Lube

Do you use lube? What do you use?

Yes we do use lube. It's a generic CVS brand similar to KY.

On occasion my patient is actually wet enough that I have inserted a speculum and opened her vagina with out the use of any lube, besides her natural lubrication.

I remember vividly one time opening her labia with my gloved fingers and exposed a glistening pool of her wetness at the opening of her vagina. She is embarrassed at times with how wet she becomes. But I love it. It seems to reveal just how anxious and ready she is for her exam.

My preference for RTs is still old-fashioned Vaseline. It is harder to get off afterward, but is thicker and seems to give a richer sensation compared with KY as the thermometer is inserted.

In an actual GYN exam, lube is not used with the speculum, it is only used after for the bimanual.

"Vaginal speculum lubrication (water and gel) does NOT increase unsatisfactory cervical cytology so it's safe to use it and helpful for the woman's comfort."

from....

http://www.vaginismus-awareness-network.org/bestpractices.html

There is conflicting information on whether a lube can/should be used in a vaginal exam involving a Pap Smear. Conventional practice is to avoid using any lubricant for fear of contaminating the cell sample. And indeed, the following paper from the National Institute of Health recommends the avoidance of any lube other than saline water:

http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=cm.chapter.5183

"All talcum powder should be washed away from the gloves before touching the patient, instruments, or slides. A contaminant talcum crystal on a smear may hide the only diagnostic cell of the specimen! The speculum should be introduced without lubricant. Saline solution may be used for moistening. The lubricant does not dissolve during processing of the slide. It often stains dark purple and may hide numerous cells. Before scraping, the wooden spatula should be dipped in saline to moisten it and prevent too rapid dehydration of the scraped cells. When smeared, the slide should be dropped immediately into 95% ethyl alcohol or sprayed before it has a chance to air dry."

Sample contamination was a problem with the traditional pap smear on a glass slide. Improvements in the Pap Smear over the last 10 years involving the use of liquid-based cytology (Thin Prep System) has increased the accuracy of reading cell samples, especially when coupled with computer-assisted reading of the cell sample vs. the traditional manual reading by microscope. Using a water-based lubricant (KY) in conjunction with Thin Prep is less likely to produce a false negative that using lubricant with the older glass smear process. The NIH article cited relates to the older glass smear protocol, and not the liquid based Thin Prep process.

To ensure the best accuracy of detecting suspect cells under either process, it is probably best to use no lubricant other than water, unless the patient has a really tight vagina and cannot accomodate the speculum without KY.

KY is good, but I have been told that an oil based lubricant is never a good way to go, and that the lubricant should always be water based. I can recommend WET lube, but putting it in a separate container will be more realistic, and would work well rectally.

Standard practice in the real world (at least here in the USA) is to use warm water on the speculum. Anuscopes would be lubricated with something like KY or other water-based lubricants.

For play exams, I love to make sure the patient is already very wet before I insert a vaginal speculum. Anything anal is always well-lubricated. Astroglide is very good for this (as was originally designed as a cooling fluid for rocket engines ). Vaseline is good for multiple enemas - it helps protect the anal canal and does not wash away easily.

My doctor lubes my up for my bimaual and rectal exam.

Genuine KY for me!!!

Surgilube.

KY for me

Surgilube or generic equivalent for vaginal use. sterile keeps my patient's vagina much happier. For anal petroleum jelly. It is the best for enemas and preventing hemmoroid issues due to irritation.

I love ky

I'm an Astroglide girl ... and wow - a cooling fluid for rocket engines?! Now the name makes SO much more sense!! Thanks for that!!

[font=verdana]Astroglide is definitely the best stuff - sexier and more slippery than KY/Surgilube.[/font]

I had to get a rectal exam in emergency once and the doctor brought out KY jelly in a little pack, like a ketchup packet. I was amazed and asked him where they got them. He looked at me funny and didn't know.

I know the package doesn't make the KY feel different, but I think its all part of the experience. I just liked the one use packet thingy. I like KY but haven't really tried a ton of different ones. I should experiment with some more.

Surgilube and astroglide are much better than ky in that they are quite slippery. Insertion of instruments or fingers is easy for both the doc and patient. Propylene glycol is an ingredient in astroglide....hence the "coolant" association others have made...lol. Sugilube is sterile and contains an antibacterial ingredient

Either way get the single use packs and that prevents risk of any contamination. One pack is more than enough for an internal exam

Surgilube, Its cheaper than KY.

I'm not an expert, as this is usually decided by someone else 😉, but there seem to be some heavier lubes that can be used if something is going to be "in place" for a long time.

Isn't anything oil-based bad if there's sexual contact afterwards and a condom is used? Latex and oil-based lubes don't mix, I think.

I like KY just like at the docs office.

Something very thick like Vaseline for the anus. Liquid Silk (expensive but worth it) for everything else, including the urethra because it is incredibly slippery and bacterostatic.

I prefer to use vaseline as well. Somehow the somewhat heavier texture it has makes it more exciting for me. Moving in the thermometer or fingers gives a much stronger sensation than with traditional lube. I also find it less messy than the more fluid lubes.

Water based Lube in the vagina only,

an oil based lube such as vaseline or crisco will be only used in my mock rectal exam sessions.

KY has always worked best for me.

KY- jelly. yes in a real exam doctors don't use it for speculum exam because o f the pap smear, but in play exams it's better to use it anyway, unless natural lubrication is enough. by the way talking of regular sex is common to use lube at least for anal sex. if you do this allways use KY or other water base lube, if you use something like vaseline it can damage the condom (in case you're concerned in safe sex).

You would be surprised how many doctors are now using lubrication for speculum insertion. For the most part it is possible to use the silicone like cytobrushes that look like brooms. These samples are not affected by lubrication as they are not slide mounted samples. Only with a personal history of abnormal paps would it be absolutely necessary to revert back to the slide mounted smears. This advance makes it more comfortable for the woman in all aspects of the examination.

As for what I use, I just order extra surgilube and bring it home. It's dirt cheap and you can get it, without prescription, at any medical supply store. Where I live you can walk in to the med. supply store and get a decent size tube for $2 compared to a similar tube of KY at the pharmacy for $6.

(And since I'm new, and just a note about my signature...The only thing there that was changed is my name for my personal and professional protection. So, YES, I have really spent that much time in school...What was I thinking? lol)

I had to get a rectal exam in emergency once and the doctor brought out KY jelly in a little pack, like a ketchup packet. I was amazed and asked him where they got them. He looked at me funny and didn't know.

I know the package doesn't make the KY feel different, but I think its all part of the experience. I just liked the one use packet thingy. I like KY but haven't really tried a ton of different ones. I should experiment with some more.

Care to share more details about your rectal exam?

I have had KY and Vaseline both used on me by various play doctors and for different purposes, but my all-time favorite lube would have to be Astroglide. Jodi