Jake Weinraub

Lube Safety for Rectal Use

Filed By Jake Weinraub | May 22, 2011 4:00 PM | comments

Filed in: Living
Tags: anal sex, Astroglide, ID, IRMA, ky jelly, lube, lubricant, rectal

The International Rectal Microbicide Advocates (IRMA) recently released a study examining the Screen shot 2011-05-22 at 12.54.01 PM.pngeffect of lubricants on rectal tissue. They ran an internet-based survey in six languages, receiving 8,945 responses highlighting behaviors and attitudes around anal intercourse, condom use, lube use, as well as acceptability of rectal microbicides if they were on the market.

IRMA shares that lubricants, as well as anal sex, enemas, and douching cause some level of inflammation in the rectum, most of which occurs naturally and repairs itself within minutes or hours.

Knowing this, IRMA builds off existing science to better examine levels of inflammation and damage that are a result of AI alone, without lubes, and with lubes.

Key Findings:

  • Many water-based lubes (such as Astroglide, ID, KY Jelly, and Elbow Grease) are hyperosmolar, meaning they have a higher concentration of soluble components than normal cells in the body, "sucking" away water from inside vaginal/rectal cells, making them shrink in size. A question for IRMA is whether or not this damage is a factor relating to HIV infection risk.

Out of the 41 lubricants examined,

  • Most of the lubricants were found to be hyperosmolar.
  • KY Jelly, ID Glide, Elbow Grease, and Astroglide are similarly toxic for cells, cell lines, and tissues, with Astroglide being the most toxic.
  • PRE and Wet Platinum appear to cause the least damage.
  • None of the lubricants have show any significant activity against HIV-1.
  • Four Astriglide lubricants actually significantly enhanced HIV-1 replication in vitro.

While water-based lubes don't look great, there are questions of how this translates into real-world use and real-world risk, where factors such as timing, frequency, saliva, accessibility, and condom/lubricant regulation all come into play. There is also the question of IRMA advocating for anal sex without lubricant, which would be painful and unrealistic, so they hope to find out which are the safest.

Bottom line: more research is urgently needed to explore if there is a link between lube use and acquiring HIV and/or rectal STI's.

In the meantime, IRMA reiterates that "using male or female condoms is still considered the best way to prevent acquiring HIV and STIs during AI. In addition, the use of condom-compatible lubes has been associated with a decreased risk of condoms breaking or slipping."

These studies will inevitably inform the development of rectal microbicides, a cream or gel (or potentially a douche or an enema) that could be inserted vaginally or rectally and used to reduce a person's risk of HIV infection. IRMA chair Jim Pickett shared with Bilerico in 2008 that rectal microbicides represent a viable option when condoms fail or when their use cannot be easily negotiated.

For more information on the study, check out IRMA's May 18 presentation. Here is a link to their slides.


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um...interesting. Its a good step and I think that the sex lube industry should work together to investigate fully the study and where improvements for product improvements can be made. Things like single use packageing to prevent cross contamination and lubricant products that are closer to human mucosal secreations and less irritating.

"There is also the question of IRMA advocating for anal sex without lubricant, which would be painful and unrealistic..."

I don't get why this keeps coming up, since I know plenty of folk that manage without lube. Not an option for everyone though, yes. (and not all the time. it's possible sometimes and not others, according to those individual factors you mentioned)

I think I'm in Gina's boat on this one...it's.....interesting haha (interesting photo selection, too, btw). I guess you really do learn something new every day hah.

warmscience | May 23, 2011 4:44 AM

Speaking theoretically, there are some slippery natural/simple things that have antimicrobial properties and yet are at least mild on external skin. I'd like to see these researched as lubricants on rectal and vaginal tissue. E.g. ...

Coconut oil is famed for antimicrobial properties (e.g. we used it for its anti-fungal and anti-HIV properties "back in the day", before the HIV drugs got so much better, in a complementary therapies clinic). However, it's fat-based/not water-soluble, so not good with plastic condoms.

We also used high long-chain mucopolysaccharide (e.g. carefully processed "whole leaf") aloe for its anti-HIV properties, with the caveat that in the long run its TNF-boosting property was pro-inflammatory. That's water-soluble.

Various herbs are microbicidal, e.g. oregano, as are various food/herbal isolates, e.g. quercetin (another one we used before the HIV drugs etc). A water extract of these could be weak enough to be mild/not irritating on tissue but maybe worth adding to aloe maybe.

And there are anti-inflammatory herbs and food/herb isolates, e.g. turmeric (ooops, stains things yellow).

Since rectal and vaginal tissue are so absorbent, one could also be adding things that are beneficial to the body (e.g. another reason I like turmeric, coconut, and quercetin).

If anyone knows of research in this area, please let me know.

I find it interesting that your article doesn't address silicon lubes. WET Platinum is silicon based. This is the original study abstract http://www.microbicides2010.org/files/LubesDezzuttiAbstract.pdf that I saw originally where the actual reasons for the issues were given.

It specifically stated on the second page of the abstract in the results section that WET Platinum had NO toxicity. That is a very important and relevant distinction to just overlook. It would have been a good idea to mention that specifically in the article here. Many may not know that WET Platinum is silicon based AND safe for use with both latex and non-latex condoms.

I have been recommending silicon lube for some time as superior to water based for several reasons. This study showed the best one as far as health impacts. There are other benefits as well. It takes less lube and lasts far longer. It is nonstaining to cloth. It can be used in water and only comes off once you add soap. The cost is somewhat higher than water based but over time it evens out as most people end up using far more of water based due to reapplying it after 15 to 20 minutes when water based gives out and becomes tacky/sticky rather than slippery.

Just thought I would point this out.

Oh, right! I thought I was seeing it wrong, but I was right. Very informative post for lubes but... uhmmm. I can't really explain my stand on this one. But nice to learn new stuff!