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. Susan
    Fort Worth

    Thanks for all your feedback on this Osphena. While I’ve had hot flashes like forever, Osphena made them worse. It does help, unfortunately my prescription drug plan, Silver Script, refuses to help pay any of this med, along with the Minivelle patches that could have helped with hormones.

    My cost is in the hundreds and I cannot afford it. I’ve tried using the coupon and ‘no can do.’ I had a hysterectomy at 19, only option drs had back then, ovaries removed at 40, so I’m literally at my wits end. Maybe if I were dirt poor or qualified for Medicaid I would get help. As it is, no help. It’s no sex at 68. Not by choice.

  2. verne

    There is discount programs for Osphena at $25.00 a month with insurance. I had terrible face and neck swelling. I take at night every third day to help. Looks like the patent will expire in 2026. Long time away for generic.

  3. Kathy

    I’ve been reading about DHEA suppositories being used for vaginal dryness and atrophy. Has anyone tried this and did it help you? Thanks.

  4. Cindy clark

    I took Osphena 60 mg for 3 months, It did help, but 2 months after I stopped taking it symptoms are returning with burning and odor. I really do not see this being the help that I need for this issue!

  5. Lynn
    bflo ny

    I am 59 yrs old and had my last period at 51 – shortly afterward intercourse started to become painful and now it is impossible to have intercourse at all – I started on Osphena 4 mos ago and I have EVERY side effect from the annoying vaginal discharge to waking up at night with leg cramps and the worst is the copious sweating – to the point that all summer I have been having to keep a towel with me…however, I still have such painful intercourse that sex seems to be a thing of the past for me – it is expensive – and for me did not work whatsoever for the purpose I was taking it – it has only been making me miserable – done with it – looking into bioidenticals

  6. Sheryl
    Dripping Springs Tx

    Hi, I am 59 and started taking Osphena 4 months ago and really helps. I did have some early side effects but worked though them. Sex became so painful for me a about 4 years ago and I really tried to handle the pain with several creams and lubricants but in the end my husband decided to go find a younger woman he could not handle being married and not having the sex he wanted. It shattered me.
    I am divorced now and have a boyfriend and thankfully I still have it with a little help with Osphena.

  7. Kathy

    I looked forward to menopause, thinking it was just the end of my periods; little did I know it would also be the end of my sex life! I can’t use hormones due to having had a TIA (mini-stroke). Lubricants don’t help with painful intercourse. Vaginal atrophy and dryness changed everything. I don’t feel like a woman and would gladly go back to having periods again.

  8. Southern Cali Girl

    Hello Ladies,
    So glad I found this site. Although I don’t wish painful sex for anyone, so glad to read that you all experience it as I do…like a fire rod! UGH! Like most of you I didn’t want to take any Hormone supplements. My OB recommended Osphena and gave me a months worth of samples. So now I’ve been on it for about 2 1/2 months. I already had hot flashes and wasn’t taking anything, just working through them. The sweating as a side effect from Osphena can be really bad at times, but I just deal with it.

    My husband and I had sex this past weekend and I was disappointed that it was still so painful, even though they say it takes 12 weeks before you can feel the difference, after reading some of your reviews I’m worried I’m wasting my time and money (as I paid $50 for 3 months worth), and in the back of my mind so worried about the side effects. I’m 52 very active, in good health no history of cancer in my family. I can tell it’s working as I do have the discharge, no other side effects besides the sweating, my husband could tell the difference too….. just hoping the pain goes away at least after the 3 month mark. Anyone else still experience this same issue?

  9. Cathy
    Talladega, AL

    Can you tell me which is safer, Estrace cream or Osphena tablets? I am 72 yrs old. I have been using Estrace for many years & it does not help with intercourse. My doctor just prescribed Osphena & after I read side effects just not sure about it.

    • Joanne

      Yes, I had the same exact issue . Months on the medication and still painful intercourse . Just decided today to stop taking it. The hot flashes are awful!

  10. Kricket

    Ladies I have been taking Osphena for about 2 weeks. After the first week I developed a very nasty yeast infection. I am not sure if this has any thing to do with the Osphena. Has anyone else had this problem after taking this pill??

    • Paula
      Naperville IL

      Yes, me too. I’m 58 and have been dealing with the atrophy and dryness for many years. Intercourse is impossible. I was on Vagifem for a while, which made things down yonder more comfortable on a day-to-day basis, but did not help with intercourse. I’ve tried everything else and started Osphena three weeks ago.

      Right now, I have the most absolute worst yeast infection I’ve ever had. Also had been on antibiotics, so I’m assuming that neither is helping the problem. So I’m on the fence about it. May stop it until things are under control, and then give it another try. But I’m not going to deal with horrible yeast infections (on top of the atrophy) from Osphena if that’s what’s happening. I’ll have to wait and see :(

  11. Dot
    Chicago, IL

    I had a robotic vaginal hysterectomy (one very tired ovary remaining) in 2015 for adenomyosis. Best decision I have made surgically to finally be pain free after 10+ years of cyclical awfulness. Premarin was helpful for hot flashes but after a couple of months on that med, I was having issues with vaginal discomfort, dryness and just sitting for prolonged periods of time. My surgeon prescribed Osphena as a daily medication.

    After one week, my pelvic floor PT noted an improvement in the fullness of the vaginal tissues, and I could appreciate I was not as aware of what was going on down there, if that makes any sense. Eventually the normal, side effect discharge from this medication was overwhelming so I decided to take half about every 2-3 days. I’m actually on a three day interval now and maintaining that way for the last four months. No issues and feel very comfortable. A 30 day prescription lasts me quite some time. Everyone experiences medications differently, but this has worked for me. Good luck to you!!!

  12. sally
    United States

    I started using osphena about a month ago . My head has been feeling funny not sure if it’s from that or not.

  13. Marie
    New York

    Does anyone find that using Osphena makes you have an unpleasant odor?

    • Diane

      Yes, I have quite taking osphena and after more than a week, I am finally not so sweaty and “stinky”. Very embarrasing. I did not feel the medication was at all beneficial. I felt like I was going through menopause again!

  14. Jane
    North Carolina

    Osphena is just another high price RX to substitute or fail to substitute for bio identical hormones. I tried it for 6 months while suffering post menopausal symptoms that were very painful. Doctors seem to be working for the drug companies. Never did it help with ANY symptoms. I finally found a compound pharmacy that helped me with a bio identical cream, but no local doctor would help me by prescribing this inexpensive remedy that worked without torturing pregnant horses (Premarin). Shame on the politics of the medical profession not using the science we women need and deserve. As females we need to follow the money. Drug companies and Med Schools are in bed together.

    • Evelyn

      Please share! What is this inexpensive bio identical cream you got from the compounding pharmacy? I was on bio identical cream several years ago, and it was $150/month WITH insurance. I’m willing to try anything at this point. I’m 52, had a hysterectomy in 2002, and haven’t been able to have sex in over a year because it is excruciatingly painful. I’m starting Osphena today, but the side effects scare me.

    • Ann

      So am wondering what was in the compound you mentioned

  15. Valerie
    Nova Scotia , Canada

    yes I am 65 , I have painful sex it really hurts and I only have pharacare in Canada, I need help

  16. Cheryl

    Ladies I need your advice. I’m 60 and a widow of 7 years. Now I have a man that I want to have a sexual relationship with but I had a full hysterectomy several years ago. I had painful sex with my late husband so much so that we stopped. What I need to know is should I ask my doctor about Osphena or try Premarin cream first? Yes I have hot flashes every once in a while now without anything. AND I’m on a weightloss program. So any suggestions please.

  17. 29 Again

    I had such high hopes that Osphena would be the answer to my situation, but the first day I took it my face felt tight. The second day my face was on fire and swollen. I had to stop taking it and begin my search again for an answer.

  18. jane
    Concordia Kansas

    I am 71 years old, and bioidentical hormones are the way to go in my opinion.

  19. Garnet bell
    Corpus Christi Tx

    I’m 58 and have been using osphena for over a year for my dryness and painful sex it works very well but it is very pricey i use to only pay $95.00 but because of my insurance Humana that I had to change toI have to pay $ 185.00 a month now so I can’t afford it anymore after this month . so I wish I could buy a generic brand or they could lower the price

  20. Julie

    Hi, I am now 51 years old. I had a complete radical hysterectomy 5 years ago as I was at high risk for ovarian cancer. Sex became severely painful. Lubricants were OK for a while but still quite painful. I began Osphena 8 months ago. I think it works very well. I noticed a difference in just a week. My insurance covers $154 each month, I pay the additional $60. I feel that it is worth it. I haven’t noticed any side effects. I am very healthy, I run, no tobacco or alcohol. I still have hot flashes, I had hot flashes before Osphena, they have not increased. I’d suggest trying it.

    • Janine

      I pay for my osphena myself. CVS pharmacy charges me $50.00. Go to osfena site & you can get a discount card.

  21. renay
    valdosta ga

    I would like someone to share some light about the osphena because I am only 42 and I have a husband and between my sex drive and the hotflashes I am about to loose it I need something quick and fast.

    • Renee

      I believe that Osphena actually has hot flashes as a SIDE EFFECT for some and certainly will not help them. You may instead need to use a more systemic source of estrogen to help the hot flashes – perhaps a Femring.

    • Garnet bell

      Wow what insurance do you have with my insurance. I pay $185.00

  22. BJ
    Grenada, MS

    I’m almost 52 and I’ve started taking Osphena. I’m just not sure about anything. One doctor recommends a hysterectomy. One says no need for that. I’ve been having a major discharge like yeast, but it’s not. I’ve learned it’s the lining of my uterus. Not a pretty picture I know.

    I need treatment, but I’m honestly scared of the prevalent warning of blood clots with Osphena. I’ve been through 2 surgeries since April. One was appendectomy. The other was a stomach sleeve. I don’t know if that increases my risk for blood clots or not. I just don’t know what to do. Any suggestions?
    I’m in such a state of indecision.

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