The active ingredient in Intrarosa is prasterone 6.5 mg per pessary. Key inactive ingredients include hard fat, which forms the pessary base and allows it to dissolve at body temperature. The hard fat base is not confirmed as plant-derived, which means Intrarosa is not considered suitable for a strict vegan diet, if this is relevant to you, discuss alternative vaginal treatments with your clinician. The fatty base can also weaken latex condoms and diaphragms, so non-latex alternatives should be used if contraception is needed.

Intrarosa is popular because:

• Works locally in vaginal tissues with minimal systemic absorption
• Once-daily dosing for consistent symptom relief
• Contains body-identical prasterone (DHEA)
• Provides both oestrogen and testosterone locally
• Effective for vaginal dryness, soreness, and pain during sex
• Can be used long-term for ongoing symptom management
• Well-tolerated by many women

Intrarosa may be right for you if you:

• Are postmenopausal
• Experience vaginal dryness, soreness, or irritation
• Have pain or discomfort during sex
• Want a local treatment that works in the vaginal area without systemic effects
• Prefer a once-daily treatment option
• Have tried non-hormonal lubricants or moisturisers without sufficient relief

Intrarosa is specifically for vaginal symptoms. If you also have systemic symptoms like hot flushes or night sweats, you may need systemic HRT as well. Your doctor will help determine the best treatment plan for your symptoms.

It may not be appropriate if you have:

• Unexplained vaginal bleeding
• Current hormone-sensitive cancer (such as breast or endometrial cancer) - discuss with your specialist
• Are pregnant or breastfeeding
• Known hypersensitivity to prasterone or any ingredients

Your doctor will assess your medical history to determine if Intrarosa is right for you.

Intrarosa can be more expensive than some other vaginal treatments because:

• It is a relatively newer treatment option with patent protection
• The manufacturing process for prasterone pessaries is specialised
• It requires daily use rather than 2-3 times weekly like some vaginal oestrogen products

However, many women find the daily routine and effectiveness worth the cost. Some NHS Integrated Care Boards (ICBs) may have restrictions on prescribing Intrarosa due to cost, so availability on NHS prescription may vary by area.

If cost is a concern, discuss alternative options with your doctor, such as vaginal oestrogen treatments which may be more cost-effective.

Intrarosa vs vaginal oestrogen (e.g. Vagifem, Vagirux): Vaginal oestrogen delivers estradiol directly to the vaginal tissues and is used daily for an initial two-week period, then reduced to two to three times per week for maintenance. Intrarosa delivers prasterone daily and continuously, which some women prefer for routine consistency. Vaginal oestrogen is generally more cost-effective and may be more widely available on NHS prescription. Both are effective local treatments, the choice depends on individual preference and response.

Intrarosa vs estriol cream (e.g. Ovestin): Estriol is a weaker form of oestrogen applied as a cream or pessary, used initially daily then reduced to twice weekly. Like Intrarosa, it works locally with minimal systemic absorption. Intrarosa's hormone precursor approach means it produces both oestrogen and testosterone locally, whereas estriol provides oestrogen only, which may be a relevant distinction for some women.

Intrarosa vs non-hormonal vaginal moisturisers: Non-hormonal moisturisers and lubricants can provide symptomatic relief but do not restore the underlying hormonal environment of the vaginal tissues. Intrarosa addresses the root hormonal cause of genitourinary symptoms rather than managing surface dryness alone. For women with mild symptoms, non-hormonal options may be tried first. Your clinician can advise on the most appropriate starting point.

No, not meaningfully. Whilst small amounts of oestrogen and testosterone are created locally inside the vaginal tissues from the prasterone, clinical studies show that these do not result in significant changes to blood hormone levels.

This local action is one of the benefits of Intrarosa, it restores vaginal tissue health without the systemic effects of traditional HRT.

This is a complex decision that should be made with your specialist. Whilst Intrarosa works locally with minimal systemic absorption, it does involve hormone treatment. Some specialists may consider it appropriate for women with a history of breast cancer who have significant vaginal symptoms, whilst others may prefer non-hormonal options first.

Always discuss your full medical history with your doctor and oncologist before starting any hormone-based treatment.

No, Intrarosa is available in a single fixed dose of 6.5 mg and should not be adjusted without clinical guidance. Do not use more than one pessary per day. If your symptoms are not improving after twelve weeks of regular use, contact your Voy clinician rather than increasing the dose independently. There are alternative local and systemic treatment options your clinician can discuss with you.

Light spotting in the early weeks of treatment can occur as the vaginal tissues respond to restored hormone activity and is not necessarily a cause for concern. However, any heavier or unexpected vaginal bleeding should always be reported to your clinician promptly so that other causes can be ruled out. Intrarosa is not associated with cyclical withdrawal bleeds, as it is a local rather than systemic treatment. If you are also using systemic HRT, your clinician will advise what bleeding patterns to expect from your combined regimen.

There is no evidence that Intrarosa causes weight gain. Because it works locally in the vaginal tissues with minimal systemic absorption, it does not have the same effects on metabolism or body composition that systemic hormones might. Any weight changes during the postmenopausal period are more likely related to wider hormonal and metabolic shifts. If weight changes are a concern, discuss them with your clinician.

Using Intrarosa (prasterone) and vaginal oestrogen together is generally not recommended because the combination has not been studied for safety or efficacy. While both treat vaginal dryness, combining them may cause excessive hormone levels. Consult your doctor, as they may suggest using one or the other based on your symptoms.

No, Intrarosa isn’t considered safe to use with latex condoms. Intrarosa (prasterone) vaginal pessaries contain a fatty/oily base, which can weaken latex condoms or diaphragms, making them less reliable for contraception or STI protection.

What to do instead:

• Use non-latex condoms (polyurethane or polyisoprene), or
• Use an alternative method of contraception while using Intrarosa

This is a mechanical issue with the pessary base, not a safety problem with the hormone itself.

No, Intrarosa is not considered vegan. Intrarosa vaginal pessaries contain hard fat (a fatty base) and the manufacturer does not confirm that all ingredients are plant-derived, or suitable for a strict vegan diet. Because of this lack of confirmation, it isn’t classified as vegan.

If vegan formulations are important to you, it’s best to discuss alternative vaginal or hormonal options with your clinician or pharmacist, who can advise based on ingredient sourcing.

Yes, you can use vaginal lubricants during sex whilst using Intrarosa. However, avoid using vaginal moisturisers or other vaginal products at the same time of day as Intrarosa, as they may interfere with absorption.

If you need additional moisture support, use water-based lubricants during sexual activity and discuss ongoing dryness with your doctor.