Intrarosa Is a Vaginal Insert Used to Treat Painful Sex Caused by Menopause

Intrarosa (Prasterone) is a prescription vaginal insert used to treat moderate to severe dyspareunia — painful sexual intercourse — caused by vulvar and vaginal atrophy (VVA) due to menopause. It contains 6.5 mg of Prasterone (a form of DHEA) and is used once daily at bedtime.

If you've been prescribed Intrarosa or are wondering whether it might help you, this guide covers everything you need to know: what it does, how to take it, what it costs, and who should avoid it.

What Is Intrarosa?

Intrarosa is a small, bullet-shaped vaginal insert made by Cosette Pharmaceuticals. It contains Prasterone, which is a synthetic form of dehydroepiandrosterone (DHEA) — a hormone your body naturally produces but makes less of after menopause.

When you insert Intrarosa vaginally, the Prasterone is converted locally into small amounts of estrogen and androgens right in the vaginal tissue. This helps restore moisture, thickness, and elasticity to the vaginal walls — without flooding your entire body with hormones.

For a deeper dive into the science, see our guide on how Intrarosa works.

What Is Intrarosa Used For?

Intrarosa is FDA-approved for one specific indication:

• Moderate to severe dyspareunia (painful intercourse) that's a symptom of vulvar and vaginal atrophy due to menopause

Vulvar and vaginal atrophy (VVA), also called genitourinary syndrome of menopause (GSM), happens when declining estrogen levels after menopause cause the vaginal tissues to become thin, dry, and less elastic. This can make sex painful and affect quality of life.

While Intrarosa is only officially approved for dyspareunia, some doctors may consider it for broader GSM symptoms like vaginal dryness and irritation. However, other treatments may be recommended for those symptoms instead.

How Is Intrarosa Taken?

Taking Intrarosa is straightforward:

• Dose: One 6.5 mg vaginal insert, once daily at bedtime
• How to insert: Use the single-use applicator that comes in the box. Lie on your back with knees bent, insert the applicator gently into the vagina, and push the plunger to release the insert.
• When to use: At bedtime. This allows the insert to dissolve while you sleep.
• What's in the box: Each box contains 28 inserts and 28 disposable applicators — exactly one month's supply.
• Storage: Store at room temperature (41°F to 86°F). You can also keep it in the refrigerator.

Important tips:

• Use Intrarosa at the same time every day for best results
• Don't skip doses — consistent use is key to seeing improvement
• Wash your hands before and after inserting
• Throw away each applicator after a single use

Who Should Not Take Intrarosa?

Intrarosa is not right for everyone. You should not use Intrarosa if you have:

• Undiagnosed abnormal genital bleeding: Any unexplained vaginal bleeding needs to be evaluated before starting any hormonal treatment.
• Known or suspected breast cancer: Because Prasterone is partially converted to estrogen, women with a history of breast cancer should discuss the risks carefully with their doctor.

You should also tell your doctor if you:

• Are taking any other hormonal medications (estrogen patches, pills, or other vaginal products)
• Have liver or kidney problems (Intrarosa hasn't been studied in these populations)
• Have a history of blood clots, stroke, or heart disease

For information about potential interactions with other medications, see our guide on Intrarosa drug interactions.

What Are the Side Effects?

Most women tolerate Intrarosa well. The most common side effect is:

• Vaginal discharge (about 6% of women in clinical trials)

Other possible side effects include abnormal Pap smear results and mild vaginal irritation. Serious side effects are rare but can include allergic reactions and signs of cardiovascular events. Read our complete guide on Intrarosa side effects for more details.

How Much Does Intrarosa Cost?

Intrarosa is a brand-name medication with no generic available. Here's what you can expect to pay:

• Without insurance: $288 to $402 for a 28-day supply
• With the Intrarosa Savings Program: As little as $35 per month for eligible commercially insured patients
• With insurance: Varies by plan. Some plans cover it; others may require prior authorization or step therapy (trying a cheaper option first).

If cost is a concern, there are several ways to save. Coupon cards, patient assistance programs, and other options are covered in our guide to saving money on Intrarosa.

How to Get Intrarosa

Intrarosa requires a prescription from a doctor — typically an OB/GYN, primary care physician, or menopause specialist. If you need help finding a prescriber, see our guide on how to find a doctor who prescribes Intrarosa.

Because it's a specialty product, not every pharmacy stocks Intrarosa. Use MedFinder to check pharmacy availability near you without calling around.

Final Thoughts

Intrarosa is a unique treatment option for postmenopausal women dealing with painful intercourse. Its local mechanism of action, once-daily dosing, and favorable side effect profile make it a solid choice for many women. If you think Intrarosa might be right for you, talk to your doctor — and when you're ready to fill your prescription, MedFinder can help you find it in stock.