What is Intrarosa and how do I use it?

Intrarosa is a pessary that is inserted into your vagina. It’s used to treat changes in and around the vagina that commonly occur when levels of estrogen begin to decline during the perimenopause and menopause.

This includes symptoms of vaginal dryness, such as soreness, itching and pain during sex. Declining levels of estrogen can also cause urinary symptoms such urinary tract infections, urgency or occasional leaks.

Intrarosa is one of the newest treatments available in the UK and, unlike other topical products used to ease menopause symptoms, Intrarosa doesn’t actually contain estrogen. Instead, it contains a hormone called DHEA, which your body produces naturally. Once inserted into the vagina, this hormone is released and converted to both estrogen and testosterone.

How does Intrarosa work?

The hormone estrogen keeps the vagina healthy by acting as a natural lubricant. When levels of estrogen start to decline, the tissue lining the vagina thins and becomes drier and less flexible.

This can cause dryness, irritation and painful sex. Intrarosa is made with a plant-derived form of DHEA, combined with coconut and palm oils. As the pessary dissolves, these ingredients also help to lubricate and improve the condition of the affected vaginal tissue.

Who is Intrarosa suitable for?

Intrarosa is safe for long-term use and can be used alongside HRT.

As it’s the only topical treatment that doesn’t contain estrogen, it may also be a good option for those who can’t, or don’t want to, use a product containing estrogen.

It may also be a good option for those who experience irritation from other topical products.

When and how do I use Intrarosa?

Intrarosa is a small, waxy pessary that you insert into the vagina every day, using the applicator provided. You can insert it when you’re standing up or lying down, but it’s best to do this before you go to bed so that it can dissolve overnight.

Symptoms should begin to improve within 12 weeks, with continued improvement over time.

Can I expect any side effects?

The most common side effect is vaginal discharge, which occurs when the waxy pessary melts and leaks out of the vagina. The discharge is whitish in colour. In the absence of other symptoms this is normal and does not mean you have a vaginal infection or irritation.

What are the benefits?

Intrarosa is the only vaginal non-estrogen treatment available. Research suggests that testosterone therapy can help to combat the symptoms of vaginal dryness, so it may be beneficial that the DHEA in Intrarosa releases both estrogen and testosterone directly to the affected area.

What doses does Intrarosa come in?

Each pessary contains 6.5mg of prasterone, which is a type of steroid. It’s biologically identical to the hormone DHEA, which is made naturally in the body.

Resources

British National Formulary (BNF): Prasterone