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What the science says about lubricants in anal sex

Science library Health and safety

Last reviewed: Written and reviewed by the Loviux Team. 7 studies

We check every summary against the study's original abstract: the quotation is verbatim and the figures match. How we verify our information

This page reports on published research. It is not medical advice and does not replace a healthcare professional.

If you have pain or discomfort, speak to a healthcare professional.

On this page
  1. In 30 seconds
  2. What the studies say overall
  3. Where they disagree
  4. Limits of the evidence
  5. The studies, one by one
  6. What this means in practice
  7. Other topics in the library

In 30 seconds

What the studies say
The evidence is scarcer than for vaginal use and comes mainly from studies of men who have sex with men, carried out in the context of infection prevention.
The main limitation
Many are observational studies of a specific group, and changes in the microbiome are not a disease.
In practice
The data point to not sharing the same bottle or gel between people or between practices where there may be bleeding.

What kind of studies there are

  • Syntheses of studies 1
  • Randomised trials 2
  • Observational 4

We classify each study by its design. A synthesis of many studies or a randomised trial supports firmer conclusions than a survey or an expert opinion. The design does not tell you whether a result is good or bad.

What the studies say overall

The evidence is scarcer than for vaginal use and comes mainly from studies of men who have sex with men, carried out in the context of infection prevention.

A systematic review carried out for the WHO concludes that, although the evidence is limited, lubricants appear to be an acceptable option for improving sexual health and wellbeing.

In a diary study of adult women, water-based lubricant was associated with more pleasure and satisfaction in anal sex than using none.

As for condoms, one study of male couples linked breakage to not using additional lubricant or to using an unsuitable one.

Other studies add nuances: a small trial saw changes in the rectal microbiome after applying a hyperosmolar lubricant for seven days; in Nigerian men, using petroleum jelly was associated with lower microbiome diversity; a carrageenan gel showed no protective effect against anal HPV and had more adverse effects than placebo; and in a case-control study, sharing lubricant during fisting was associated with recent hepatitis C.

Where they disagree

There is no single message because the studies measure different things: pleasure, condom breakage, the microbiome or infections. A lubricant may be associated with greater comfort and, at the same time, with changes that we do not yet know how to interpret.

Limits of the evidence

Many are observational studies of a specific group, and changes in the microbiome are not a disease. None directly compares the types of lubricant on sale, and several are old or have small samples.

The studies, one by one

We have gathered 7 verified studies. Each summary is our own; the quotation in inverted commas is taken word for word from the original abstract, in English.

In this guide (7)
Type of study: Systematic review2021

Lubricants for the promotion of sexual health and well-being: a systematic review.

What they found: A systematic review carried out for the WHO concludes that, although the evidence is limited, lubricants appear to be an acceptable option for improving sexual health and wellbeing. (Kennedy et al., 2021)

Population Review of effectiveness and preference studies in diverse populations Journal Sex Reprod Health Matters

Verbatim quotation from the original abstract (in English)

“Although evidence is limited, lubricants appear to offer an acceptable approach to improving sexual health and well-being.” Kennedy et al., 2021

See the original: DOI · PubMed

Type of study: StudySample n = 2,4532011

Association of lubricant use with women's sexual pleasure, sexual satisfaction, and genital symptoms: a prospective daily diary study.

What they found: In a diary study of 2,453 women, water-based lubricant was associated with greater pleasure and sexual satisfaction in anal sex with a penis compared with not using lubricant. (Herbenick et al., 2011)

Population 2,453 adult women who used one of six water- or silicone-based lubricants for 5 weeks Journal J Sex Med

Verbatim quotation from the original abstract (in English)

“Water-based lubricant use was associated with higher ratings of sexual pleasure and satisfaction for penile-anal sex as compared with no lubricant use.” Herbenick et al., 2011

See the original: DOI · PubMed

Type of study: StudySample n = 2832001

An evaluation of a thicker versus a standard condom with gay men.

What they found: In a trial with 283 male couples, condom breakage was associated, among other factors, with not using additional lubricant and with using an unsuitable lubricant. (Golombok et al., 2001)

Population 283 male same-sex couples Journal AIDS

Verbatim quotation from the original abstract (in English)

“Behaviours associated with breakage were unrolling the condom before fitting to the penis, longer penis length, absence of additional lubricant, the use of inappropriate lubricant, and longer duration of intercourse” Golombok et al., 2001

See the original: DOI · PubMed

Type of study: Randomised controlled trialSample n = 602018

Repeated rectal application of a hyperosmolar lubricant is associated with microbiota shifts but does not affect PrEP drug concentrations: results from a randomized trial in men who have sex with men.

What they found: In a trial with 60 men who have sex with men, applying a hyperosmolar lubricant in the rectum for seven days was associated with changes in the rectal microbiome, without affecting the concentrations of HIV prophylaxis drugs. (Haaland et al., 2018)

Population 60 HIV-negative men who have sex with men Journal J Int AIDS Soc

Verbatim quotation from the original abstract (in English)

“Repeated rectal application of a hyperosmolar lubricant does not affect mucosal PrEP drug concentrations but is associated with changes in the rectal microbiome.” Haaland et al., 2018

See the original: DOI · PubMed

Type of study: Randomised controlled trial2022

Efficacy of a carrageenan gel in preventing anal human papillomavirus (HPV) infection: interim analysis of the Lubricant Investigation in Men to Inhibit Transmission of HPV Infection (LIMIT-HPV) randomised controlled trial.

What they found: In a placebo-controlled trial in men who have sex with men, a carrageenan gel used in anal sex showed no protective effect against new detections of anal HPV and had more adverse effects (59.8% versus 39.8% with placebo). (Laurie et al., 2022)

Population Gay, bisexual and other men who have sex with men in Montreal (Canada) Journal Sex Transm Infect

Verbatim quotation from the original abstract (in English)

“The interim analysis did not demonstrate a protective effect of carrageenan on the risk of new detections of anal HPV infection among gbMSM.” Laurie et al., 2022

See the original: DOI · PubMed

Type of study: Observational study2026

Metagenomic analysis reveals rectal microbiota features associated with HIV and behavioral factors in Nigerian men who have sex with men.

What they found: In Nigerian men who have sex with men, using petroleum jelly as a lubricant in anal sex was associated with lower diversity of the rectal microbiome (observational study). (Nowak et al., 2026)

Population Nigerian men who have sex with men Journal Sci Rep

Verbatim quotation from the original abstract (in English)

“Lower α-diversity (Shannon) was associated with use of petroleum jelly lubricant for anal sex.” Nowak et al., 2026

See the original: DOI · PubMed

Type of study: Case-control study2024

Still trouble with bleeding: Risk factors for HCV transmission in men who have sex with men and behavioural trajectories from 2019 to 2021.

What they found: In a case-control study of men who have sex with men in Germany, sharing the lubricant used in fisting was associated with recent hepatitis C infection, along with other practices involving exposure to blood. (Schmidt et al., 2024)

Population 197 cases of recent hepatitis C and 314 controls, men who have sex with men, in Germany Journal HIV Med

Verbatim quotation from the original abstract (in English)

“Factors independently associated with case status included sex-associated rectal bleeding, shared fisting lubricant, anal douching” Schmidt et al., 2024

See the original: DOI · PubMed

What this means in practice

  • The data point to not sharing the same bottle or gel between people or between practices where there may be bleeding.
  • The studies do not allow us to recommend a particular type or brand of lubricant.
  • If you have pain, bleeding or discomfort that does not go away, speak to a healthcare professional.

If you have pain or discomfort, speak to a healthcare professional.

Other topics in the library

All topics in the science library