corn syrup and makes up a small percentage of the lubricant.
  • In rare cases can cause irritation in people with sensitive skin.

Found In: Waterslide

Chapter 6:

Finding Your Perfect Lube


Since every body is different, there's no guarantee that any one lube will work perfectly for everyone.  We can get pretty accurate, though, just by searching for lubes that meet our own personal criteria and needs.

Key

Water-based

Silicone-based

Plant-based

Best Safe Anal Lubes

Anal Lubricants should be...

Thick and long lasting; extra cushion for the pushing

Silicone-based (unless using silicone sex toys)

If water-based, anal lube should be iso-osmolar with a pH of 6-7

Here are some good anal lubes that meet the above requirements.

Sliquid Silver - silicone based

Uberlube - silicone based

Pjur Back Door - silicone based

Sliquid Sassy (Thickest Iso-Osmolar Water Lube)

Aloe Cadabra (Water)

Ride H20 (Water)

Southern Butter Bliss-on

Lubes For Conception

Lubes with glycerin can damage sperms and slow their sprint to the uterus.  Here are some glycerin free lubes that will help, not hinder, the baby making process.  

  • Waterslide - good for sensitive skin or skin allergies, good if you are prone to chronic BV or yeast infections.
  • Coconu Water Based - Natural and organic
  • Yes Baby - Natural and organic
  • Preseed
  • Sliquid Organics Oceanics

Flavored Lubes

When it comes to flavored lubes it is important to avoid products that contain sugars and sugar derivatives, which can cause a yeast infection.  The flavored lubes in this list contain natural flavorings that don't mask natural tastes just enhance them.  They contain small amounts of citric acid, which is a preservative found in foods and completely edible.

  • Hathor Lubricant Lickeurs - natural and organic
  • Sliquid swirl - eight flavors
  • Aloe Cadabra Flavored Lubes (Tastiest)
  • Blossom Organics - Doesn't taste bad

Warming and Stimulating Lubes

Warming and stimulating lubes contain different herbal extracts.  Some contain small amounts of Capsaicin which is also in chilli peppers.

  • Power Glide - Best for penises
  • On Arousal Oil
  • Arousal Balm
  • Southern Butter Enhance Balm
  • Hathor Aphrodisia (Warming)
  • Aloe Cadabra Peppermint Tingle (Warming)
  • Blossom Organics Warm Sensation (Warming)

My Favorite Lube Companies

Just like sex toys, it's important to choose lube brands that care about your health and won't take advantage of the lack of regulation.

Here's a list of companies vetted and sold by sex-positive shops around the US.

Sources

[1] World Health Organization. "Use and procurement of additional lubricants for male and female condoms", 2012, http://apps.who.int/iris/bitstream/handle/10665/76580/WHO_RHR_12.33_eng.pdf

[2] Carballo-Diéguez A, Stein Z, Sáez H, Dolezal C, Nieves-Rosa L, Díaz F. "Frequent use of lubricants for anal sex among men who have sex with men: the HIV prevention potential of a microbicidal gel." American Journal of Public Health, 2000, 90(7):1117-1121

[3]Herbenick, Debby, et al. “Women's Use and Perceptions of Commercial Lubricants: Prevalence and Characteristics in a Nationally Representative Sample of American Adults.” The Journal of Sexual Medicine, vol. 11, no. 3, 2014, pp. 642–652., doi:10.1111/jsm.12427.

[4]Reece, Michael, et al. “Men's Use and Perceptions of Commercial Lubricants: Prevalence and Characteristics in a Nationally Representative Sample of American Adults.” The Journal of Sexual Medicine, vol. 11, no. 5, 2014, pp. 1125–1135., doi:10.1111/jsm.12480.

[5]Maida, Jesse. “Personal Lubricant Market on an Upward Trend as Acceptance Increases: Technavio.” Personal Lubricant Market on an Upward Trend as Acceptance Increases: Technavio | Business Wire, 6 Dec. 2016, www.businesswire.com/news/home/20161206005085/en/Personal-Lubricant-Market-Upward-Trend-Acceptance-Increases%20%C2%A0.

[6]Dezzutti, Charlene S., et al. “Is Wetter Better? An Evaluation of Over-the-Counter Personal Lubricants for Safety and Anti-HIV-1 Acitivity.” PLoS ONE, Public Library of Science, 2012, www.ncbi.nlm.nih.gov/pmc/articles/PMC3492332/.

[7]Thomas, Pat. “Behind the label: K-Y Jelly” The Ecologist, Oct. 2007.

[8]Wolf, Lauren. “Studies Raise Questions About Safety Of Personal Lubricants.” Chemical & Engineering News, vol. 90, no. 50, 2012, pp. 45–46.

[9]Fuchs, Edward J., et al. “Hyperosmolar Sexual Lubricant Causes Epithelial Damage in the Distal Colon: Potential Implication for HIV Transmission.” The Journal of Infectious Diseases, vol. 195, no. 5, 2007, pp. 703–710., doi:10.1086/511279.

[10]Adriaens, Els, 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, vol. 35, no. 5, 2008, pp. 512–516., doi:10.1097/olq.0b013e3181644669.

[11]Moench, Thomas R, et al. “Microbicide Excipients Can Greatly Increase Susceptibility to Genital Herpes Transmission in the Mouse.” BMC Infectious Diseases, vol. 10, no. 1, 2010, doi:10.1186/1471-2334-10-331.

[12]Begay, Othell, 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, vol. 27, no. 9, 2011, pp. 1019–1024., doi:10.1089/aid.2010.0252.

[13]Ayehunie, Seyoum, et al. “Hyperosmolal Vaginal Lubricants Markedly Reduce Epithelial Barrier Properties in a Three-Dimensional Vaginal Epithelium Model.” Toxicology Reports, vol. 5, 2018, pp. 134–140., doi:10.1016/j.toxrep.2017.12.011.

[14]Samuel Mettler, Department of Agricultural and Food Sciences, ETH Zurich, et al. “Osmolality and PH of Sport and Other Drinks Available in Switzerland.” Osmolality and PH of Sport and Other Drinks Available in Switzerland, 2006.

[15]Nicole, Wendee. “A Question for Women's Health: Chemicals in Feminine Hygiene Products and Personal Lubricants.” Environmental Health Perspectives, vol. 122, no. 3, 2014, doi:10.1289/ehp.122-a70.

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