Sex isn’t supposed to hurt — but sometimes it does. Well over half of all women will, at some point in their lives (most especially after menopause), experience vaginal dryness severe enough to interfere with lovemaking. “Nothing shuts down sexual feelings faster than pain,” says Harry Fisch, MD, clinical professor of urology and reproductive medicine, Weill Cornell Medical College/New York Presbyterian Hospital, and a regular guest on The Dr. Oz Show. He added that the cause of most pain during sex is vaginal dryness.

What’s Up Down There?

When I talked with Dr. Fisch, he explained that there are two ways women can solve the problem of vaginal dryness. Using a lubricant is obviously easiest and we’ll go into that in a moment. However, it’s important to first realize that there are several possible underlying reasons your body might not produce adequate lubrication. Potential causes include…

  • Normal hormonal changes. Even premenopausal women can experience dryness during parts of their menstrual cycle, during pregnancy and while nursing.
  • Menopause. The decline in estrogen production during menopause can leave women feeling as if someone has suddenly, and literally, shut off the “fountain” of youth.
  • Medications. Some drugs cause dryness, everywhere — for example, antihistamines don’t just keep your nose from running! Medications for anxiety or depression also can result in a lack of lubrication.
  • Personal-care products. Bubble bath, scented soaps and lotions and douching can disrupt the natural chemistry of the vagina.
  • “Baggage.” Life stress and unresolved issues between you and your partner also can turn off the juice at the wrong moments.
Some of these issues can be more easily solved than others — some on your own, and some with your doctor’s input.

Lubricating Solutions

Because it is so easy and effective, however, most women have great success by simply using some sort of lubricant. Dr. Fisch said that many women find natural solutions work beautifully — he says botanical oils such as coconut, canola, olive, grape seed and aloe vera can all serve the purpose quite nicely. Also helpful is squalane, a natural oil usually made from shark liver, but which can be formulated from plant seeds. It is used as a base in many high-end skin products and is available online at, or at health-food stores. Note:It’s important to be aware that these oils may adversely affect the latex in condoms and diaphragms and/or can cause allergic reactions in some people.

You can buy a wide variety of over-the-counter lubricating gels that are not only inexpensive, but in some cases can even enhance the sexual experience — for instance, by adding warmth. If you decide to try one of these, Dr. Fisch advises reading the label carefully before buying. Whether sold at the local supermarket, a drugstore or an adult emporium, be aware that…

  • Some lubricants contain hormones that many women don’t want.
  • Petroleum-based (and oil-based) lubricants can cause latex condoms or diaphragms to deteriorate and fail. They also may promote yeast infections.
  • Some contain topical anesthetics — so much for pleasure, huh?
  • You may find the way they smell, feel or taste to be a turnoff.

Because of these concerns, Dr. Fisch has developed products including a lubricating gel called Sexual Health Formula Lubricating Warming Gel ( It uses natural ingredients that improve blood flow. He recommends massaging a drop onto the clitoris — you can reapply it as needed. Price:$59.99 for a one-ounce bottle.

Of course, less expensive and more basic lubricants such as KY jelly are still an option — and the usual advice to take care of yourself (eat healthfully… don’t smoke — it lowers estrogen levels… don’t overindulge in alcohol, which dehydrates you… and drink plenty of water) will help to lubricate you from within. But don’t be afraid to try something new — many couples find that using lubricants enhances their experience in ways that they didn’t expect.