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Ospemifene for the treatment of dyspareunia associated with vulvar and vaginal atrophy: potential benefits in bone and breast

Authors Soe LH, Wurz GT, Kao C, DeGregorio MW

Received 8 August 2013

Accepted for publication 21 August 2013

Published 25 September 2013 Volume 2013:5 Pages 605—611

DOI https://doi.org/10.2147/IJWH.S39146

Review by Single-blind

Peer reviewer comments 3


Video abstract presented by Chiao-Jung Kao

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Lin H Soe, Gregory T Wurz, Chiao-Jung Kao, Michael W DeGregorio

Department of Internal Medicine, Division of Hematology and Oncology, School of Medicine, University of California, Davis, Sacramento, CA, USA

Abstract: Ospemifene is a selective estrogen receptor modulator (SERM), or estrogen receptor agonist/antagonist, that was recently approved by the US Food and Drug Administration for the treatment of dyspareunia associated with vulvar and vaginal atrophy, a chronic condition that affects up to 60% of postmenopausal women. Ospemifene is the first and only nonestrogen compound approved for this indication. Compared with other approved SERMs, such as tamoxifen, toremifene, bazedoxifene, and raloxifene, the estrogen-like effects of ospemifene in the vaginal epithelium are unique. This review first discusses the rationale for developing ospemifene, including its mechanism of action, and then focuses on the clinical development of ospemifene for the treatment of dyspareunia associated with vulvar and vaginal atrophy. Included are discussions of the effects of ospemifene on the endometrium, serum lipids, coagulation markers, bone, and breast cancer. In conclusion, ospemifene is a SERM with a unique estrogen agonist/antagonist tissue profile that was recently approved in the US for the treatment of dyspareunia associated with vulvar and vaginal atrophy in postmenopausal women. Ospemifene warrants further clinical investigation for the treatment and prevention of osteoporosis and breast cancer.

Keywords: ospemifene, dyspareunia, vulvar and vaginal atrophy, osteoporosis, breast cancer

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