As estrogen levels drop for women in middle age, certain menopause symptoms may follow, including vaginal atrophy. An estimated 50-60% of postmenopausal women experience some vaginal atrophy, which causes the vagina to become thinner, drier, and less elastic. This thinning of vaginal tissue can cause sex to become painful, and some postmenopausal women may give up sex to avoid that pain.
Women who want to continue enjoying sex after menopause can pursue certain treatment options for vaginal atrophy. In cases where pain during sex is mild, women may find relief from over-the-counter lubricants. However, for more severe pain, women may need to try a prescription vaginal atrophy medication. For years, estrogen replacement drugs that can be taken as a pill, worn as a patch, or inserted into the vagina have been the main treatment options for post-menopausal dryness. However, in 2013, the FDA approved another option: oral Osphena.
How Does Osphena Work?
Osphena (ospemifene) is an estrogen agonist/antagonist, meaning that it acts like the hormone estrogen when introduced to the uterine lining. When taken once daily as directed by a doctor, it can help treat moderate to severe vaginal atrophy by thickening vaginal tissue and making that tissue less susceptible to tearing.
Osphena underwent three rounds of clinical trials with close to 1,900 participants. The first two trials showed statistically significant improvement in vaginal atrophy among women who took Osphena compared to women who took a placebo for 12 weeks, and the third trial supported the drug’s long-term safety as a treatment for post-menopausal dryness.
While Osphena is considered a non-hormonal drug, it’s important to note that it can have some of the same side effects as other hormonal vaginal atrophy treatment options. Serious side effects are rare but can include blood clots, stroke, and uterine cancer. Women who experience unexplained vaginal bleeding should contact their doctor right away, as this may be a sign of uterine cancer.
Clinical trials have also shown that Osphena increases a woman’s likelihood of experiencing hot flashes (7.5% of participants who took Osphena reported this side effect, as opposed to 2.6% who took a placebo).
Osphena vs. Other Treatments for Vaginal Atrophy
Considering that Osphena comes with the risk of some of the same side effects as estrogen replacement treatments, one might wonder why a doctor would prescribe this vaginal atrophy medication over a hormonal option.
In some cases, it may come down to the convenience of the form. Some women simply prefer taking a pill by mouth rather than applying a cream, ring, or pill to their vagina. Women who have arthritis or another condition that limits their flexibility may find that they have a hard time using a vaginal applicator but can take a pill without any problem.
What Should You Do If You’re Considering Osphena?
As with all medications, it’s important to discuss the risks and benefits of Osphena and other post-menopausal dryness treatments with your health care provider. Your doctor will need to know about all medications you are taking, as well as your personal and family medical history, to help you make a decision that is safe and effective.
