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Intrarosa

prasterone
Used for Menopause, Atrophic Vaginitis
Used for Menopause, Atrophic Vaginitis

Intrarosa (prasterone) is a vaginal insert used to help ease pain from intercourse (sex) caused by the thinning, drying, and inflammation of vaginal walls as a result of menopause. This medication is a man-made, plant-based version of dehydroepiandrosterone (DHEA), a hormone made by your body. Intrarosa (prasterone) is inserted vaginally once a day at bedtime. The most common side effect of this medication is vaginal discharge. There are currently no generic alternatives of Intrarosa (prasterone) available.

Reviewed by:
reviewer
Allison Gourley, PharmD
reviewer
Connie Zheng, PharmD
Last reviewed on May 21, 2023
BasicsSide effectsPros & consPharmacist tipsFAQsWarningsDosageCostContraindicationsAlternativesLatest newsReferencesPricesMedicare
basics-icon

What is Intrarosa (prasterone)?

What is Intrarosa (prasterone) used for?

  • Painful sexual intercourse as a result of menopause

How Intrarosa (prasterone) works

Intrarosa (prasterone) is a synthetic (man-made) version of DHEA, a steroid made by your body. It's not clear exactly how this medication works. But it's thought that your body changes prasterone into active hormones called estrogens and androgens. These hormones can help restore vaginal tissue and lubrication, which can ease pain from sexual activity.

Are you looking for information on DHEA dietary supplement or progesterone (Prometrium) instead?

Drug Facts

Common BrandsIntrarosa
Drug ClassSynthetic steroid
Controlled Substance ClassificationNot a controlled medication
Generic StatusNo lower-cost generic available
AvailabilityPrescription only
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Avg retail price
$351.96(save 14.41%)
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$301.24
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What are the side effects of Intrarosa (prasterone)?

The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

Common Side Effects

  • Vaginal discharge (up to 14%)

Other Side Effects

Source: DailyMed

The following side effects have also been reported

Side effects that you should report to your care team as soon as possible:

Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):

  • Vaginal discharge
  • Vaginal irritation at application site
pros-and-cons

Pros and cons of Intrarosa (prasterone)

thumbs-up

Pros

Once-daily dosing

Only vaginal non-estrogen treatment for painful sex due to menopause

Plant-based ingredients

Not many side effects

thumbs-down

Cons

Might take about 3 months to feel relief from painful intercourse

Not for people who have or have had breast cancer

Brand only, no lower-cost generics available

Not for people who haven't been through menopause

pharmacist-tips

Pharmacist tips for Intrarosa (prasterone)

pharmacist

  • Before using Intrarosa (prasterone), read the instructions in the product label. If you have questions about how to use it, speak to your provider or pharmacist.

    • When ready to use Intrarosa (prasterone), empty your bladder and wash your hands before touching the vaginal insert and applicator.

      • Only use each applicator once to prevent infection. Don't reuse them.

        • If the Intrarosa (prasterone) insert falls out of the applicator and it hits the ground or another dirty surface, replace it with a new one.

          • Intrarosa (prasterone) can affect your Pap smear results. Make sure to tell all of your healthcare providers that you use this medication.

            • You can store Intrarosa (prasterone) inserts either at room temperature or in the fridge. It might be more comfortable to remove the insert from the fridge a few minutes before using it so it has a chance to warm up to room temperature.

              faqs

              Frequently asked questions about Intrarosa (prasterone)

              Does Intrarosa (prasterone) contain estrogen?
              Not quite. Intrarosa (prasterone) is a man-made version of DHEA, the steroid hormone your body naturally makes, made from plants. Once it's inserted, this medication changes into estrogen and androgen hormones.
              What is Intrarosa (prasterone) made of?
              The Intrarosa (prasterone) insert is made with coconut and palm oils. Tell your provider if you have an allergy to these ingredients before starting this medication.
              How long does it take for Intrarosa (prasterone) to work?
              It can take up to 3 months to feel relief from painful intercourse, so continue to take it as prescribed even if you don't feel relief right away. Talk to your provider if you haven't felt any relief from this medication after 3 months.
              Can Intrarosa (prasterone) cause cancer?
              Intrarosa (prasterone) hasn't been well-studied in people who have cancer. Research show that having too much estrogen can raise the risk of breast cancer. And because Intrarosa (prasterone) gets converted into estrogen by your body, the manufacturer of this medication says that people who have a history of breast cancer shouldn't take Intrarosa (prasterone). If you've questions about Intrarosa (prasterone) and cancer, talk with your provider.
              Does Intrarosa (prasterone) cause weight gain?
              People who took Intrarosa (prasterone) in clinical trials didn't report weight gain as a side effect.
              What's the difference between Intrarosa (prasterone) and estradiol?
              Both Intrarosa (prasterone) and estradiol (Estrace) are medications that are inserted vaginally and used to help with vaginal dryness related to menopause. The main difference between them is that Intrarosa (prasterone) is a plant-based medication that gets converted into sex hormones in your body, whereas estradiol (Estrace) is a form of estrogen. Because Intrarosa (prasterone) doesn't contain estrogen, it's not known to be linked to many of the estrogen-related side effects of estradiol (Estrace), such as the higher risk for heart attack and stroke. Keep in mind that because Intrarosa (prasterone) gets converted into estrogen in your body, you shouldn't take it if you've a history of breast cancer. Talk with your provider if you've more questions about the differences between Intrarosa (prasterone) and estradiol (Estrace).
              What are the pros and cons of Intrarosa (prasterone)?
              One pro of Intrarosa (prasterone) is that it's made from plant-based DHEA, not from estrogen. Unlike other estrogen-based medications for vaginal dryness, Intrarosa (prasterone) isn't known to cause many of the side effects related to estrogen, such as a higher risk for heart attack and stroke. Intrarosa (prasterone) might be a possible option for people who can't take medications made from estrogen. One con of Intrarosa (prasterone) is that you have to use a vaginal insert nightly and it can take up to 3 months before you experience relief from your symptoms. Ask your provider if you want to know more about the pros and cons of Intrarosa (prasterone).
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              What are the risks and warnings for Intrarosa (prasterone)?

              Intrarosa (prasterone) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.

              risk-warning

              Breast cancer

              • Risk factors: History of breast cancer

                Intrarosa (prasterone) is changed to estrogen by your body. Having too much estrogen can raise your risk of breast cancer. It isn't known if Intrarosa (prasterone) is safe for females who have a history of breast cancer. Don't use Intrarosa (prasterone) if you currently have or have had breast cancer in the past. It's important that you regularly check your breasts for any changes and get breast scans (mammograms) done. Let your healthcare provider know if you notice any unusual changes in breast shape, size, or color.

                dosage

                Intrarosa (prasterone) dosage forms

                The average cost for 1 carton of 28 inserts of 6.5mg of Intrarosa (prasterone) is $301.24 with a free GoodRx coupon. This is 14.41% off the average retail price of $351.96.
                carton
                Carton
                DosageQuantityPrice as low asPrice per unit
                28 inserts of 6.5mg1 carton$301.24$301.24

                Typical dosing for Intrarosa (prasterone)

                Each vaginal insert contains 6.5 mg of prasterone.

                Place one vaginal insert into the vagina once daily at bedtime, using the applicator that comes with the medication.

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                How much does Intrarosa (prasterone) cost?

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                Intrarosa (brand)
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                contraindications-icon

                Intrarosa (prasterone) contraindications

                Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Intrarosa (prasterone) will not be safe for you to take.

                • Abnormal vaginal bleeding that hasn't been checked by a healthcare provider

                alternatives

                What are alternatives to Intrarosa (prasterone)?

                There are a number of medications that your doctor can prescribe in place of Intrarosa (prasterone). Compare a few possible alternatives below.
                Intrarosa (prasterone)
                Used for:

                • Painful sexual intercourse as a result of menopause

                $301.24 Lowest GoodRx priceView Prices
                Estradiol vaginal insert
                Used for:

                • Vaginal dryness, thinning, and irritation caused by menopause - generic estradiol, Vagifem, and Yuvafem

                • Moderate-to-severe painful sex due to vaginal dryness and thinning caused by menopause - Imvexxy only

                $44.00 Lowest GoodRx priceView Prices
                Osphena (ospemifene)
                Used for:
                $198.00 Lowest GoodRx priceView Prices

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                References

                Best studies we found

                Hayes, R., et al. (2019). Prasterone (Intrarosa) for dyspareunia. American Family Physician. 

                Millicent Pharma Ltd. (n.d.). Frequently asked questions about Intrarosa.

                Millicent Pharma Ltd. (n.d.). What is Intrarosa? 

                View All References (3)

                Millicent US, Inc. (2023). INTRAROSA- prasterone insert [package insert]. DailyMed.

                National Cancer Institute. (2015). Hormones.

                GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.
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