WhelWomen's Health Evidence Lab
WHEL-C-052 · Moderate evidence · 6/10

PRASTERONE for menopause

A clinical review reports that vaginal prasterone improves genitourinary syndrome of menopause symptom severity by approximately 40% to 80%.

Origin · Existing drug · repurposing candidatePathway · 505(b)(2) · existing active ingredient, new indicationEvidence arm · Direct researchEvidence supports
How to read thisThe summary above and the proposed mechanism are generated by the model from the sources it ingested, and are written as the model’s reasoning rather than established fact. Any figure quoted from MATRIX is a model-derived association score, not a clinical measurement. How far the published record backs this pair is carried by the score’s own rigor dimension and traced to verbatim sources at the foot of the page.

Hypothesized mechanism

Locally administered prasterone (DHEA) is converted to estrogens and androgens in vaginal tissue, restoring epithelial integrity and reducing GSM symptoms.

This is the model’s proposed mechanism from the sources on file, not a demonstrated causal pathway. How well the published record supports it is reflected in the rigor and plausibility dimensions of the score, and traced to the verbatim sources at the foot of the page.

How the score was reached, for this pair

The composite score is the sum of five dimensions, each scored 0 to 2 by the model from the evidence on file. Below is the sub-score this specific pair received on each, with what that dimension measures. It scored 6 of 10 overall, a moderate reading, from a direct rated moderate in strength.

The model’s overall reasoning for this pair is the summary at the top of the page, and the mechanism it proposed is in the section above.

Pathway arm0.0 / 10 · Exploratory

Scored for women. Female representation not stated — applicability to women uncertain (flagged for full text). (band F4, ×0.75).

Corroboration

Only a single claim is present, stating PRASTERONE is a Phase 3 clinical candidate for menopause per Open Targets. No mechanistic lines of evidence are described, so there is no convergence to assess.

0 / 2

Rigor

The claim provides only a regulatory/clinical-stage annotation from a database, not any human or in-vitro mechanistic model. No experimental rigor can be evaluated from this single registry-type statement.

0 / 2

Specificity

No molecular target or mechanism of action is named in the claim. The drug's specificity of action on any target cannot be assessed from the provided text.

0 / 2

Plausibility

Without any stated target or phenotype mechanism, target-phenotype fit cannot be judged. The claim merely notes clinical-stage status, offering no biological rationale.

0 / 2

Consistency

There is only one claim, so there are no multiple mechanistic signals to compare for directional consistency. Consistency is therefore not demonstrable.

0 / 2
Direct research arm · anchors the headline6.0 / 10 · Moderate

Scored for women. Evidence generated in women (female population, ~100% female). (band F1, ×1.00).

Corroboration

Evidence comes from a single review article ('Management of Menopausal Symptoms: A Review'), which represents one synthesis rather than multiple independent sources. A single review scores at most 1, and there is no second independent study presented.

1 / 2

Rigor

The source is a narrative/clinical review reporting a range of symptom improvement, not an explicitly described RCT or meta-analysis. Without clear evidence of a systematic review or RCT design behind the cited figure, it warrants a moderate rigor score of 1.

1 / 2

Specificity

The claim names vaginal prasterone directly and the GSM (genitourinary syndrome of menopause) symptom context, tying the specific drug to the menopause-related condition. Both intervention and condition are explicitly identified.

2 / 2

Plausibility

Prasterone (DHEA) acts locally to restore vaginal tissue, a plausible mechanism for improving GSM symptoms, but the claim itself only reports symptom improvement without articulating or evidencing the mechanism. Thus the mechanism is plausible but not explicitly evidenced here.

1 / 2

Consistency

Only a single source reporting a range of improvement is provided, so directional agreement across independent studies cannot be assessed. Per rules, a single source defaults to a neutral consistency score of 1.

1 / 2
How the scoring rubric works, in general

Layers not covered for this pair

Sex-specific pharmacokineticsNone on file

Not covered for this pair. This layer holds documented sex-specific pharmacokinetics for a limited set of drugs, and this compound is not among them yet. A blank here means the drug is not covered by the layer, not that no sex difference exists.

More on the sex-specific pharmacokinetics layer and its sources
Cycle-phase dependenceNone on file

Not covered for this pair. The cycle-phase layer is seeded for the strongest-evidence cases so far (PMDD), and this pair is not among them yet. A blank here means the pair is not covered by the layer, not that the effect was found to be phase-independent.

More on the cycle-phase layer and its sources

Source evidence · what the pipeline ingested

These are the sources the pipeline ingested to detect and score this signal, the published literature the model actually read, each tagged by study type. Where the model combined findings the claim is marked as a synthesis (S), and where the literature disagrees the contradiction is shown (!).

Every source below belongs to this signal’s evidence arm, Direct research. Whel reads each drug-condition pair through four such arms, each held to its own inclusion bar; a signal is surfaced through one of them.

  • 1improvement in severity by 40% to 80% for vaginal prasterone PubMed · PMID 36749328
  • 2Per Open Targets (retrieved 2026-06-16), PRASTERONE (a Small molecule) is a clinical candidate for menopause (maximum clinical stage PHASE_3). Open Targets · mechanistic

These are the verbatim sources the pipeline surfaced and read; they may not be the full published record for a pair, and the score reflects the strength and agreement of the evidence rather than its volume. The strength of these source types is what the rigor dimension of the score reads off. MATRIX, sex-specific pharmacokinetics, and cycle phase are separate layers the pipeline does not ingest, external cross-references reported beside the score, and they link to their own sources in their sections above.

The primary sources and pipelines this evidence is drawn from