Positive results from a phase 3 trial of intravaginal dehydroepiandrosterone (DHEA; EndoCeutics) suggest it may be a viable alternative to intravaginal estrogen in combatting dryness and painful sex after menopause.
"The fact that we would have another new hormonal treatment that is not estrogen is exciting," JoAnn Pinkerton, MD, NCMP, executive director of the North American Menopause Society, told Medscape Medical News. "And unlike lubricants and moisturizers, it actually corrects the problem. For women who are fearful of or don't want to use vaginal estrogens, it gives them a hormonal vaginal product that works."
DHEA is a hormone, but the effects appear to be localized, which means no significant amount of sex hormone gets released into the bloodstream. All estrogen-based vaginal formulations increase estrogens in the bloodstream, even at low doses, say lead author Fernand Labrie, MD, PhD, president and chief executive officer of EndoCeutics Inc, Quebec City, Quebec, Canada, and colleagues.