Ospemifene (Osphena)

Treats vulvovaginal atrophy in postmenopausal women.

Treats moderate to severe dyspareunia.

An estrogen agonist/antagonist with selective effects.

Activates estrogen in some tissues and blocks estrogen pathway in others.

A selective estrogen receptor modulator.

60 mg daily orally.

Associated with cerebral thromboembolic and hemorrhagic stroke incidence rates of 0.72 and 1.45 per thousand women vs 1.04 and 0 per thousand women for placebo and DVT incidence of 1.45 vs 1.04 per thousand for placebo.

Well tolerated.

Normalizes vaginal maturation index and pH and improves symptoms of vaginal dryness and dyspareunia associated with vulvovaginal atrophy.

When prescribed in women with a uterus, a progestin should be considered to reduce the risk of endometrial cancer.

Use contraindicated in undiagnosed abnormal genital bleeding, known or suspected estrogen dependent neoplasia, active DVT, pulmonary embolus, or history of these conditions, active arterial thromboembolic disease such a stroke or myocardial infarction or history of these conditions.

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