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[Postmeno3]

Hi,
It's been a while since anyone posted on Intrarosa and, as it's relatively new on the scene (compared to Vagifem/Ovestin), I wonder if any new or existing, postmenopausal forum members are having success with it as success tends not to be reported so much.
I'm giving serious thought to giving up on systemic HRT as I feel I may be too sensitive for it and it could be stimulatory, but in a negative way if that makes sense. I think this is where, in unusual cases potentially, like mine, going by symptoms alone is futile. This is the mindset I am caught up in, both in specialist clinic and gp settings. However, I don't want to get caught up in debate about testing. That's not the reason for this post. I am just keen to know if anyone is finding continuing success with Intrarosa and, especially, why they think this may be? Equally, I'm interested in the clinical knowledge of those on here who don't use the product, but can explain why Intrarosa's configuration could be hormonally beneficial. I note it is especially recommended for postmenopausal women so there must be qualities and efficacies specific to this group which may not be so apparent in baseline treatments used in other stages of this journey? I've read existing threads and there is nothing recent which answers these points. Thanks in advance!
😊

[pollywollydoodle]

Hi Postmeno3 - I used intrarosa when it first became available a couple of years or so ago. I really liked using it as I found vagifem irritating and this product was more soothing. I imagine you’ve read the marketing info and even the manufacturer isn’t clear on exactly what the mechanism of conversion is.

The mechanism of action of INTRAROSA is not fully established.

†Decreased percentage of parabasal cells, reduced vaginal pH, and increased percentage of superficial cells.

‡In two 12-week, randomized, double-blind, placebo-controlled studies that included 640 postmenopausal women with moderate to severe painful sex as their most bothersome symptoms, INTRAROSA showed a statistically significant decrease in pain during sex.

Essentially it’s a very low dose of DHEA which each individual will then convert to oestrogen/testosterone, not sure if it’s systemically or locally only and I didn’t feel any systemic effects, but did feel more vulval sensitivity, having said that, I’ve never experienced really bad VA, presumably because I’ve used full hrt replacement for around 10 years now, but the irritation I did have, was cleared. If you’re struggling with conventional hrt products, you might find some value in DHEA supplementation. For various reasons, I can no longer use supplemental oestrogen, it makes me feel ill, but I’m fine with DHEA, I use an otc cream at 15mg dose per day.

The only downside with intrarosa is it melts very quickly and is oily when it melts, so if you wanted to use it other than nighttime you’d need some sort of underwear protection. It’s fine if used at night.

Hope that helps.

[Wrensong]

Hi Postmeno3, I haven't used Intrarosa myself but looked into it in the past in connection with the increase in pre-existing systemic dryness I experienced with the loss of ovaries via BSO carried out a few years postmenopause.  Research shows a link between androgen deficiency & systemic dryness so this may be one of the reasons DHEA may improve symptoms of GSM & sexual function.  You may be interested in the following links & extracts:-

https://www.ccjm.org/content/88/1/35

"Androgen and estrogen receptors are present in the vaginal mucosa, submucosa, stroma, smooth muscle (vaginal, urethral, and bladder), and vascular endothelium. In the vagina, androgens regulate vaginal mucin production in epithelial cells, improve blood flow by increasing nitric oxide, and influence neurotransmitter content and nerve density."

"DHEA therapy for GSM
The only FDA-approved vaginal androgen for GSM is intravaginal DHEA 6.5 mg (prasterone), which improves cell maturation, pH, and dyspareunia compared with placebo,42 leads to improvements in all domains of sexual function,43 and has neutral effects on the endometrium after 12 months of therapy.44 Most studies suggest no significant increase in serum levels of sex steroids with the use of vaginal DHEA"

"In a 12-week 3-armed randomized controlled trial,46 postmenopausal women with a history of breast or gynecologic cancer, received compounded vaginal DHEA 3.25 mg/day, DHEA 6.5 mg/day, or a nonhormonal moisturizer. Dyspareunia and dryness improved in all groups, with no significant differences between either dose of vaginal DHEA and plain moisturizer (P < .005). However, women in the DHEA 6.5-mg/day group reported a significant improvement in sexual health compared with the other groups (P < .0001)"

https://www.frontiersin.org/articles/10.3389/fendo.2019.00561/full

"Physio-Pathological Aspects of VVA/GSM
these data are in line with the evidence that both circulating estradiol and its androgen precursors (dehydroepiandrosterone/dehydroepiandrosteronesulphate [DHEA/DHEAS], androstenedione, testosterone), as well as their local metabolites, are vital to maintain normal structure and function of the vagina and surrounding uro-genital tissues (49). Indeed, the science of intracrinology supports the idea that the age-related decline of circulating DHEA translates into a local intracellular deficiency of both estrogens and androgens, significantly contributing to poor vaginal health"

Wx

[Hurdity]

In addition to Wrensong's helpful information about the research - there are a few threads where the outline of Intrarosa use has been discussed:

https://www.menopausematters.co.uk/forum/index.php/topic,45695.0.html
last few posts on the thread


https://www.menopausematters.co.uk/forum/index.php/topic,45659.0.html
Whole thread on intrarosa


https://www.menopausematters.co.uk/forum/index.php/topic,46318.msg747843.html#msg747843
Another thread


https://www.menopausematters.co.uk/forum/index.php/topic,47911.msg775505.html#msg775505
A post mentioning DHEA and intrarosa

The reason this is aimed at post-menopausal women is because the product was specifically developed as a treatment of vulvo-vaginal atrophy in post-menopausal women, in whom this condition is highly prevalent and in many cases only becomes apparent post-menopause and worsens with age. All the trials were carried out on post-menopausal women, Some years ago I downloaded the lengthy document giving detailed information about the trials which I have only had a quick glance through - but is very technical! I don't have a link unfortunately...

Hope this helps

Hurdity x

[Postmeno3]

Thanks for all this comprehensive info everyone. I'll need time to digest it. Pollywollydoodle - Are you still using it? Thanks again.

[pollywollydoodle]

Hi Postmeno3 - yes, I still use it, but only sporadically. I need to be more routine with using it though, I'm pretty much hormone free in terms of using hrt, (apart from the odd experiment with low dose) so I don't want VA to creep up and become unbearable because I've been tardy, but I often just forget. Need to be more focussed!

I also use ovestin for the area that niggles now and again. I really don't understand why my VA hasn't worsened as my last 3 oestrogen blood tests were <50, so I'm running on vapours! Anyway, this is a timely reminder to use it preventatively.

[Postmeno3]

Bump.....

[pollywollydoodle]

I've started using the intrarosa again and intent to keep to regular use as I'm now oestrogen hrt free. One thing I noticed this morning after using last night was it seems to have a favourable action on the bowels if that's your problem!

[Postmeno3]

No, thankfully, that's one thing that IS ok!
I'm going to ask the specialist in my phone consultation later today about Intrarosa. Do you feel you are just too sensitive to systemic oestrogen? If so, how was that manifesting? Thanks.

[pollywollydoodle]

No, thankfully, that's one thing that IS ok!
I'm going to ask the specialist in my phone consultation later today about Intrarosa. Do you feel you are just too sensitive to systemic oestrogen? If so, how was that manifesting? Thanks.

Hi Postmeno3 - I seem intolerant of systemic oestrogen because it seems to interact with thyroid hormones ie. binds them, and therefor pushes me into a brain-fogged, fatigued mess. It's a real head scratcher because all the medics I've seen so far can't understand why oestrogen would do that, it's a long and boring for everyone but me story, BUT I've got a new endo on the case and she's seen it before - yay! She said it's a problem in the adrenal-ovary-thyroid axis, also related to the hypo-pituitary axis (they're all connected with feedback loops), aaanywaay, when one aspect of the axis is failing, like a jenga tower, it'll take the rest with it. She thinks the problems started with the adrenals which would track for me as I was seriously over stretching myself a few years ago, and this has impacted on the thyroid, which in turn is impacted by oestrogen. I'm just so pleased I've found someone who finally 'gets it'. So, in answer to your question, no, I'm not sensitive to oestrogen per se, it's just my pathetic
systems that need some tlc, and I think I might have found a way to move forward.

I really like intrarosa, and pleased your post reminded me to re-boot it.

[Postmeno3]

Gosh, threads fall off these pages so fast sometimes! Anyone else with any experience? Thanks! 😊

[sprocket]

I was using it for 3 months. Initially I thought it was wonderful but in the last 4 weeks or so my vaginal atrophy has returned along with more frequent urinary symptoms. Id initially felt that it wasnt working as well on my urinary symptoms as Vagifem but as the Intrarosa seemed to be settling my VA, I put up with it. Ive now decided to stop it as my external discomfort is back along with cystitis symptoms. Back on Vagifem 5xweek as of now. Such an uphill slog with VA!

[Hurdity]

Intrarosa bump!

[Rustysmum]

I would be very interested in hearing of any experience with Intrarosa. My Gp prescribed it for me back in July, but my local pharmacies have been unable to get hold of any and have no idea when it will be available again. I am keen to try it though.

[SuperSixty2]

I’ve been using Intrarosa for a few months now and it works well for me. The only problem with it is that I find it a bit messy. I use it before I got to bed and tend to wear a panty liner but when I wake up in the morning it’s seeped through the liner, underwear and on to my sheets. There’s always what looks like s damp patch, it also ends up on my inner thighs which isn’t a massive problem but I am conscious of the smell as it does smell a bit funny. All this is s small problem at home but I’m worried about going on holiday next year especially a girls trip, it might be a bit embarrassing. So much so I’ve considered not using it whilst I’m away. Has anyone else had this experience and is there anything you can do to put a stop to this? TIA