Osphena is part of a class of medications known as Selective Estrogen Receptor Modulators (SERM). To place into very simple terms the way hormones and many other chemicals in the body work is like a lock and key. The cells of the body have a variety of receptors on them (Locks) and when the appropriate chemical (key) comes along it is unlocked and the hormone or chemical can make its effect happen. SERM's as well as many other medications/chemicals can be made to look like something else (estrogen) which allow them to attach to a target cell's estrogen receptors and create the programmed response (agonist). These same chemicals can be formulated to also bind to a specific receptor but serve only to block out the intended chemical/hormone from stimulating the cell (unlocking it) which is called antagonistic. Think of this like a master key that can open a specific set of locks by looking like the individual ones that require their own key but in a different building this same key will not open the lock. There are many SERM's in clinical use today and they differ by which target estrogen receptors (you have them throughout the body) they can bind to "unlock/agonist" and which ones they will attach to "block/antagonistic" to achieve the benefits desired without using estrogen. This is a discussion to have with your gynecologist or other physician who may be managing your menopausal concerns.
If vaginal dryness, irritation (atrophy) and painful intercourse (dyspareunia) are your concerns for seeking hormonal treatment (Estrogen/SERM) and you do not want to take or cannot take hormones there are specific lasers available (FemTouch/MonaLisa) or ThermiVi available to create the same healing changes of the vaginal tissue without the use of hormones. Hope this helps you.