Q. I went through menopause several years ago and have struggled ever since with vaginal dryness and pain. A few years ago I used Premarin cream, but it was messy and smelly and I was scared that it might promote cancer.

Vitamin E soft gels as vaginal suppositories were not messy. They did help some, but the physician’s assistant at our clinic said I shouldn’t use vitamin E that way.

Replens helps slightly with the dryness but not with the pain. I’ve recently seen TV ads for a pill called Osphena that is supposed to treat this. What can you tell me about that option?

A. Osphena (ospemifene) was approved a year ago for postmenopausal women suffering from painful intercourse. Though it is not estrogen, vaginal tissues respond to it as if it were, becoming thicker and less fragile.

You might ask your doctor about trying these tablets for a short time. This drug might not be a long-term solution for you because uterine tissues respond to Osphena as if it were estrogen, increasing the risk for endometrial cancer. Women who have had a hysterectomy are not at risk of this problem and could use it without worrying. Any woman who develops vaginal bleeding while on Osphena should see her doctor promptly. Blood clots are another potential side effect.

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  1. Dawn
    Colorado Springs, CO

    I had a complete hysterectomy when I was 25. I had endometriosis, severe bleeding and cysts everywhere. I was put on Premarin low dose and increased to 0.9mg .My insurance quit paying for it. Now I have painful intercourse and my boyfriend is having problems with believing I am making it up since I just been quiet and now it feels like sandpaper, knives all of the above I don’t know what works. Can someone please tell me. I saw the ad for ospreys but I don’t know what to do.

  2. T

    For all those suffering with the pain, I use vagisel cream and a silicone lubrication. This helps from pain and dryness during sex

  3. Sheri

    I had a terrible experience with Premarin Cream . The first month of use was wonderful but then it began to burn and itch me day and night. I believe it also caused me to develop intetsitial cystitis and vulvadinia. My doctor wad an idiot. It’s a long story but when I syoppef all attempts of estrogen therapy and stopped seeing the highly educated quack and used my own common sense, I gradually got better, I dtill have atrophy, but that is wrll handled compared to 24 hour pain, and sex doesn’t mean that much. Any way, if this new product mimics estrogen
    then you may as well be using estrogen. Don’t do it,

  4. Kathy

    I’m 64 and on the Climara patch and progesterone. This hasn’t helped the dryness and discomfort much at all. I had some bleeding and my doctor has increased the progesterone from 100 mg a day to 200 mg per day, and now I feel like I have to pee all the time! Has anyone experienced this with progesterone?

    Also, has anyone tried Chinese medicine for menopausal symptoms? Let me know if it has worked for you. Thank you.

  5. Triplets n 1

    I am a 50 y.o. woman who has Not gone through menopause just yet, but sex with my husband honestly feels like he has knives taped to him (is that an accurate description for anyone else?). In my mid-30s I underwent IVF & took LOTS of Estrogen & even more progesterone to maintain my pregnancies.

    My Gyn initially prescribed Clobetasol cream but it did absolutely nothing to ease the pain. Followed up with Premarin but admittedly I never tried it bc of all the scary side effects. Saw a commercial for Osphena & wonder if it could be the answer to my prayers…? I do have a history of cervical dysplasia & have uterine fibroids currently. But having such a terrible sex life is really taking a toll on my marriage and every time I just “grin & bear it” I end up totally torn to pieces for the next week-10 days.

    And due to 5 totally different sets of circumstances, I’ve gone through 5 gynecologists in the past 8-9 years (same office); this most recent one doesn’t seem to grasp the gravity of my situation, he wants me to try the Premarin & if that doesn’t work, have a hysterectomy, which I Really Don’t Want… :(. I’d love any feedback anyone might have. While I feel badly for each of the women who have posted in this forum, I take some comfort in knowing that it’s NOT just me having an isolated issue of unknown seriousness. So here’s to all of us suffering through this total BS condition; praying we all find some relief SOON!!!

    • Lee-Ann

      I am 50 years old, had a hysterectomy when I was 27 and have had some hotflashes now and then since 35, but the last year with them has been brutal. I have severe vaginal dryness which feels like he is wrapped in sandpaper and hurt for days after. If your doctor thinks a hysterectomy is the answer to your vaginal dryness, think again my dear. Like I said, had it when I was 27, and nope, the menopause symptoms are present and not seeming to ease off. I went to a Kinesiologist, he has taken away my hotflashes, now this week going to talk to him about the dryness and what I can do for it. If he leads me to something that will help, I will come back here and let you all know. Just wanted to tell you a hysterectomy is not the solution for vaginal dryness. Good luck in finding help. Please contact me by email if you wish.

    • Renee
      south carolina

      I’ve had frequent urinary tract infections, bladder issues, and painful sex since my hormones went whacko 4 years ago. I was 45. I loved sex with my hubby and suddenly it hurt. It wasn’t gradual. It hit like a freight train.

      My GP sent me to a urologist who told me, like my gyno, that I had a chronic bladder disease. My urologist has changed his mind about that. He now says I need to get on hormone therapy to fix my problems, which include a frequent urge to pee. My life is ruined at this point. I can’t travel. I can’t have sex. Any strenuous activity triggers painful urethral issues.

      I’m terrified of hormone therapy because of the risk of cancer. My aunt died from breast cancer. My cousin has had breast cancer twice. The last time ended in the removal of her breasts. And, no, “TRIPLETSN1″, it’s not just you. I’ve been using all sorts of natural supplements, trying to fix my problems. So far nothing has worked. I will be 50 at the end of this month and my sex life is non-existent.

      My drive is there but my nether regions are too painful. My mother is 73 and doesn’t have these issues. She never did. I’m so miserable. My poor hubby is very patient. I wish I could reward him for his patience without experiencing pain myself.

    • kath
      New York

      Ladies—-Having experienced at age 60 (I’m now almost 63) all of the symptoms mentioned below—–coconut oil. Yes coconut oil. If the oil is hard, take a q-tip and get a 1/2 a dime-sized little piece and insert. If the oil has liquified, use 2-3 q-tips held together, soak up some oil, and insert. Do this morning and before bed. Yes it can melt a little, but it’s certainly not worse than any of the @500 periods we all lived through !Takes about 6 weeks to see the difference but it made a big difference—-not perfect, but it really helps. I read this on another site for Osphena so I figured nothing to lose………….

  6. Adele S
    Orlando, Florida

    Sex hurts so much. The pain is so excruciating that it scares me. We always had a great sex life that came to a grinding halt. My gyn gave me a script for Osphena. I took it for three weeks and got bad stomach aches and diarrhea so I stopped taking it. I want to start again to see if it will help but worry about side effects.

    My partner is scared of hurting me and I feel broken. The Osphena comments on here go all the way from “miracle drug” to “dangerous drug.” I take Progesterone and use the Minivelle patch which, in my case, do nothing for vaginal atrophy. The Premarin cream did not help. This problem can destroy a relationship and, if it doesn’t, I feel horrible anyway. At least I now know I am not alone with this. What is the hyaluronic acid and what does it do?

  7. Linda m

    I haven’t had sex for 7 years. I can hardly stand the pain from my doctors GYN exam. She didn’t want me to go in osphena But I need help

    • Susan

      Just started taking it two weeks ago I know it could be weeks to see any difference I literally saw a difference in a week my vagina is moister sex is not as painful definitely not as dry it’s working like 98.9% in a positive way for me I have had a hysterectomy and am post menopausal.

  8. K Marin

    As a 55+ women who finished menopause, for the most part, I found myself suffering from Atrophic Vaginal Atrophy and such horrendous pain during intercourse that penetration was impossible. A friend recommended I try Osphena and considered it a miracle drug. By the time I finished the 15 day trial my GYN had given me, I wished I would just die. Seriously, my vagina looked like I had rubbed it with poison ivy. It was unrecognizable. I was tested for every STD, etc. known, more than once and even treated with drugs that are for STD’s. All tests were negative. All drugs failed. Six months later I still have itching and a vaginal infection that is resistant to every drug we’ve tried. MY ADVICE is DO NOT TRY this miracle drug. I would not wish this on my worst enemy!

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