The purpose of vaginal lubrication is to allow comfortable entry and thrusting of the penis during intercourse. Being sexually “turned on”, even without the vagina being touched, will result in an increase in vaginal lubrication. The factors at work here are (1) psychological receptivity, (2) a normal level of estrogen that maintains the vaginal lining appropriately thickened so that there is a constant normal shedding of vaginal cells from the vaginal surface that provides a lack of dryness.
There are small glands (Bartholin and Skene’s) that have been identified that surround the vaginal opening. It was once believed that these glands provide the lubrication necessary for sexual intercourse. It is now very clearly established that the vagina “sweats” from the entire surface. The outer glands, which sometimes may become infected and may swell to the size of a golf ball before draining, play an insignificant role in vaginal lubrication.
In older women who may express symptoms of having increasing vaginal dryness, estrogen may be applied with cream, a small retained plastic ring that releases a small amount of estrogen over a 3 month period or a small estrogen pellet that dissolves over 12 to 24 hours and may be inserted twice weekly. For milder forms of dryness, or in women who have specific reason not to receive estrogen, we have samples in the office of excellent lubricants and also there are commercial over the counter lubricants that one can buy. Some of these products a pleasant odor and may be administered prior to sex. Their principle function is to reduce friction.