A SERM for vaginal menopause symptoms
Ospemifene
A daily tablet for painful vaginal dryness after the menopause when vaginal oestrogen cannot be used.
What is Ospemifene?
Ospemifene is a daily tablet for moderate to severe vaginal dryness and discomfort, including pain during sex, after the menopause. It is a SERM (selective oestrogen receptor modulator), which means it acts like oestrogen in some tissues and against it in others; it improves the vaginal lining without being an oestrogen. It is mainly for women who cannot or prefer not to use vaginal oestrogen creams or pessaries. Like other SERMs, it carries a small risk of blood clots. The brand name is Senshio.
Education and reference only. This is a plain-language guide to Ospemifene — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Ospemifene is a selective oestrogen receptor modulator (SERM), a tablet taken once a day for the vaginal symptoms of the menopause, such as dryness, soreness and pain during sex. After the menopause, falling oestrogen thins and dries the vaginal lining; ospemifene helps reverse this. It is generally used for women in whom local vaginal oestrogen (creams, pessaries or rings) is not suitable or not preferred. It is taken by mouth.
How it works
A SERM acts like oestrogen in some parts of the body and blocks it in others. Ospemifene has an oestrogen-like effect on the lining of the vagina, helping it become thicker, more elastic and better lubricated, which eases dryness and pain. Because it is taken as a daily tablet rather than applied locally, it offers an option for women who find vaginal preparations difficult. Like other SERMs, its oestrogen-like action elsewhere brings a small risk of blood clots.
Company & origin
Originated / developed by: Generic (branded supply).
A daily tablet used in the UK for painful vaginal dryness after the menopause in women who cannot use vaginal oestrogen.
What it treats
Conditions Ospemifene is used for
Practical use
How to take Ospemifene
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- Take one tablet once a day, with food, at about the same time each day.
- Give it time — vaginal symptoms may take several weeks to improve, so keep taking it as prescribed.
- Tell your doctor about any history of blood clots, as it is not suitable if you have had them.
- If you will be immobile for a long time, such as after an operation, ask whether it should be paused.
- Report any unexpected vaginal bleeding promptly, as this always needs checking after the menopause.
Weighing it up
Advantages & disadvantages of Ospemifene
Advantages
- An effective oral option for painful vaginal dryness after the menopause.
- Useful for women who cannot use, or prefer not to use, vaginal oestrogen creams or pessaries.
- Taken as a simple once-daily tablet rather than a local application.
Disadvantages
- Carries a small risk of blood clots, like other SERMs.
- Can cause hot flushes, muscle spasms or vaginal discharge.
- Only treats vaginal symptoms, not other menopause symptoms such as hot flushes.
Practical use
Good to know
Ospemifene treats vaginal symptoms specifically and is not a general hormone replacement therapy, so it is not used for hot flushes. It can take some weeks before the benefit is felt, so it is taken regularly. Like other SERMs, it slightly increases the risk of blood clots in the legs or lungs, so it is avoided in women with a history of clots and stopped if long periods of immobility are expected, such as around major surgery. It may cause hot flushes, muscle spasms or vaginal discharge. Any unexpected vaginal bleeding after the menopause should always be reported and checked. It is an alternative for women who cannot use, or would rather avoid, vaginal oestrogen, and the choice is made with a clinician after weighing the benefits and risks.
Who should not take it / use with caution
- Women with a history of blood clots in the legs or lungs.
- Women with unexplained vaginal bleeding until it has been investigated, or with certain hormone-related cancers.
- Anyone with severe liver problems or for whom a clinician judges it unsuitable.
Monitoring
- Reviewing whether vaginal symptoms have improved after several weeks.
- Checking for any unexpected vaginal bleeding, which needs investigation.
- Reassessing the balance of benefit and clot risk over time.
Side effects
- Hot flushes, muscle spasms (such as leg cramps) and vaginal discharge can occur.
- Headache or a small rise in clot risk are possible.
- Rarely, signs of a blood clot, such as a swollen, painful leg or sudden breathlessness, which need urgent help.
Key interactions
- It should not be used together with oestrogen-containing HRT or other oestrogen-like SERMs.
- Some medicines that affect blood clotting may need review, given the clot risk.
- Tell your prescriber about all your medicines, as some can affect how it is handled by the body.
Available as: Tablets taken once a day by mouth.
Answers
Ospemifene: frequently asked questions
What is ospemifene for?
It is a daily tablet for moderate to severe vaginal dryness and pain after the menopause, mainly for women who cannot use vaginal oestrogen.
Is it the same as HRT?
No. It is a SERM that targets vaginal symptoms specifically; it is not a general HRT and is not used for hot flushes.
How long before it works?
Vaginal symptoms may take several weeks to improve, so it is taken regularly every day rather than only when symptoms are bad.
Does it increase the risk of blood clots?
Like other SERMs, it slightly raises the risk of clots, so it is avoided in women who have had clots and paused before long periods of immobility.
What should I do about unexpected bleeding?
Any unexpected vaginal bleeding after the menopause should always be reported and checked, so contact your doctor if this happens.
The wider class
About SERM (for vaginal menopause symptoms)
Ospemifene belongs to the serm (for vaginal menopause symptoms) class. For how the class as a whole works, its shared safety principles and monitoring, see the full guide.
Browse by body system
Authoritative sources
- BNF
- NICE CKS
Building a medicines information resource?
We create evidence-led, dose-free drug and formulary references for teams.