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What is Estring?

Estring is a vaginal ring containing estradiol which is a form of estrogen. Estring is a soft and flexible ring which releases estrogen which is directly absorbed through the vaginal wall in a stable and consistent manner for 90 days. This medication is used after menopause to treat vaginal changes such as vaginal dryness, burning, itching, painful sexual intercourse or urgent and irritating urination.

Always read the patient information and instructions carefully before using this medication. Follow your doctor’s directions.

• Wash your hands before and after inserting an Estring ring.
• Squeeze the sides of the ring together and insert as high as possible into the vagina. You should not be able to feel the ring once it is positioned. If you can feel it, then use a finger to push it in further. It is not possible for the ring to become too lost or to go too far.
• Estring should be replaced after 90 days. If it falls out at any time, rinse it with warm water before reinserting it.
• Estring does not need to be removed during sexual intercourse as it should not be felt by either partner. However, if it does become bothersome, it can be removed and then reinserted following intercourse. Wash the ring with warm water before reinserting.
• In order to remove Estring, loop a finger through the ring and pull it out gently.
• Self examine your breasts for lumps each months and have an annual mammogram while using Estring.

Make sure to tell your doctor and pharmacist:

• If you have any drug or other allergies.
• Which other prescription and non-prescription medications you currently take.
• Your medical history especially of unusual vaginal bleeding, cancer, heart disease, heart attack, stroke, blood clots, hereditary blood disorders, kidney disease, gallbladder disease, thyroid disease, lupus, endometriosis, uterine fibroid tumors, jaundice, liver problems, asthma, epilepsy, other seizure disorders, migraines, porphyria, hereditary angioedema and high or low calcium levels in your blood.
• If you are breast feeding.

Also be aware that:

• Estring should not be used if you are pregnant.
• Estring may increase the chance of heart attack, blood clots or stroke. You are at even more risk if you have diabetes, high blood pressure, high cholesterol, if you are overweight or if you smoke.

Common Estring side effects may include but are not limited to:

• Nausea or vomiting.
• Weight changes or bloating.
• Breast tenderness.
• Increased vaginal discharge.
• Headaches.

Contact your doctor if you experience any of the following side effects of Estring:

• Mental or mood disorders including depression or memory loss.
• Unusual vaginal bleeding including recurrent or prolonged bleeding, breakthrough bleeding or spotting.
• Unusual vaginal itching, discharge, odor or irritation.
• Breast lumps.
• Swelling of the hands, feet or ankles.
• Persistent nausea or vomiting.
• Increased thirst or urination.
• Dark urine.
• Severe stomach or abdominal pain.
• Jaundice.
• Signs of blood clot problems such as slurred speech, vision changes, breathing problems, unusual sweating, sudden or severe headache, coughing up blood, chest pain, jaw pain, left arm pain, confusion, fainting, sudden dizziness or pain, redness, swelling, tingling, weakness or numbness in your arms or legs.
• Signs of an allergic reaction such as hives, difficulty breathing or a swelling of your face, lips or throat.
• Signs of toxic shock-syndrome such as high fever, unusual muscle pain, diarrhea, sudden dizziness, fainting, unusual muscle pain or a sunburn-like rash. Remove the ring and get immediate medical help if you have any of these symptoms.

What should I do if I my Estring ring falls out?

If it falls out at any time, rinse it with warm water before reinserting it for the remaining time.

How high should I insert an Estring vaginal ring?

Insert Estring as far as possible into the vagina. You should not be able to feel the ring once it is positioned. If you can feel it, then use a finger to push it in further. It is not possible for the ring to become too lost or to go too far.