DHEA now has FDA approval as INTRAROSA™

As women age and hormone levels naturally decline, sexual problems can occur. The most common sexual problems among women aged 50+ are: decreased libido, inadequate vaginal lubrication, and difficulty with climax. Vaginal dryness, or the more severe vaginal atrophy, can be a debilitating symptom and a major contributor to low libido. Instead of avoiding the pain and therefore intimacy, many women are seeking treatment from their physicians.

While lubricants can make sexual intercourse more comfortable and/or pleasurable, it is important to remember that lubricants are palliative, not preventative. The bio-identical hormone estradiol (E2) effectively treats the dryness and atrophic changes at low doses when applied vaginally. Commercial products such as Estring Vaginal ring, Estrace Vaginal cream and Vagifem tablets contain estradiol. Other bio-identical hormones such as Estriol (E3), Testosterone and DHEA (dehydroepiandrostenediol) have also been used clinically alone or in combination in low vaginal doses to treat this issue. These hormones had to be compounded since there was not an FDA approved product on the market.

Mary Heim, RPh, FAAFM

In November 2016, the FDA released a press announcement about the approval of Intrarosa (prasterone) to treat women experiencing moderate to severe pain during intercourse. Prasterone may be better known by the name dehydroepiandrosterone (DHEA). For those uncomfortable with or unable to use Estradiol, this gives us an alternative FDA approved product. One caveat to remember would be that DHEA or prasterone is actually a precursor in the body to both estrogens and testosterone. So, if you have been told to avoid estrogen, this may not be your best choice.

If pain is causing unwanted choices limiting intimacy, talk to your physician about treatment options.

References:
Bachmann GA, Nevadunsky NS. Diagnosis and treatment of atrophic vaginitis. Am Fam Physician 2000;61:3090-6.
Chism LA. Overcoming resistance and barriers to the use of local estrogen therapy for the treatment of vaginal atrophy. Int J Womens Health. 2012; 4: 551-57.
Hustin J, Van der Eynde JP. Cytologic evaluation of the effect of various estrogens given in Post-menopause. Acta Cytologica. 1977; 21: 225-28.
Leiblum S, et al. Vaginal atrophy and the postmenopausal woman: the importance of sexual activity and hormones. JAMA 1983;249:2195-8.
National Survey of Sexual Health and Behavior (NSSHB). Findings from the National Survey of Sexual Health and Behavior, Centre for Sexual Health Promotion, Indiana University. Journal of Sexual Medicine, Vol. 7, Supplement 5.
Raz R, Stamm WE. A controlled trial of intravaginal estriol in postmenopausal women with recurrent urinary tract infections. N Eng J Med. 1993; 329: 753-56.
This entry was posted in Anti-Aging, Functional Medicine, Hormones, Pain Management and tagged , , , , . Bookmark the permalink.

2 Responses to DHEA now has FDA approval as INTRAROSA™

Leave a Reply

Your email address will not be published. Required fields are marked *