*Product monograph dosing is higher than as posted and could require endometrial protection. Start with 0.5-1.0 gm nightly pv x 2 weeks then twice weekly. At those doses endometrial protection should not be required however any unexplained vaginal bleeding should be investigated.
There are no studies at this time supporting the use of vaginal prasterone with systemic MHT. Oral ospemifene cannot be combined with systemic MHT.
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