Estradiol vaginal ring is indicated for the treatment of menopausal symptoms affecting the vagina and urinary tract, including vaginal dryness, painful intercourse, painful urination, and increased frequency of urination. This medication falls under the category of local estrogen replacement therapy, which specifically targets the affected areas.
Estrogen, a female hormone produced by the ovaries, is the active component of estradiol vaginal ring. Its mechanism of action involves delivering estrogen locally. This medication does not provide sufficient estrogen levels to effectively manage other menopausal symptoms such as hot flashes.
Uses and Dosage
Prior to handling the vaginal ring, ensure that your hands are thoroughly washed and dried. Insert the ring deeply into the vagina according to the provided instructions. Typically, the ring remains in place for 90 days, after which it should be removed and replaced with a new ring if treatment is to be continued.
Do not exceed the 90-day timeframe for ring usage. Adhere to the prescribed dosing schedule with precision.
When properly positioned, the ring should not be perceptible and should not interfere with sexual intercourse. If you can feel the ring or experience mild discomfort, it may indicate that the ring is not positioned high enough. In such cases, gently push the ring higher using your finger.
In the event that the ring falls out of the vagina, rinse it with lukewarm water and reinsert it into the vagina. If the ring frequently falls out, contact your doctor for further guidance.
To remove the ring, insert your finger through the ring and gently pull it out. If you encounter difficulties in removing the ring, consult your doctor. Dispose of the used ring in the trash; do not flush it down the toilet.
It may take approximately 2 to 3 weeks before the full benefits of this medication are realized. Inform your doctor if your condition does not improve or worsens.
Some side effects may occur that usually do not need medical attention:
- breast pain or tenderness
- difficulty falling asleep or staying asleep
- changes in sexual desire
- hair loss
- spotty darkening of the skin on the face
- sudden feelings of heat or sweating
- stomach pain or bloating
- swelling, redness, burning, itching, or irritation of the vagina
- vaginal discharge
- painful or difficult urination
- back or joint pain
- runny nose or congestion
Inform your healthcare provider immediately if you experience any serious side effects:
- bulging eyes
- ongoing pain that begins in the stomach area but may spread to the back nausea, vomiting, or loss of appetite
- rash, hives, itching, hoarseness, or difficulty breathing or swallowing
- swelling of the eyes, face, tongue, throat, hands, arms, feet, ankles, or lower legs
- nausea or vomiting
- muscle pain
- dizziness or fainting
- rash on face or body
Before initiating estradiol treatment, inform your healthcare provider or pharmacist about any known allergies you may have, including allergies to estradiol or other substances. This product may contain inactive ingredients that can potentially cause allergic reactions or other complications.
Before using this medication, disclose your medical history to your doctor or pharmacist, particularly if you have a history of vaginal bleeding of unknown cause, certain types of cancers, blood clotting disorders, stroke, heart disease, liver disease, kidney disease, a family history of specific medical conditions (such as breast lumps, cancer, or blood clots), a personal or family history of a swelling disorder called angioedema, blood clotting disorders, high blood pressure, diabetes, high levels of cholesterol or triglycerides, obesity, lupus, underactive thyroid (hypothyroidism), mineral imbalances, a particular hormone problem known as hypoparathyroidism, uterine problems, gallbladder disease, asthma, seizures, migraine headaches, mental or mood disorders (such as dementia or depression), a certain blood disorder called porphyria, or a history of frequent vaginal infections.
Refrain from smoking or using tobacco products while taking this medication. The combination of estrogens and smoking significantly increases the risk of stroke, blood clots, high blood pressure, and heart attacks, particularly in women above the age of 35.
Notify your doctor if you have recently undergone or will be undergoing surgery, or if you anticipate prolonged periods of immobilization (such as during a long plane flight). These circumstances heighten the risk of developing blood clots, especially when using estrogen products. Your doctor may recommend temporarily discontinuing this medication or taking additional precautions.
This medication may cause the appearance of blotchy and dark areas on the face and skin, a condition known as melasma. Sun exposure can exacerbate this effect. Limit your time in the sun, avoid tanning beds and sunlamps, and utilize sunscreen and protective clothing when outdoors.
Individuals who are nearsighted or wear contact lenses may experience vision problems or difficulties with contact lens wear while using this medication. Should these issues arise, promptly contact your eye doctor.
If you develop a vaginal infection while using the estradiol ring, remove the ring and resume treatment only after the infection has been properly treated.
This medication should not be used during pregnancy. If you become pregnant or suspect that you may be pregnant, promptly inform your doctor.
This medication passes into breast milk and may reduce the quantity and quality of breast milk produced. Prior to breastfeeding, consult your doctor for guidance.
Form and Strength
Estring is available in the following forms and strengths:
Estring vaginal ring:
How often should Estring be changed?
Estring should be removed and replaced every 90 days.
How long does it take for Estring to work?
You should start to feel relief from vaginal dryness and burning within 2 to 3 weeks after you start Estring.