USA: painful sex and have Medicare? Your treatment is NO LONGER excluded from Medicare Part D

Huge game changer for women! If you suffer from painful sex and have Medicare, your treatment is NO LONGER excluded from Medicare Part D.

The United States’ Centers for Medicare and Medicaid Services (CMS)made a clarification of the statutory intent of “Prescription Drug Benefits” section 1860D-2(e)(2)(A) of the Social Security Act, stating that drugs for the treatment of moderate to severe dyspareunia (pain during sexual intercourse) due to menopause, are NOT excluded from Medicare Part D coverage when used consistent with this labeling.

Dyspareunia, a symptom of vulvar and vaginal atrophy (VVA), also referred to as genitourinary syndrome of menopause (GSM), can affect up to 40 per cent of all postmenopausal women.

This is a chronic and progressive medical condition resulting from decreases in androgens and oestrogens at the time of menopause. Unlike vasomotor symptoms of menopause (e.g. hot flashes and night sweats), GSM typically does not subside without treatment.

What is genitourinary syndrome of menopause?

GSM is a set of symptoms that appear with menopause, and do not go away without treatment. This can include changes to vulvar and vaginal tissue, causing easy tearing, pain, soreness, dryness and thinning tissue.

These symptoms are caused by low or no oestrogen, since oestrogen helps keep skin cells healthy, particularly those with a lot of oestrogen receptors present like the vagina and vulva. 

Atrophic vaginitis is the old term used for these vulvar and vaginal symptoms, but GSM can also affect the bladder, urethra and surrounding tissue.

Pelvic tissue can become weak and fragile, resulting in uncomfortable symptoms that inhibit normal living, like going to the toilet, sex, masturbating or wearing tight clothes.

Some women who are on breast cancer suppression (oestrogen suppression) drugs are likely to experience vaginal symptoms that can cause great distress, since breast cancer doesn’t always coincide with a natural menopause.

This means some women are thrown into premature menopausal states, and experience the same symptoms (or worse, because oestrogen is completely blocked).

There are options for all women in treating GSM, so speak to your practitioner.

Read more about safe oestrogen treatments for women on oestrogen-blocking drugs.