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MenoPause Blog

You got your wish! Nonhormonal alternatives have arrived

by Margery Gass | Aug 12, 2013
Earlier this year, we asked women whether they thought there was a need for prescription nonhormonal treatments for menopausal symptoms. Overwhelmingly (89%), women said “yes!” We took that message to the FDA. The good news is that now there are two new approved treatment options for menopausal symptoms. Ospemiphene (Osphena) received FDA approval in February for painful sex that can be a consequence of the changes in and around the vagina that can come with low estrogen levels. Then in June, the FDA approved low-dose paroxetine (Brisdelle) for moderate to severe hot flashes. Ospemiphene acts like an estrogen in some tissues, but not others. The major advantage is its estrogen-like activity in the vagina and surrounding tissues, which keeps them supple and moist. It acts on the uterus as well, so you and your healthcare provider need to be alert to any unusual vaginal bleeding. Paroxetine is a name you might have heard before because in higher doses, it’s sold as the antidepressant Paxil. It doesn’t take much to reduce hot flashes, so the dose is lower than that used for antidepressant activity. It carries the same warnings as the antidepressant formula, so be sure to discuss all treatment options with your healthcare provider to determine if it is right for you.

This is a milestone year. For decades, hormone therapy has been the only medication approved for menopausal symptoms. Now there are choices. We hope this encourages others to conduct research in the field of menopause.


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4 Comments

  1. 1 Ellie 21 Jul
    I was so excited at the onset of this article.  Finally something non-hormonal to help with this terrible pain during intercourse.  Then I read the side effects and I an no longer excited.  Can't they make something that's natural that does not put me at risk for unusual bleeding which may be a sign of endometrial cancer.  It also puts women at risk for thrombotic and hemorrhagic strokes along with hot flashes, vaginal discharge, muscle spasms, genital charge and excessive sweating.  I don't know which is worse the painful intercourse or all the side effects and health risks.  I just don't know what to do anymore.
  2. 2 EGF 02 Apr
    Does one need to prescribe progesterone with osphena in a woman with a uterus?
  3. 3 Terri 14 Mar
    I've been on Osphena since early January. It has been an absolute godsend! If you have never gone through the painful intercourse that atrophic vaginitis can bring, you have no idea how much relief this product offers in a relatively short time frame.
  4. 4 sharon 13 Aug
    Please check out our new menopause site:  menopausenu.org     I'd like you opinion on the sit

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MenoPause: the blog!

Posts to our Blog are written by NAMS staff members and Dr. Margery Gass. All posts are reviewed and edited by Dr. Gass. We strive to bring you the most recent and interesting information about various aspect of menopause and midlife health. We accept no advertising for our website. We want you to have accurate, unbiased, evidence-based information. 

Margery L.S. Gass, MD, NCMP
NAMS Executive Director

An internationally recognized leader in the field of menopause, Dr. Gass became Executive Director of The North American Menopause Society in 2010. Dr. Gass has been an investigator on numerous research projects, including serving as a principal investigator for the Women’s Health Initiative, and has published and presented on a wide range of topics related to menopause, including osteoporosis, sexual dysfunction, and hormone therapy.

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