What Is Intrarosa and What Does It Do?

Intrarosa (Prasterone) is a 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 (also known as DHEA), which is inserted vaginally once daily at bedtime. Intrarosa helps restore vaginal tissue by converting locally into active hormones, relieving pain and discomfort associated with postmenopausal vaginal changes.

How Does Intrarosa Work?

Intrarosa contains Prasterone, an inactive endogenous steroid (DHEA) that is converted locally within vaginal tissues into active androgens and estrogens. This localized metabolism helps restore vaginal tissue integrity, improve lubrication, and relieve symptoms of vulvar and vaginal atrophy — all without causing significant systemic hormone exposure. This intracrine mechanism makes Intrarosa unique compared to traditional hormone replacement therapies.

Available Doses of Intrarosa

• 6.5 mg vaginal insert (28-count box with single-use applicators)

Intrarosa Findability Score: 55 out of 100

Intrarosa receives a moderate findability score of 55. As a brand-name specialty product with no generic equivalent, many pharmacies do not routinely stock it. While there is no formal FDA-reported shortage, patients may need to call several pharmacies or use a pharmacy locator tool to find it in stock. Specialty pharmacies and larger chain pharmacies tend to have better availability. Using Medfinder can help you quickly locate a pharmacy near you that has Intrarosa on hand.

What Kinds of Doctors Prescribe Intrarosa?

Intrarosa is most commonly prescribed by obstetricians and gynecologists (OB/GYNs), particularly those who specialize in menopause management. Primary care physicians, family medicine doctors, and internal medicine providers may also prescribe it. If you are experiencing symptoms of vaginal atrophy due to menopause, your gynecologist or primary care doctor can evaluate whether Intrarosa is appropriate for you.

Is Intrarosa a Controlled Substance?

No, Intrarosa is not a controlled substance. It does not have a DEA schedule classification and is not considered to have abuse potential. It is available by prescription only but does not require the special prescribing or dispensing procedures associated with controlled substances.

What Are Common Side Effects of Intrarosa?

• Vaginal discharge (most common, occurring in approximately 6% of patients)
• Abnormal Pap smear findings (such as ASCUS or LSIL, reported in about 2% of patients during long-term use)
• Allergic reactions including rash, itching, or swelling (rare but seek immediate medical attention)
• Sudden vision changes, severe headache, confusion, or slurred speech (rare — seek emergency care)

What Are Some Alternative Medications to Intrarosa?

• Estradiol vaginal inserts (Vagifem, Yuvafem) — Low-dose vaginal estradiol tablets for vaginal atrophy; generic versions are available.
• Estradiol vaginal cream (Estrace) — Topical vaginal estrogen cream; generic versions are available.
• Conjugated estrogens vaginal cream (Premarin Vaginal Cream) — Vaginal cream with conjugated estrogens for atrophic vaginitis.
• Ospemifene (Osphena) — An oral selective estrogen receptor modulator (SERM) for moderate to severe dyspareunia due to menopause; the only oral option for this indication.

Does Intrarosa Interact with Other Drugs?

• No specific drug interactions are listed in the prescribing information for Intrarosa.
• Patients should inform their healthcare provider about all medications and supplements they are taking.
• Theoretical interactions may exist with other hormonal therapies or estrogen-containing products due to additive hormonal effects.
• Always consult your doctor or pharmacist before combining Intrarosa with other hormone treatments.

Final Thoughts on Intrarosa

Intrarosa offers a unique approach to treating painful intercourse caused by postmenopausal vaginal atrophy. Its localized mechanism of action — converting DHEA into active hormones directly in vaginal tissue — sets it apart from traditional estrogen therapies. While the cash price of $288 to $402 per month can be steep, manufacturer savings programs can bring the cost down to as little as $35 for eligible commercially insured patients. Since Intrarosa is a specialty product without a generic alternative, finding it in stock may require some effort. Medfinder can help you locate pharmacies that carry Intrarosa near you, saving you time and phone calls.