Estradiol 

Estring Vaginal Ring

The Estring vaginal ring is a flexible ring containing 2 mg of estradiol, an estrogen hormone designed to alleviate moderate to severe menopausal symptoms such as vaginal dryness, irritation and pain during intercourse. As compared to other estrogen treatments, Estring is more convenient as you need to replace it only after three months. Once inserted deep into the vagina, the ring will remain in place for 90 days. Remove and, if needed, replace the ring after 90 days. For safe and effective use of the medication, carefully read the directions for use that come along with the prescription and follow the directions for use given by your doctor. You should talk to your healthcare provider or doctor if you have any queries or concerns. 

Product Overview

The Estring Vaginal Ring is a flexible ring containing 2 mg of estradiol, an estrogen hormone. It alleviates moderate to severe menopausal symptoms, including vaginal dryness, irritation, pain during intercourse, itching, frequent urination urges, and painful urination. This targeted treatment delivers estradiol directly to the vaginal area, providing relief by replenishing estrogen levels in the body.

To use the Estring Vaginal Ring, carefully follow the instructions provided with the prescription. Insert the ring deep into the vagina, where it will remain in place for 90 days, continuously releasing estradiol. Estring ring usually does not interfere with sexual intercourse, but if it does, it can be removed, washed, and reinserted as needed. It may take two to three weeks to experience the full benefits of this medication, so patience is key.

Common side effects of the Estring Vaginal Ring may include nausea, abdominal pain, bloating, increased vaginal discharge, discomfort or pain in the vagina, breast tenderness, headache, insomnia, weight changes, hot flashes, urinary tract infection, upper respiratory tract infection, and back pain. Serious side effects such as hives, depression, mood changes, memory loss, difficulty breathing, breast lumps, abnormal vaginal bleeding, and swelling of the face or extremities should be reported to a healthcare professional immediately. It’s crucial to follow your doctor’s advice regarding usage and to consult them if you have any concerns or questions.

Uses 

Targeted Treatment 

• It is indicated for use to reduce moderate to adverse symptoms of menopause. 

Benefits

It also provides relief from: 

• Vaginal dryness
• Irritation  
• Pain during intercourse
• Itching 
• Frequent urges to urinate 
• Painful urination

[Note: Do not take an Estring Vaginal Ring without consulting your doctor. They will determine whether you need this medication based on your conditions.]

Estring Vaginal Ring Dosage

Forms & Strengths

Form: Flexible vaginal ring

Strength: 2 mg of estradiol

How to Take It?

• You should insert the Estring Vaginal Ring deep into the vagina. 
• The ring will remain in place continuously for 90 days. 
• After three months, remove the ring and replace it with a new one if needed.
• Before using the Estring estradiol vaginal ring, carefully read the Patient Information Leaflet that comes along with the prescription and follow the instructions for use. 
• Consult your doctor, pharmacist or healthcare provider at once if you have any queries or concerns regarding the medication.
• Your doctor will tell you how much medication you should take. Do not take more than recommended. 
• Properly wash your hands and make sure they are dry before and after handling the ring. 
• To insert the ring on your own, choose a comfortable position. 
• Squeeze the sides of the ring into an oval and insert the ring as deeply as possible into the vagina as directed by your doctor. 
• Once the ring is in place, you may not feel anything. But if you feel uncomfortable or if you are still able to feel the ring after insertion, it means that it is not properly inserted. You should gently push the ring farther into your vagina. If you feel pain, call your doctor. 
• The ring can’t become lost or go too far in. 
• After proper insertion of the ring, it should not interfere with your sexual intercourse. It should not be removed or felt by either partner during intercourse. 
• However, if it becomes bothersome during sexual intercourse, it can be removed, washed with rinse water and reinserted after intercourse. 
• The ring will remain in place continuously for 90 days. After three months, remove the ring and replace it with a new one if needed. Do not leave a ring inside the vagina for more than 90 days. 
• It may take around two to three weeks to start feeling the full benefit of this medication. 
• Sometimes, the ring may move down accidentally. Gently push it back into place. 
• If the ring comes out and falls out of the vagina, rinse it with lukewarm water and put it back into place. 
• Contact your doctor if the ring keeps falling out often. 
• While using the ring, examine your breasts for lumps every month and have a mammogram every year to determine if you should continue taking this medication.
• If you notice something unusual, contact your doctor right away.  
• Do not stop using the Estring Vaginal Ring without consulting your doctor. 
• To remove the ring after 90 days, hook your finger through the Estring ring and gently pull it out. 
• If you have trouble removing it, call your doctor. 
• Once you remove the ring, ensure that the ring is intact. 

[Note: Your doctor will decide the right amount for you based on your condition, following guidelines and studies on the drug. They’ll adjust it as needed over time.]

How Does Estring Vaginal Ring Work?

Estring releases estrogen called estradiol, which is absorbed directly into the skin of the vaginal wall. It releases estradiol in a stable and consistent manner for 90 days to treat moderate to severe menopausal changes. It provides relief from urinary and vaginal symptoms by releasing estrogen directly into the area where it is needed most. It may take around two to three weeks to start feeling the full benefit of this medication. 

Important Safety Information

Side Effects

Common side effects of Estring Vaginal Ring may include: 

• Nausea 
• Abdominal pain
• Bloating 
• Vomiting 
• Increased vaginal discharge
• Discomfort or pain in the vagina
• Breast tenderness 
• Headache
• Insomnia
• Weight changes 
• Hot flashes
• Urinary tract infection 
• Upper respiratory tract infection
• Back pain 

Serious side effects of Estring Vaginal Ring may include:

• Hives 
• Depression 
• Mood changes
• Memory loss 
• Difficulty breathing
• Breast lumps
• Abnormal vaginal bleeding
• Unusual vaginal irritation, itching, or odor
• Persistent nausea or vomiting
• Swelling of your lips, tongue, face, or throat
• Swelling of hands, ankles, or feet
• Severe abdominal pain
• Jaundice 
• Increased thirst or urination

[Note: Remember, this list may not cover all possible side effects. Always consult with your healthcare giver for medical advice about side effects.]

Warnings

• Using estrogen-alone can increase the risk of endometrial cancer in women with a uterus. Report any abnormal vaginal bleeding immediately. Your healthcare practitioner or doctor will examine you to check for any abnormal vaginal bleeding to find out the cause, as postmenopausal vaginal bleeding could potentially indicate uterine cancer.
• You should not use estrogen to prevent cardiovascular conditions such as stroke or heart attack and probable dementia. 
• Using estrogen-alone may increase the risk of getting blood clots or strokes. 
• Estrogen and Progestin therapy, when combined, have been linked to an increased risk of cancer of the breast.
• Estrogen therapies should be used at the lowest effective doses and for the shortest duration needed to achieve treatment goals while considering the risks for each woman. 
• After three months, remove the Estring estradiol vaginal ring and replace it with a new one if needed. Do not leave the ring inside the vagina for more than 90 days. 
• Do not share your medications with others, even if the symptoms are the same. 
• If you are planning to have surgery, let your doctor know about all the medications you are taking. This includes all the prescription and non-prescription drugs and herbal supplements you take. 

Boxed Warning 

Estrogen-Alone therapy

• Cardiovascular conditions and probable dementia- Estrogen-alone therapy should not be used to prevent cardiovascular disorders and probable dementia. 
• Endometrial cancer- Using estrogen alone can increase the risk of endometrial cancer in women with a uterus. Adding Progestin can help reduce this risk of endometrial hyperplasia. Women should undergo diagnostic tests if they experience persistent or recurring unusual genital bleeding. 

Estrogen plus Progestin therapy

• Cardiovascular disorders and probable dementia- Estrogen and Progestin therapy should not be used in combination to avoid cardiovascular disorders and probable dementia. 
• Breast Cancer- Estrogen plus Progestin therapy has been linked to an increased risk of cancer of the breast.

Precautions

• If you have difficulty inserting or removing the ring, contact your doctor immediately. 
• If you think you may be pregnant or planning to become pregnant, tell your doctor right away. 
• Do not use an Estring Vaginal Ring if you are breastfeeding a baby. 
• It is considered unsafe to smoke or consume alcohol while you are taking estradiol, as it increases the risk of getting a stroke or blood clot. 
• If the Estring estradiol vaginal ring comes out and falls out of the vagina during the 90 days, rinse it with lukewarm water and put it back into place.
• Do not use other vaginal products without consulting your doctor.

Contraindications

You should not take Estring Vaginal Ring if you have: 

• Hypersensitivity to estradiol or any other ingredient
• Or ever had a heart attack, blood clots, or stroke
• Undiagnosed abnormal vaginal bleeding
• Liver disease or impairment
• Kidney disease
• Endometriosis or uterine fibroid tumors 
• Gallbladder disease
• Thyroid disorder 
• Suspected or known pregnancy
• Hereditary blood disorder
• Cancer of the vagina, uterus/cervix or breast

Missed Dose

• Estrogen therapies should be used at the lowest effective doses and for the shortest duration needed to achieve treatment goals while considering the risks for each woman.
• Sometimes, the ring may move down accidentally. Gently push it back into place. 
• If the ring comes out and falls out of the vagina, rinse it with lukewarm water and put it back into place. 
• Contact your doctor if the ring keeps falling out often.
• Do not replace the ring without consulting your doctor. . 

[Note: If you have missed a dose of your medication and are unsure about when to take the next one, immediately consult your doctor or pharmacist.]

Overdose

Do not use more than one ring at a time. For more information consult your doctor. 

[Note: If you consumed more than the recommended dose, get medical help right away or call the Poison Help line at 1-800-222-1222.]

Storage

• You may store the unopened Estring Vaginal Ring in its original container until you are ready to use it. 
• Keep it at a controlled room temperature of 59 °F to 77 °F or 15° to 25 °C, away from direct sunlight, excess heat and moisture. 
• Do not keep it in the bathroom. 
• Do not keep medications that are no longer needed or outdated. 
• Throw away the medication after its expiration date has passed, even if it is unused. 
• Do not flush the used ring unless instructed to do so. 
• Do not throw the used medication into the drain or wastewater. 
• Properly dispose of the medications that are no longer required or expired. 

[Note: Discuss with your healthcare professional about the proper disposal of any unused medicine and any questions you may have regarding its storage.]

Estring Vaginal Ring Interactions

• Amoxicillin 
• Anticoagulants
• Aromatase inhibitors such as:
  • Anastrozole
  • Aminoglutethimide
  • Letrozole
  • Exemestane
  • Testolactone
  • Vorozole
• Betamethasone
• Carbamazepine
• Certain oral diabetes medications
• Corticosteroid  
• Fezolinetant 
• Fulvestrant 
• Insulin 
• Medications for fungus infections such as: 
  • Ketoconazole 
  • Itraconazole 
• Ospemifene 
• Penicillin
• Ritonavir
• Raloxifene 
• Toremifene 
• Tamoxifen 
• Thyroid medications
• Tranexamic acid 
• Voriconazole
• Warfarin 

[Note: This isn’t a complete list, and there could be other drugs that interact with Estring Vaginal Ring. Make sure to tell your doctor about any prescription, over-the-counter medicines, and herbal products you’re taking.]

Estring Vaginal Ring Alternatives

• Catapres (clonidine)
• Desyrel (trazodone)
• Estrace Vaginal Cream (estradiol)
• Femring (estradiol)
• Neurontin (gabapentin)
• Paxil CR (paroxetine)
• Vagifem (estradiol)

[Note: Your doctor will choose what’s best for you. Don’t use any of these alternative medications without consulting your healthcare provider. Taking them by yourself may cause serious side effects.] 

Frequently Asked Questions

1. How does the Estring Vaginal Ring work to alleviate menopausal symptoms?

The Estring Vaginal Ring contains estradiol, an estrogen hormone, which is absorbed directly through the skin of the vaginal wall. It releases estradiol stably and consistently for 90 days, replenishing estrogen levels and providing relief from moderate to severe menopausal symptoms in and around the vagina.

2. What are the common side effects of the Estring Vaginal Ring?

Common side effects of the Estring Vaginal Ring may include nausea, abdominal pain, bloating, increased vaginal discharge, discomfort or pain in the vagina, breast tenderness, headache, insomnia, weight changes, hot flashes, urinary tract infection, upper respiratory tract infection, and back pain.

3. How should the Estring Vaginal Ring be inserted and used?

The Estring Vaginal Ring should be inserted as deep as possible into the vagina and will remain in place continuously for 90 days. It should not interfere with sexual intercourse, but if it does, it can be removed, washed, and reinserted as needed. It may take two to three weeks to experience the full benefits of this medication.

4. What precautions should be taken while using the Estring Vaginal Ring?

It is important not to use the Estring Vaginal Ring if you have certain conditions such as hypersensitivity to estradiol, a history of blood clots, heart attack, or stroke, undiagnosed abnormal vaginal bleeding, liver disease, or breast or uterine cancer. It is also considered unsafe to smoke or consume alcohol while using estradiol, as it increases the risk of stroke or blood clots.

Our Guarantee

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