The Medical Letter on Drugs and Therapeutics
Ospemifene (Osphena) for Dyspareunia
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The FDA has approved ospemifene (os pem’ i feen; Osphena – Shionogi), an estrogen agonist/antagonist, for oral treatment of moderate to severe dyspareunia in postmenopausal women. Ospemifene is the fourth estrogen agonist/antagonist to be marketed in the US, but it is the only one that has an estrogen-like effect on vaginal epithelium. The other three, tamoxifen (Nolvadex, and generics), toremifene (Fareston), and raloxifene (Evista), are used for treatment and prevention of breast cancer and osteoporosis.

TREATMENT OF DYSPAREUNIA — Vulvovaginal atrophy is common among postmenopausal women and may cause irritation, itching, vaginal dryness and pain with intercourse (dyspareunia). Over-the-counter nonhormonal moisturizers and lubricants (Replens, K-Y, and others) may provide adequate symptom relief for some women, but do not treat the underlying ... more      

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