The Medical Letter on Drugs and Therapeutics
Addendum: Ospemifene (Osphena) for Dyspareunia
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Some readers have objected to our recommendation (Med Lett Drugs Ther 2013; 55:55) that postmenopausal women with an intact uterus who take the oral estrogen agonist/antagonist ospemifene (Osphena) to reduce the severity of dyspareunia should also take a progestin.1 Ospemifene has agonistic effects on the endometrium, and the Osphena package insert says: "Generally, when a product with estrogen agonistic effects on the endometrium is prescribed for a postmenopausal woman with a uterus, a progestin should be considered to reduce the risk of endometrial cancer."

Endometrial hyperplasia has been reported in more than 20% of women taking unopposed systemic estrogen for more than one year; the risk is closely related to the dose and duration of treatment. Adding a progestin to estrogen therapy in women with a uterus reduces the risk of ... more      

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Title: Addendum: Ospemifene (Osphena) for Dyspareunia
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