Intravaginal dehydroepiandrosterone (DHEA) relieves women of postmenopausal pain, dryness and atrophy.

The most bothersome symptoms of menopause is moderate to severe pain due to vulvovaginal atrophy and other genitourinary symptoms causing dysparunia. Local estrogens increase blood hormonal level even in the lowest possible dose  and systemic hormone therapy has its own shortcoming. 

A study published in December issue of Menopause by Labrie F et al aims to confirm the local beneficial effects of intravaginal dehydroepiandrosterone (DHEA, Prasterone) on moderate to severe dyspareunia or pain at sexual activity, the most frequent symptom of vulvovaginal atrophy.

This is a prospective, randomized, double-blind, and placebo-controlled phase III clinical trial.

325 women were registered as the study subjects and they used daily intravaginal 0.5% DHEA (6.5 mg) as suppositories for 12 weeks while 157 women who served as control used placebo.

There was a significant improvement in all the parameters tested like dysparunia, vaginal dryness and vaginal pH.

At physical examination the gynecologists saw an improvement in vaginal secretions, epithelial integrity, epithelial surface thickness, and color all by 86% to 121% over placebo (P < 0.0001).

Vaginal pH decreased by 0.66 pH unit over placebo (P < 0.0001) on a scale of 0-3.

Serum steroid level also remained in the menopausal range.

Local DHES, through local androgen and estrogen formation, causes a rapid and efficient reversal of all the symptoms and signs of vaginal atrophy with no or minimal changes in serum steroids, which remain well within the normal postmenopausal range. This approach avoids the fear of systemic effects common to all presently available estrogen formulations and adds a novel physiological androgenic component to therapy.


References:

http://journals.lww.com/menopausejournal/Abstract/publishahead/Efficacy_of_intravaginal_dehydroepiandrosterone.98078.aspx

http://journals.lww.com/menopausejournal/pages/articleviewer.aspx?article=00015&issue=16050&trendmd-shared=0&type=abstract&year=2009

http://journals.lww.com/menopausejournal/pages/articleviewer.aspx?article=00016&issue=16050&trendmd-shared=0&type=abstract&year=2009