*Content reviewed by HotPause Health Medical Advisor & Doctor of Pharmacy Audrey Hou, PharmD, CMPP

Ospemifene is a medication approved by the FDA for the treatment of moderate to severe dyspareunia (painful intercourse), a symptom of genitourinary syndrome of menopause (GSM). GMS describes the various menopausal symptoms and signs associated with physical changes of the vulva, vagina, and lower urinary tract. GSM includes not only genital symptoms (dryness, burning, and irritation) and sexual symptoms (lack of lubrication, discomfort or pain, and impaired function), but also urinary symptoms (urgency, dysuria, and recurrent urinary tract infections [UTIs]). [1] Doctor of Pharmacy and therapeutic expert, Audrey Hou, explains why Ospemifene offers an alternative for women seeking relief from dyspareunia without using traditional estrogen-based therapies.

How Ospemifene Works

Ospemifene is classified as a selective estrogen receptor modulator (SERM). Unlike traditional estrogen therapy that adds estrogen to the body, SERMs selectively mimic or block estrogen's effects on different tissues. Ospemifene works by mimicking the effects of estrogen on the vaginal tissue, which helps rebuild the tissue, making it thicker and less fragile, thereby reducing pain during intercourse.

Potential Benefits of Ospemifene for Menopause

• Dyspareunia Relief: Ospemifene effectively reduces pain during intercourse, a common and distressing symptom for many postmenopausal women.
• Non-Estrogen Option: It provides an option for women who cannot or choose not to use estrogen therapy, such as those with certain health risks or a history of hormone-sensitive cancers.
• Improvement in Vaginal Health: Besides relieving pain, ospemifene also contributes to the overall health of the vaginal tissue, improving moisture and elasticity.

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Usage and Considerations

Ospemifene is taken orally, typically once a day. If you miss a dose, wait until your next regularly scheduled pill. As with any medication, it's important to use ospemifene under the guidance of a healthcare provider, following the prescribed dosage and regimen closely. The effectiveness and any side effects should be regularly reviewed with your provider.

Side Effects and Considerations

Common side effects of ospemifene may include hot flashes, vaginal discharge, and sweating. There are also potential risks associated with ospemifene, including an increased chance of developing endometrial hyperplasia, which could lead to cancer of the lining of the uterus if left untreated. Women using ospemifene are advised to report any unusual vaginal bleeding to their healthcare provider since it could be a sign of endometrial hyperplasia or cancer. Because of its selective action, ospemifene may not be suitable for all women, especially those at increased risk for blood clots or stroke.

Conclusion

Ospemifene offers an important treatment option for postmenopausal women experiencing painful intercourse due to vaginal atrophy. By mimicking the effects of estrogen on vaginal tissue, it can provide relief from one of the more challenging symptoms of menopause without the use of traditional hormone replacement therapy. As with any medication, careful consideration and ongoing communication with a healthcare provider are key to maximizing the benefits of ospemifene while managing potential risks.