Are Genital Desensitizers Safe To Use?
The Bottom Line
Genital desensitizers contain local anesthetics and are designed to numb the external genitalia to enhance sexual activities. When used in excess or too frequently, genital desensitizers can cause severe toxicity. Antidotes and medical treatments are available in hospital settings. Delays in seeking medical care can result in more severe symptoms or even death.
The Full Story
Genital desensitizers are over-the-counter products that numb the external genitalia and are often used to prolong sexual encounters and delay premature ejaculation. Genital desensitizers are packaged in spray or gel formulations. They contain local anesthetic medications, including lidocaine and benzocaine, that act as the numbing ingredient. The package label may recommend application of a “small amount” of product prior to sexual activity.
While use of a small amount of lidocaine or benzocaine on the skin of the external genitalia is unlikely to be harmful for most individuals, application of larger amounts or repeated use of the product can result in significant toxicity. Lidocaine and benzocaine are absorbed through human skin and can cause toxicity when spread through the bloodstream to other organs. Lidocaine poisoning, sometimes resulting in death, has occurred after application of lidocaine to the skin before and after cosmetic surgical procedures. Lidocaine toxicity affects the brain and the heart, and can cause tremors, dizziness, and abnormal heart rhythms. When high levels of lidocaine circulate in the bloodstream, low blood pressure, seizures, and death can occur.
Toxicity from lidocaine, as well as benzocaine, can also cause an illness called methemoglobinemia. Methemoglobinemia is a dangerous condition that occurs when human blood is unable to bind oxygen and deliver it to organs in the body. Patients with methemoglobinemia often experience shortness of breath, headache, and cyanosis (blue-tinged skin) due to a lack of oxygen. Severe methemoglobinemia can result in seizures, heart problems, and death. The signs and symptoms of methemoglobinemia occur quickly, often within an hour of exposure to a causative agent. Many local anesthetics can cause methemoglobinemia, and benzocaine is responsible for more than half of the cases of methemoglobinemia related to local anesthetic drugs.
When adverse events occur after exposure to genital desensitizers, use of the product must be stopped immediately. Soap and water can be used to wash off remaining product from the genital regions, to reduce further exposure. There is an IV antidote for methemoglobinemia called “methylene blue”, but it is only available in hospital settings. There are also specific treatments for lidocaine toxicity, but to be most effective they should be given within a short time after the poisoning is identified, before severe and/or permanent damage has occurred. Many people might not be aware that the use of over-the-counter products such as genital desensitizers may result in severe poisoning, or they might be embarrassed to seek medical attention after use of these products. Since delays in diagnosis and treatment can result in more severe poisoning or even death, it is important to seek medical attention immediately if any adverse events occur after the use of genital desensitizer products.
If you have a question about poisoning or adverse reactions related to use of genital desensitizers, use the webPOISONCONTROL® online tool or call 1-800-222-1222. Both options are free for the public, and available 24 hours a day.
Kelly Johnson-Arbor, MD
Medical Toxicology Physician
Poisoned?
Call 1-800-222-1222 or
Prevention Tips
- Use genital desensitizing products with care and only according to the directions on the package labeling.
- Know that over-the-counter medications can be poisonous, when used too frequently or in larger-than-normal amounts.
- If you have a question about poisoning or adverse reactions related to use of genital desensitizers, get help online at www.poison.org or call 1-800-222-1222. Both options are free for the public, and available 24 hours a day.
This Really Happened
Case 1. A 47-year-old woman presented to an Emergency Department with shortness of breath, fatigue, low oxygen saturations, and cyanosis (blue-tinged skin). A blood test confirmed a diagnosis of methemoglobinemia. She was given an antidote and was admitted to the hospital, but the methemoglobinemia persisted. The patient eventually admitted that she had been applying topical Vagicaine® cream to her external genitalia, both at home and also while she was in the hospital. She reported using a “quarter-sized dab” of the cream every 2 hours. The use of Vagicaine® cream was stopped, and the affected areas of her skin were cleansed with soap and water. The patient was discharged after a 5-day hospital stay.
Case 2. A 48-year-old man presented to an Emergency Department with chest pain of 2 days’ duration. He reported that he had sprayed a “large amount” of lidocaine solution on his penis prior to sexual activity over a 2-week period. Physical examination revealed an abnormally slow heart rate, which was attributed to overuse of topical lidocaine. He was monitored in the Emergency Department for several hours, and his heart rate remained slow over that time. He was eventually able to be discharged home with instructions to follow up with a cardiologist.
For More Information
References
Poisoned?
Call 1-800-222-1222 or
Prevention Tips
- Use genital desensitizing products with care and only according to the directions on the package labeling.
- Know that over-the-counter medications can be poisonous, when used too frequently or in larger-than-normal amounts.
- If you have a question about poisoning or adverse reactions related to use of genital desensitizers, get help online at www.poison.org or call 1-800-222-1222. Both options are free for the public, and available 24 hours a day.
This Really Happened
Case 1. A 47-year-old woman presented to an Emergency Department with shortness of breath, fatigue, low oxygen saturations, and cyanosis (blue-tinged skin). A blood test confirmed a diagnosis of methemoglobinemia. She was given an antidote and was admitted to the hospital, but the methemoglobinemia persisted. The patient eventually admitted that she had been applying topical Vagicaine® cream to her external genitalia, both at home and also while she was in the hospital. She reported using a “quarter-sized dab” of the cream every 2 hours. The use of Vagicaine® cream was stopped, and the affected areas of her skin were cleansed with soap and water. The patient was discharged after a 5-day hospital stay.
Case 2. A 48-year-old man presented to an Emergency Department with chest pain of 2 days’ duration. He reported that he had sprayed a “large amount” of lidocaine solution on his penis prior to sexual activity over a 2-week period. Physical examination revealed an abnormally slow heart rate, which was attributed to overuse of topical lidocaine. He was monitored in the Emergency Department for several hours, and his heart rate remained slow over that time. He was eventually able to be discharged home with instructions to follow up with a cardiologist.