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Vaginal DHEA

Prasterone

Brand names: Intrarosa

Prasterone is intravaginal dehydroepiandrosterone (DHEA) used to treat vulvovaginal atrophy with moderate to severe symptoms in postmenopausal women.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

Locally it is converted within vaginal cells to oestrogens and androgens, restoring epithelial maturation and improving vaginal symptoms with minimal change in systemic hormone levels.

Prescribing in practice

  • It is contraindicated in undiagnosed vaginal bleeding, which must be investigated before treatment.
  • It has not been studied in women with a history of breast cancer and should be used with caution where hormone-sensitive malignancy is a concern.
  • Vaginal discharge is a common local effect and is generally benign.

Monitoring

No routine laboratory monitoring is required; review symptom response and investigate any unexpected vaginal bleeding.

Counselling the patient

  • Insert the pessary into the vagina at bedtime as directed.
  • Vaginal discharge is common and usually harmless.
  • Report any unexpected vaginal bleeding to your clinician.

Evidence & guidelines

Licensed for postmenopausal vulvovaginal atrophy on the basis of randomised placebo-controlled trials, as reflected in the SPC.

Reference: SmPC; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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