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All about: Estring

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Generic name: Estradiol vaginal ring
Brand names: Estring

Why is Estring prescribed?

Estring is an estrogen replacement system for relief of the vaginal problems that often occur after menopause, including vaginal dryness, burning, and itching, and difficult or painful intercourse. Estring is also prescribed for postmenopausal urinary problems such as difficulty urinating or urinary urgency.

Most important fact about Estring

Estrogens increase the risk of cancer in the lining of the uterus, called the endometrium. Because estrogen replacement therapy is not advisable if you are in any danger of developing cancer, your doctor should take a complete medical and family history, and perform a complete physical exam, before prescribing Estring. It is important to have regular check-ups (at least once a year) and to report any unusual vaginal bleeding to your doctor immediately.

Estring and other estrogen drugs, with or without progesterone, should not be used to prevent heart disease. Recent studies have confirmed an increased rate of heart attack, stroke, and dangerous blood clots among women taking estrogen or estrogen combinations for 5 years. Blood clots can lead to phlebitis, stroke, heart attack, a loss of blood supply to the lungs, a blockage in the blood vessels leading to the eye, and other serious disorders.

How should you use medication?

Each Estring is left in place for 3 months. Press the Estring into an oval and insert it as deeply as possible into the upper third of the vagina. The exact position is unimportant as long as you don't feel the ring. If the ring causes discomfort, it is probably not far enough inside.

If the ring slips down into the lower part of the vagina, push it back up with your finger. If it falls out, rinse it in warm water and reinsert it. When replacing the ring, simply hook a finger through it and pull it out.

--If you miss a dose...

If the ring is not replaced after 90 days, the dose of estrogen will gradually decline and your symptoms will return.

--Storage instructions...

Store at room temperature.

What side effects may occur?

Side effects cannot be anticipated. If any develop or change in intensity, tell your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue using Estring.

  • More common side effects may include:
    Abdominal pain, arthritis, back pain, flu-like symptoms, headaches, insomnia, joint pain, nausea, sinus inflammation, upper respiratory tract infections, vaginal discharge, vaginal discomfort or pain, vaginal inflammation or bleeding, yeast infection

Why should Estring not be prescribed?

Do not use Estring if you have unexplained vaginal bleeding. Also avoid Estring if there is a possibility that you are pregnant.

Do not use Estring if there is any chance that you have breast cancer or any other cancer stimulated by estrogen. You will also have to avoid Estring if it causes an allergic reaction.

Special warnings about Estring

Estrogen replacement therapy increases the risk of developing cancer of the lining of the uterus. The risk increases with longer use and higher doses. Therefore, you should use Estring for as short a time and at as low a dose as is necessary to relieve your symptoms. Report any unusual vaginal bleeding to you doctor immediately.

Using estrogen may also increase the risk of breast cancer, ovarian cancer, heart attack, stroke, blood clots, and gallbladder disease.

Use estrogen with caution if you have severely low blood levels of calcium (hypocalcemia).

Tell your doctor if you've ever had liver problems, high cholesterol, high blood pressure, thyroid problems, or visions problems. Using estrogen could make these conditions worse.

Estrogens can cause water retention. If you have a condition that could be affected by this--such as heart or kidney problems--your doctor will monitor you closely

While using Estring, contact your doctor right away if you develop any of the following:

Abdominal pain, tenderness, or swelling
Abnormal bleeding from the vagina
Breast lumps
Coughing up blood
Difficulty with speech
Dizziness or faintness
Pains in your chest or calves
Severe headache or vomiting
Sudden shortness of breath
Vision changes
Weakness or numbness of an arm or leg
Yellowing of skin or whites of the eyes (could signal a liver problem)

Any vaginal infection should be cleared up before you begin Estring therapy. If an infection develops after you begin, you'll need to remove the ring during treatment.

Possible food and drug interactions when using Estring

No interactions have been reported, but Estring should be removed during treatment with other vaginally administered drugs.

Special information if you are pregnant or breastfeeding

Estring must not be used during pregnancy and is not intended for nursing mothers.

Recommended dosage

Insert a new ring every 3 months.

Overdosage

An overdose from Estring is unlikely. An oral overdose of estrogen could be expected to cause the symptoms listed below.

  • Symptoms of estrogen overdose may include:
    Nausea, vomiting, vaginal bleeding

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