Experience with ospemifene in patients with vulvar and vaginal atrophy and associated sexual dysfunction: case studies

Abstract

The pathophysiological changes associated with hypoestrogenism of menopause, a condition known as genitourinary syndrome of menopause, are responsible for the hallmark symptoms of vulvovaginal atrophy (VVA), namely dyspareunia secondary to vaginal dryness. Many postmenopausal women with VVA find sexual relations to be challenging or impossible. Ospemifene has estrogen-like effects on the vaginal epithelium, and is indicated to treat moderate-to-severe symptomatic VVA (Europe) or moderate-to-severe symptomatic dyspareunia and vaginal dryness (United States) in postmenopausal women. The case studies presented in this article follow the progress of two women who began treatment with ospemifene for the main presenting symptom of dyspareunia. Both women had concerns about the impact of their symptomatology on new relationships. The patient in case 1 experienced relevant improvement within 3 months of treatment start and, by 1 year, dyspareunia was absent. Vaginal lubricants were no longer required. The patient in case 2 experienced relevant improvement within 4 weeks of starting ospemifene. At 15 months, with the use of a lubricant for vaginal penetration, she could enjoy sexual intercourse without pain. At the time of writing, she had been receiving ospemifene continuously for more than 2 years with effective symptom relief and good tolerability.

Ospemifene for vulvar and vaginal atrophy: an overview

“…To gain more insight into the profile of ospemifene in daily practice, the case studies presented in this Special Issue examine its use across a range of clinical scenarios in postmenopausal women with VVA. The case reports cover its effects on bone markers; 30 its use in breast cancer survivors 31 and in women with dyslipidemia, 32 urinary incontinence, 33 or VVA-related sexual dysfunction; 34 and its concomitant use with laser therapy. 35 …”