By Darci L.D. Janarelli
Gynaecologist

To Masters and Johnson, accordingly, the human sexual response may be divided in four phases; sex-linked arousal, plateau, orgasm, resolution. All of which maintain a relation of interdependency, that is to say, one would not occur unless the other does. Thus, it implies in a less satisfactorily sexual relation and dysfunction when any given alteration exists in one of the phases.

All begins when through imagery, fantasies, scents and recollect, the woman develops desire, which is fundamental to the start of sexual response. The desire leads to the arousal phase whence several changes of bodily order start to take place, being one of them and perhaps the most important the vaginal lubrication.

Such intimate lubrication bears the result of a psycho-neural-endocrinal interaction, on which point glands existing in the vulva and the vaginal opening produce a viscous secretion, inodorous and transparent, responsible for rendering the vagina fit to receive penetration in a comfortable and painless manner.

The lack of lubrication is one of the key factors that lead to the onset of pain and discomfort during sexual intercourse, often reported by women as stinging, which may sets off from the first moment in penetration as well as appear off middle towards the end of intercourse, capable of lasting until the day after.

In certain occasions the lack of lubrication may spark off coital bleeding even so intense, by laceration of the vaginal mucosa through abrasion triggered by the penetrative movements.

Physiologically speaking, the decrease in lubrication is bound to occur in menopause, in the post-labor period and in breastfeeding. Occurrences likewise radiotherapy and chemotherapy, diabetes and hypertension tend to render further vaginal dryness.

The treatment for the deficit of intimae lubrication hinges on the cause-factor, although there are modes of ceasing it disregarding of the causal factor.

Once excluded the organic factors, the decrease or absence of vaginal lubrication is directly proportional to the state of arousal, in other words, the bigger the level of excitement the higher the amount of lubrication. So far, the sexual therapy should be referred to those women with arousal difficulty, almost always as consequence of the diminishing or absence of sexual desire.

When the cause is of hormonal nature, in case of women in menopause, the hormonal treatment whether systemic or local, so long as discarded all of its side-effects, ensures in its totality the therapeutic success, "rejuvenating" a vagina so far "aged" by hormonal deficit, physiological of the period.

For each and every case it is possible to tap on artificial intimae lubricants largely available in pharmacies, which may come in aqueous or oily base. Those oil-based, whose prime representative is the Vaseline, are derivatives of petroleum, of difficult extraction, likely to leave residues, apart from promoting rupture of preservatives of latex made. Those water-based ones, attempt to mimic natural lubrication, providing a blissful sexual relation, with no damage to the condom, hence the most-recommended.

In all cases of diminish or absence of lubrication, lubes comply thoroughly with their duty in the sense of treating the symptom, even though the ideal being always treat the cause, after all a relation as comfortable as painless is not synonym of pleasurable relation and neither guarantee of orgasms.