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. Kimbo

    My Dr just prescribed osphena, about how long does it take to see any positive results ?

  2. jmk

    I have been using Osphena for 10 months. I no longer have vaginal dryness. I felt relief after a few months but I am now having pain in the joints of my fingers and have burning in the vaginal area on the outside. Going for hand x-ray this week to see what is causing finger pain. Has anyone else had joint pain in their fingers? Some days I have no pain but other days I do.

  3. Barb

    I have been on Osphena for 9 months I had the painful intercourse severe dryness burning just to be completely honest I felt like I had glass in my vagina thats the best way to describe the pain, it took about six months of being on Osphena before I really seen inprovements now a nines months iI feel normal again !

    I know ther are side effects but for me my comfort and being able to have my life back is worth it, I couldn’t hardly walk so this wasn’t just about sex, things were so bad everyday task were almost impossibe for me!

    I tried other things first I use estrace for 6 mons did not help at all and use replens no help either along with different lubricants nothing work, OSPHENA has helped me and I am thankful for my doctor prescribing it for me!!!

    • Debbie
      Los angeled

      Omg. Me too. I also starting itching on my back. Yikes. Bring 64 is no fun.

  4. Barbara

    I have used Osphena for nearly 3 years. It works well–vaginal dryness and tender tissues are gone. However, since I worry about cancer and the other complications, for the last year and a half I have only taken one tablet every 3 days. It is enough to help, but hopefully it is not enough to create serious problems.

  5. DD

    There is a rare infection called Desquamative Infectious Vaginitis aka DIV that is not being diagnosed by Drs. who usually think it is a UTI or Yeast Infection, etc. It is hard to diagnose.

    Symptoms are vaginal dryness & intense vaginal pain in general. There is usually a heavy, thick discharge which does not smell but is yucky to say the least. The lining of the vagina actually sloughs off causing these symptoms. Your vaginal are will be extremely red. It hurts to sit down when you have full blown DIV.

    Please ask your OBGYN to test for this hard to treat, hard to diagnose infection or you will NEVER find relief if you actually go untreated. It took 6 months for my Dr. to figure it out.

    And the treatment takes time but at least you can find relief. When you have DIV, sex is out of the question until you get treatment. Believe me, it is the last thing you will even consider.

    I hope that the ladies out there who have been miserable for so long will please ask about this.

    A simple vaginal swab will determine diagnosis!

  6. Elaine

    I have been taking osphena for about 2 months now. It has changed my sex life!! No pain, I am super lubricated and sex is fantastic!! I do feel a bit queasy sometimes but I will work through that to feel like I am 21 again! I also get some warm flashes but nothing too serious.

  7. j

    Reading all of this, I am amazed that no one has mentioned Estring!

    It’s an estradiol infused silicone ring that you use for 3 months at a time. I have used it for years, am 63, and although sex got painful after a long stretch of no sex due to prostate surgery, with a little practice I am ok again. Use it or lose it!

    I tried Osphena once, and actually thought it improved my libido, and dryness issue was fixed, but had a few problems. Memory issues, urinary continence issues, achy joints. So I went back to osphena. Try the ring!

  8. Nancy

    I am 69 and was on a low dose of estrogen for bone density, vaginal dryness, et. al. Last year I was diagnosed with estrogen positive breast cancer, so there went the estrogen. I have finished treatment and, as far as we can tell, am cancer free, but now I am on Femara to prevent recurrence and I am getting bladder infection after bladder infection. I will finish a bout of antibiotics and within a week will have another UTI.

    One doctor suggested Osphena to remedy the vaginal atrophy that makes me susceptible to the infections. Does anybody know anything about this?

    • Tina

      I take a low-dose of Nitrofurantoin to prevent urinary tract infections. You might try that?

  9. Cheryl R.

    I’ve been on Osphena for two weeks now, and while intercourse already seems less painful, I find that I’m becoming ridiculously emotional. It’s almost like I’m PMSing, and at 62, that’s totally unacceptable! I can’t take this restless, uneasy irritability. Has anyone else experienced this?

  10. norma
    wichita, ks

    I was taking estrdiol. the dr, put me on osphena. which is best for burning in the vagina and constant urination?

  11. Marie

    I’ve been taking Osphena for a year. I stopped, and my symptoms seem to be back. Osphena has worked great for me.

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