Many of my patients are post menopausal women. They are still, I feel, in the prime of their lives. They are very attractive, mature women full of goals that they’re still actively pursuing. They are successful wives, significant others, mothers and grandmothers living busy, fulfilling lives. Yet, in the privacy of their doctor’s office, many of them report an area of their lives that they feel could use improvement, or in some cases, a complete overhaul. That area is their sexual desire and their sexual functioning. Now, it seems that there’s a pill made just for women – that aims to specifically target female sexual dysfunction. It’s called Osphena. Let me tell you about it.
Osphena: Is it the Answer You’ve Been Looking For?
Since menopause, many of my over-50 female patients tell me that they’ve lost a lot of their sexual desire. They also report another type of sexual dysfunction that’s putting a big damper on their sex lives as well – pain with intercourse that they didn’t have before. As a result, many women aren’t having very fulfilling sex lives with their husbands or significant others. In some cases, the relationships have deteriorated because of the lack of intimacy and discomfort, in completing sexual intercourse.
Now, there’s a little pill called Osphena that can help. It’s being touted as the “female Viagra” as it aims to re-awaken sexual desire in women the way Viagra does with men. But Osphena doesn’t really work the way Viagra works on a man’s system. Osphena aims to treat a fairly common condition that affects about half of menopausal women – dyspareunia or painful intercourse.
Dyspareunia occurs from decreased estrogen levels that create another gynecological condition called vulvo-vaginal atrophy. This is a condition where a woman’s vaginal tissues become inflamed, dry, thin, and shrink. With attempted intercourse, a woman often feels pain from the burning that these dry tissues create. She may often experience bleeding of the very thin vaginal wall tissues with the friction of intercourse as well. It suffices to say that this kind of sexual experience is not very pleasant for either the woman or her partner and can significantly dampen desire.
What Are the Pros and Cons of Osphena?
The good news is Osphena’s manufacturers claim it can boost estrogen levels which help to re-thicken and re-lubricate vaginal tissues making painful intercourse a thing of the past. Think of giving a beautiful, yet wilted, flower much needed water. The moisture revitalizes and plumps up all its tissues literally reviving it back to life. Osphena is also what’s called in drug manufacturing circles, a SERM – selective estrogen-receptor modulator – in the same class of drugs as tamoxifen (treats and prevents breast cancer) and Clomid (stimulates ovulation). SERMs help women better utilize estrogen circulating in their body.
On the downside, Osphena, like tamoxifen and Clomid, also comes with “black box” risk label warnings, which include blood clots and stroke. In trials of Osphena, women reported increased amounts of urinary tract infections, yeast infections, and hot flashes. It also shouldn’t be taken with the drug fluconazole – the very drug used to treat yeast infections. Also in trials, the results were that that only 14% of women experienced relief of their dysfunction symptoms and just as many experienced some type of adverse event – like infection, etc. Generally, when deeming a treatment successful, you want to see the benefits outweigh the harm by a better margin. Yet, the FDA approved Osphena ruling that it did just that – its benefits outweigh any potential risks. You may want to see how it works for, and affects, you.
Is There Anything Else I Can Do To Treat Dyspareunia?
In the world of medicine, there’s always something else you can do besides taking a drug that may help some symptoms yet cause a lot of others. In the case of dyspareunia women have the following options:
- Bioidentical Hormone Replacement. Many women can take “bioidentical” hormones consisting of plant-based phytoestrogens and progesterones that do not carry the side effects of synthetic hormones. They are by prescription only though.
- DHEA. Recent studies out of Italy revealed that supplementing DHEA at low levels daily helped about half of the women in the study revive sexual interest and activity. DHEA is a hormone precursor which provides the “building blocks” that allow your body to make its own specific hormones, in the amounts it needs, both estrogen and testosterone. DHEA was shown to relieve hot flashes, rejuvenate vaginal tissues, as well as boost mood and participation in sexual intercourse.
- Topical Estrogen Cream. Estrace is a common low-dose estrogen cream that women can get through prescription from their GYN doctor. It works locally inside the vagina and only trace levels are absorbed by the entire body.
- Olive Oil. Women in Italy, Sicily and Greece have long used olive oil (an Omega-3/6 natural fat) to treat vaginal dryness and discomfort. Olives also contain beneficial plant estrogens which can have a revitalizing effect on vaginal tissues.
- Grapeseed Oil. From grapes, contains traces of resveratrol a powerful antioxidant, and Vitamin C which fights breakdown of skin tissues. Many skin specialists recommend it as a pure, chemical-free moisturizer that works particularly well on thin-skinned areas like eyes and neck. For this reason, many women use grapeseed oil as a vaginal moisturizer as well.
- Commercial lubricants: Replens is an over-the-counter vaginal re-moisturizer that actually binds to vaginal wall tissues helping them heal and get stronger with regular use. It restores the normal pH within the vagina and decreases inflamed tissues.
- Omega-3 Fats. Diets deficient in these essential fatty acids may experience more vaginal dryness than others. Get 2,000 mg a day in your diet.
- Kegal Exercises. Kegel exercises have been used for many years to help restore proper tension to lax pelvic floor muscles and ligaments, which support the vagina and bladder. Doing Kegels everyday can enhance sexual relations, and orgasm, by tightening the surrounding muscles.
Just because you hit menopause doesn’t mean you have to pause your sex life too. Just as men have many options to deal with low testosterone issues which affect their ability and desire to have regular sexual relations, there are options for women as well. Osphena is just one of your options to treat dyspareunia that may work well for you. Do not be afraid to bring up the subject to your doctor – that’s what we’re here for! Voicing your concerns and symptoms can help you reclaim a healthy, happy, satisfying sex life long into your old age!
Mark Rosenberg, M.D.