What to Know About Intrarosa Side Effects Before You Start

Starting a new medication always comes with questions — especially about side effects. If your doctor has prescribed Intrarosa (Prasterone) for painful intercourse caused by menopause, you'll be glad to know that most women tolerate it well. But it's important to understand what's normal, what's not, and when you should reach out to your doctor.

This guide covers everything you need to know about Intrarosa side effects in plain language.

What Is Intrarosa? (A Quick Refresher)

Intrarosa is a vaginal insert that contains Prasterone (also known as DHEA). It's used once daily at bedtime to treat moderate to severe dyspareunia — that's the medical term for painful sex — caused by vulvar and vaginal atrophy (VVA) due to menopause. For a deeper look, see our full guide on what Intrarosa is and how it works.

Unlike systemic hormone therapy, Intrarosa works locally in the vaginal tissue. The Prasterone is converted into small amounts of estrogen and androgens right where it's needed, which is why side effects tend to be mild and localized.

Common Side Effects

The most frequently reported side effect of Intrarosa is:

• Vaginal discharge: About 6% of women in clinical trials experienced vaginal discharge, compared to about 4% taking a placebo. The discharge is typically mild and not a sign of infection.

Other common but less frequent side effects may include:

• Abnormal Pap smear results (ASCUS or LSIL) — seen in about 2% of women during long-term use
• Mild vaginal irritation or discomfort during the first few days of use

These side effects are generally mild and temporary. Many women find that discharge decreases after the first few weeks of use.

Serious Side Effects

Serious side effects with Intrarosa are rare, but you should be aware of them. Call your doctor right away or seek emergency help if you experience:

• Signs of an allergic reaction: Rash, itching, swelling of the face, tongue, or throat, or difficulty breathing
• Sudden vision changes: Blurred vision, partial or complete loss of vision
• Severe headache, confusion, or slurred speech: These could be signs of a stroke
• Unusual vaginal bleeding: Especially if you haven't had a period in years

Intrarosa does not carry an FDA boxed warning. However, because Prasterone is converted into small amounts of estrogen in the body, the prescribing information includes precautions about use in women with certain health histories — particularly breast cancer.

Special Populations: Who Needs Extra Caution?

Certain groups of women should talk to their doctor carefully before starting Intrarosa:

Women With a History of Breast Cancer

Since Prasterone is partially converted to estrogen, women with a known or suspected history of breast cancer should discuss the risks and benefits with their oncologist or gynecologist before using Intrarosa.

Women With Undiagnosed Vaginal Bleeding

If you have unexplained vaginal bleeding, your doctor will want to figure out the cause before prescribing Intrarosa or any hormonal treatment.

Older Women (65+)

In clinical trials, about 19% of participants were 65 or older. No specific age-related problems were identified, but older women should still discuss their full medical history with their doctor.

Women With Liver or Kidney Issues

Intrarosa has not been specifically studied in women with hepatic or renal impairment. If you have liver or kidney problems, let your doctor know before starting treatment.

How to Manage Common Side Effects

If you experience mild side effects, here are some tips:

For Vaginal Discharge

• Wear a thin panty liner if the discharge bothers you
• Give it a few weeks — discharge often improves as your body adjusts
• If the discharge has an unusual color, odor, or is accompanied by itching, contact your doctor to rule out infection

For Mild Irritation

• Make sure you're inserting the vaginal insert correctly using the provided applicator
• Apply at bedtime so you're lying down afterward
• Avoid using other vaginal products (douches, fragranced washes) at the same time

For Abnormal Pap Results

• Abnormal Pap smear results (like ASCUS) can occur with vaginal hormone treatments and are usually not a cause for alarm
• Your doctor may recommend follow-up testing or a repeat Pap
• Continue taking Intrarosa as prescribed unless your doctor tells you otherwise

When to Stop and Call Your Doctor

Contact your healthcare provider if:

• Side effects are getting worse instead of better after 2-3 weeks
• You develop new or unusual symptoms
• You experience any of the serious side effects listed above
• You're unsure whether what you're experiencing is normal

It's always better to ask than to worry in silence. Your doctor would rather hear from you than have you stop taking a medication that could help you.

How Intrarosa Compares to Alternatives

If side effects are a concern, it may help to know how Intrarosa stacks up against other treatments for vaginal atrophy:

• Vaginal estrogen creams and tablets (like Estrace or Vagifem) can cause similar mild discharge and irritation
• Ospemifene (Osphena), an oral option, may cause hot flashes and vaginal discharge
• Intrarosa's local mechanism of action means less systemic hormone exposure compared to oral options

For a full comparison, check out our guide on alternatives to Intrarosa.

Final Thoughts

Most women who use Intrarosa experience few or no side effects. The most common issue — vaginal discharge — is typically mild and temporary. Serious side effects are rare but important to recognize.

The key is to stay in communication with your doctor, especially during the first few weeks of use. And if cost or availability is a concern, MedFinder can help you find Intrarosa in stock at a pharmacy near you.