Vulvovaginal atrophy, along with vaginal dryness and other symptoms caused by the loss of estrogen associated with postmenopausal status, are major contributors to dyspareunia. Fortunately, a range of effective treatments are available. For women who want to avoid systemic hormone therapy, intravaginal estrogens come in several formulations. "There is also a new nonestrogen vaginal product called prasterone (Intrarosa®)—a good solution for women who don't want estrogen.
Prasterone is a synthetic dehydroepiandrosterone, a hormone precursor that is converted peripherally to androgens, which exert local effects on the vaginal mucosa. Prasterone has been shown to improve symptoms, including vaginal atrophy, dyspareunia, burning, itching, and dryness, compared with placebo.
Another alternative to hormone therapy is ospemifene (Osphena®), approved in 2013 for treatment of moderate to severe dyspareunia associated with vulvar and vaginal atrophy of menopause. Ospemifene is an oral selective estrogen receptor modulator that acts on the vaginal epithelium to address painful sex associated with genitourinary syndrome of menopause. In phase 3 studies, ospemifene demonstrated efficacy in vaginal dryness and dyspareunia by regenerating vaginal cells, improving lubrication, and reducing pain during sexual intercourse. Symptoms improved in the first 4 weeks of use, and lasted up to 1 year.
A nondrug option has recently joined the field. In observational studies, the pulsed CO2 laser (MonaLisa Touch [Deka; Manchester, New Hampshire]), which directly treats the vaginal tissue, was shown to increase collagen and extracellular matrix production and increase the thickness of the vaginal epithelium with the formation of new papilla.Three 5-minute treatments are given at 6-week intervals, and no anesthesia is required.
Low Sexual Desire in Women: What Are the Options? - Medscape -Jul 09, 2018.
Prasterone is a synthetic dehydroepiandrosterone, a hormone precursor that is converted peripherally to androgens, which exert local effects on the vaginal mucosa. Prasterone has been shown to improve symptoms, including vaginal atrophy, dyspareunia, burning, itching, and dryness, compared with placebo.
Another alternative to hormone therapy is ospemifene (Osphena®), approved in 2013 for treatment of moderate to severe dyspareunia associated with vulvar and vaginal atrophy of menopause. Ospemifene is an oral selective estrogen receptor modulator that acts on the vaginal epithelium to address painful sex associated with genitourinary syndrome of menopause. In phase 3 studies, ospemifene demonstrated efficacy in vaginal dryness and dyspareunia by regenerating vaginal cells, improving lubrication, and reducing pain during sexual intercourse. Symptoms improved in the first 4 weeks of use, and lasted up to 1 year.
A nondrug option has recently joined the field. In observational studies, the pulsed CO2 laser (MonaLisa Touch [Deka; Manchester, New Hampshire]), which directly treats the vaginal tissue, was shown to increase collagen and extracellular matrix production and increase the thickness of the vaginal epithelium with the formation of new papilla.Three 5-minute treatments are given at 6-week intervals, and no anesthesia is required.
Low Sexual Desire in Women: What Are the Options? - Medscape -Jul 09, 2018.
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