Intrarosa

Intrarosa is used to treat vaginal and vulval symptoms of women post-menopause.

What is Intrarosa?

Intrarosa is a hormone replacement therapy (HRT). Prasterone is the active component in Intrarosa. Prasterone is identical to an inactive compound found humans called dehydroepiandrosterone, which is converted into active hormones (oestrogens and androgens).

Intrarosa is used to treat women who experience moderate to severe symptoms of vulvar and vaginal atrophy after the menopause. Vulvar and vaginal atrophy is the naturally-occurring thinning of the tissues outside and inside the female genitals. Symptoms generally include genital itching and vaginal dryness, which can lead to difficult and painful sexual intercourse. Symptoms are the result of the reduction in vaginal cells and vaginal lubrication, which are caused by the decrease in oestrogen levels after the menopause.

Prasterone acts by replacing oestrogens to the normal levels found before the menopause. Vaginal cell production and lubrication are increased, thereby reducing genital itching and vaginal dryness. Also, the vaginal pH is returned to normal, which encourages growth of beneficial vaginal microbial flora.

Can I buy Intrarosa online?

The Online Clinic can prescribe Itrarosa online following a consultation. Click on the icon below to commence the process.

How to use Intrarosa

Intrarosa is a whitish pessary that is bullet-shaped. One pessary is inserted into the vagina before bedtime each day, using either your finger or the applicator provided (read the instructions provided before the first insertion). Your doctor will tell you how long to use the pessaries and should engage with you at least every six months to discuss if they are still needed.

Vaginal douching (cleaning with a liquid) is recommended if more than one pessary is inserted in a day. If you forget to insert a pessary, then insert one when you remember as long as the next pessary is not due within 8 hours. Miss the forgotten pessary if the next pessary is due within 8 hours, and take the next pessary at bedtime as usual.

Regular check-ups with a doctor (particularly if you have certain other conditions) and regular breast screening is recommended when using Intrarosa.

Who can use Intrarosa?

Intrarosa is for women after the menopause only. It is not for children or adolescents, women of child-bearing age, and women who are or become pregnant.

You cannot use Intrarosa to prevent pregnancy as it is not a contraceptive. To avoid pregnancy, additional contraception (e.g., a condom) is required if you had a menstrual period within the last 12 months and/or are younger than 50 years of age. Stop using Intrarosa and see a doctor immediately if you become pregnant.

Intrarosa should not be used if you have any of the conditions below or if such conditions first appear while taking Intrarosa (when immediately, Intrarosa must be stopped and a doctor consulted):

• If allergic to prasterone or any of the other ingredients in the pessary.
• If you have/have ever had/are suspected of having breast cancer.
• If you have/are suspected of having an oestrogen-sensitive cancer, e.g., endometrial (womb lining) or breast cancer.
• If you have: unexplained vaginal bleeding; endometrial hyperplasia (excessive thickening of the womb lining) that is not being treated; and/or a blood clotting disorder, e.g., protein C or S deficiency or antithrombin deficiency; and/or the inherited blood disorder porphyria.
• If you have/have ever had: a venous thrombosis (blood clot in a vein), specifically, in legs (deep venous thrombosis) or lungs (pulmonary embolism); a condition due to arterial thrombosis (blood clots in an artery), e.g., angina, heart attack, or stroke; and/or liver disease (and the liver function tests are still abnormal).

Inform a doctor before starting Intrarosa if you have/have ever had any of the following conditions, as they can worsen or return: fibroids in the womb; endometriosis; endometrial hyperplasia; increased risk of oestrogen-sensitive cancer or of blood clots; high blood pressure; fluid retention; a liver condition; gallstones; high blood triglyceride (fat); diabetes; migraine/severe headaches; systemic lupus erythematosus; asthma; epilepsy; and/or otosclerosis (an ear condition).

Intrarosa must be stopped and a doctor’s advice sought if you get any condition which prohibits the use of Intrarosa (listed above), or if you experience: signs of a blood clot (redness, pain and swelling in the legs, chest pain; breathing problems); symptoms indicating an increase in blood pressure (dizziness, headache, tiredness); yellowy skin or eye whites (this could indicate liver disease); and/or migraines for the first time.

All medicines (past, present and future) should be discussed with a doctor. Using Intraorsa with another HRT is not recommended.

Intrarosa side effects

Some conditions are reported more frequently when women use HRT (including Intrarosa) than when not using HRT. There is an increased risk of: developing cancer with all HRT treatments, including cancer of the womb, breast, and ovaries; blood clots in a vein; and stroke; and memory loss (if starting HRT when older than 65 years).

Vaginal discharge may occur when using Intrarosa, likely because of the fatty ingredients in the pessary melt; there is no need to stop Intrarosa. Commonly, women experience weight fluctuations and abnormal Pap smear tests (cervical smear test) while, uncommonly, benign polyps in the cervix or womb and benign breast lumps occur.

References

eMC. Patient leaflet (PIL). Intrarosa 6.5 mg pessary. Available from: https://www.medicines.org.uk/emc/product/9986/pil#about-medicine

Flores SA, Hall CA. Atrophic Vaginitis. [Updated 2022 Oct 31]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK564341/