Changes to Vulva, Vestibule, Urethral Meatus and Vagina 20 Weeks Post Daily Prasterone in Women With Dyspareunia

Inclusion Criteria: * provides written informed consent and HIPAA authorization before any study procedures are conducted; * has a body mass index (BMI) \< 37 kg/m2 * is menopausal either naturally (at least 12 months amenorrheic) or 6 weeks after a bilateral salpingo-oophorectomy prior to natural menopause; subjects with hysterectomy only must have a serum FSH \> 40 mIU/mL; * has vulvovaginal atrophy with moderate to severe dyspareunia; * has at least one score ≥ 2 on cotton-tipped swab test * agrees to comply with the study procedures and visits. Exclusion Criteria: * has a hypersensitivity to DHEA; * has used prasterone in the past 6 months; * has documented or suspected breast cancer; * has undiagnosed genital bleeding: * has clinically significant findings on physical examination; * has uncontrolled hypertension; * has any chronic medical condition or psychologic disorder that the Principal Investigator feels makes her ineligible for the study; * is currently on local or systemic androgen therapy including local or systemic testosterone (washout 14 days for local or topical androgen or non-depot injection, 1 month for depot, 6 months for pellet; * is currently on local or systemic estrogen therapy or androgen therapy (washout 14 days for vaginal estrogen, 60 days for oral/transdermal therapy); * is currently using a selective estrogen receptor modulator (SERM) or products that have estrogenic or anti-estrogenic effects within last month; * has a history of substance abuse within 12 months prior, or consuming \> 14 alcoholic drinks per week; * has received an investigational drug within 30 days prior to signing consent; * has any condition or exhibits behavior that indicates to the Principal Investigator that the Subject is unlikely to be compliant with study procedures and visits.