Prasterone is a steroid hormone that is converted into two active hormones, estrogen and testosterone. It is used in the treatment of postmenopausal women with coital discomfort due to vaginal dryness and atrophy.

Prasterone Uses:

• Dyspareunia:

  • It is indicated for the treatment of moderate to severe dyspareunia in postmenopausal women (due to vulvar and vaginal atrophy).

Prasterone Dose in Adults

Prasterone Dose in the treatment of Dyspareunia:

• Females: Intravaginal:
  • 6.5 mg once a day at bedtime.

Use in Children:

Not Indicated. It is only indicated in postmenopausal women.

Use in Pregnancy:

• The drug is not approved for postmenopausal women and has not been tested in human reproduction or animal studies.
• Other similar formulations such as dehydroepiandrosterone [DHEA]) have been found to improve pregnancy outcomes in women with reduced ovarian reserves.

Prasterone use during breastfeeding:

• It is not known whether intravaginal contraception can cause breastmilk to be excreted in this way.
• But, breast milk can contain steroids such as prasterone and steroidoids.

Dose in Kidney disease:

There are no dosage adjustments provided in the manufacturer’s labeling (it has not been studied).

Dose in Liver disease:

There are no dosage adjustments provided in the manufacturer’s labeling (it has not been studied).

Side Effects of Prasterone:

• Genitourinary:

  • Vaginal discharge
  • Abnormal pap smear

Contraindications to Prasterone:

Atypical vaginal bleeding that is not diagnosed

Warnings and precautions

• Vaginal discharge:

  • Patients may notice vaginal discharge.

• Breast cancer

  • Women with breast cancer history should not use estrogen as the active metabolite of the drug.

• Vaginal bleeding

  • Patients with persistent or abnormal vaginal bleeding should be evaluated before initiating treatment.

Monitoring Parameters:

None mentioned.

How to administer Prasterone?

• Wash hands and empty the bladder before inserting the medication.
• Insert the medicine into the vagina at bedtime using the applicator provided.

Mechanism of action of Prasterone:

It is an inactive steroids that is converted into its active compounds (androgens, estrogens). It is unknown what the exact mechanism of action is in treating vaginal atrophy in postmenopausal females.

Metabolism:

• It is metabolized to estradiol and testosterone via dehydrogenase, reductase, and aromatase.

International Brand Names of Prasterone:

• Intrarosa
• Biolaif
• Biosteron
• Di Luo An
• Intranosa
• Prolaif
• Stymen

Prasterone Brand Names in Pakistan:

No Brands Available in Pakistan.