The short answer
Intrarosa (prasterone) is an FDA-approved vaginal insert used nightly to treat moderate-to-severe painful intercourse caused by menopause. Prasterone is DHEA. Vaginal cells convert it locally into estrogens and androgens. It is not the same as over-the-counter DHEA supplements, which are not FDA-approved for any menopause use.
Important safety points
Estrogen is a metabolite of DHEA. Use of exogenous estrogen is not recommended for people with a history of breast cancer, and Intrarosa has not been studied in people with a breast cancer history. Undiagnosed abnormal genital bleeding must be evaluated before treatment.
OTC oral DHEA supplements are regulated as dietary supplements, vary in content, and are not a substitute for this prescription product.
Current label check
The medication-specific claims on this page were checked against these current product labels on 2026-10-03.
| Product label | Label date | Boxed warning on that label |
|---|---|---|
| Intrarosa (prasterone) vaginal insert | 2026-07-17 | None |
Established evidence
What is Intrarosa?
Intrarosa is a small vaginal insert containing prasterone, the pharmaceutical name for dehydroepiandrosterone (DHEA). It was approved for moderate-to-severe dyspareunia, a symptom of vulvar and vaginal atrophy due to menopause.
It belongs to the group of local therapies for genitourinary syndrome of menopause (GSM), alongside vaginal estrogen and moisturizers.
Established evidence
How prasterone works
DHEA is an inactive precursor. Inside vaginal cells, enzymes convert it into small amounts of estrogens and androgens that act on the surrounding tissue. In trials, this improved the proportion of healthy superficial cells, lowered vaginal pH, and reduced pain with intercourse compared with placebo, with blood hormone levels staying in the postmenopausal range.
Established evidence
What the trials showed
Twelve-week placebo-controlled trials found improvements in painful intercourse severity and vaginal cell measures. A 52-week open-label safety study did not find endometrial hyperplasia, though long-term outcome data in people with breast cancer are lacking.
How it is used
One insert is placed in the vagina at bedtime each night with the supplied applicator. Vaginal discharge from the melting insert base is common.
Established evidence
Common side effects
- Vaginal discharge
- Abnormal Pap smear findings were reported in trials
Is Intrarosa the same as a DHEA supplement?
No. Intrarosa is a standardized, FDA-approved prescription delivered directly to vaginal tissue. Oral DHEA supplements are absorbed systemically, are not FDA-approved for menopause symptoms, and are not reviewed for content or purity in the same way. Evidence for oral DHEA improving libido or menopause symptoms is inconsistent.
Alternatives and related options
Low-dose vaginal estradiol is generally first-line for GSM. Ospemifene is an oral alternative. Nonhormonal moisturizers and lubricants are helpful for mild symptoms and alongside prescriptions. Pelvic floor physical therapy can help when muscle tension contributes to pain.
Questions to ask a healthcare professional
- Is vaginal estrogen or prasterone the better starting point for me?
- Does my cancer history affect this choice?
- How long before I should expect a difference, and when do we reassess?
Questions, answered
What people ask about Intrarosa
Is Intrarosa a hormone?+
It contains DHEA, a hormone precursor that vaginal cells convert into estrogens and androgens locally.
Is Intrarosa FDA approved?+
Yes, for moderate-to-severe dyspareunia due to menopause.
Is prasterone the same as DHEA?+
Prasterone is the drug name for DHEA. The prescription vaginal insert is different from oral DHEA supplements in dose, route, and regulation.
Does Kindr Health offer Intrarosa?+
This page is educational and does not state or imply availability through Kindr Health.
Kindr Health does not claim to offer Intrarosa on this page. Availability and prescribing are not implied.
A broader care pathway
Explore menopause care
Learn how Kindr Health care pathways work. An educational page is not a statement that this medication is available or appropriate for you.
SOURCES & REFERENCES
Every clinical claim on this page is sourced.
- Intrarosa prescribing information (current label) (2026) — DailyMed, U.S. National Library of Medicine. dailymed.nlm.nih.gov/dailymed/search.cfm?labeltype=all&query=Intrarosa
- The 2020 genitourinary syndrome of menopause position statement (2020) — The Menopause Society (Menopause journal). pubmed.ncbi.nlm.nih.gov/32852449
- DHEA: usefulness and safety (2024) — NIH National Center for Complementary and Integrative Health. www.nccih.nih.gov/health/dhea
This resource is educational and does not replace individualized medical advice. Do not start, stop, or change a prescription without guidance from a licensed healthcare professional.