FDA-approved preparations for vulvovaginal atrophy
| Product | Proprietary name | Dosing |
|---|---|---|
| Vaginal creams | ||
| 17-beta estradiol | Estrace vaginal cream 0.1 mg/g | Initial: 2–4 g/day for 1–2 weeks Maintenance: 1 g at 1–3 times a weeka |
| Conjugated estrogens | Premarin vaginal creamb (0.625 mg/g) | Vulvovaginal atrophy: 0.5–2 g/d for 21 days, then off 7 days or twice a weeka Dyspareunia: 0.5 g/day for 21 days, then off 7 days or twice a weeka |
| Vaginal ring | ||
| 17-beta estradiol | Estring (7.5 μg/day) | Inserted for 90-day intervals without interruption |
| Estradiol acetate | Femring (5 and 10 μg/day) | |
| Vaginal tablet inserts | ||
| Estradiol hemihydrate | Vagifem, Yuvafemc (10 μg/day) | Initial: 1 tablet/day for 2 weeks Maintenance: 1 tablet twice a week |
| DHEA (prasterone) | Intrarosa (6.5 mg insert) | 1 insert into vagina, once daily |
| Oral tablet | ||
| Ospemifene | Osphena (60 mg) | 1 tablet orally every day |
↵a Common clinical dosage is 0.5 g twice a week for maintenance.
↵b Premarin vaginal cream is the only locally applied preparation with FDA approval for dyspareunia due to GSM.
↵c Yuvafem is an FDA-approved generic equivalent to Vagifem.
DHEA = dehydroepiandrosterone; FDA = US Food and Drug Administration