Estring Vaginal Ring (Estradiol)

Estring (Estradiol Vaginal Ring) Medication Information

Uses

Estring (estradiol vaginal ring) is a vaginal ring prescribed after menopause to treat moderate to severe vaginal atrophy.  Estring is a ring that is inserted into the vagina and stays in place for 90 days.  Estring contains estradiol, a form of estrogen.

What is Vaginal Atrophy?

When a woman’s body has less estrogen after menopause, the walls of the vagina may become thin, dry, and inflamed.  Vaginal atrophy can make sexual intercourse painful and also leads to urinary discomforts.

Dosage

Estring vaginal ring contains 2 mg of estradiol (a form of estrogen), which gradually releases over 90 days.  

Precautions

Estring contains a form of estrogen, which may have serious health risks.

Estring may not be safe for women with the following medical history or conditions:

• Unusual vaginal bleeding
• Stroke or heart attack
• Cancer
• Blood clots
• Liver problems
• Bleeding problems
• Previous allergic reaction to Estring or any of its ingredients
• Pregnancy or breastfeeding

Side Effects

Estring, like all estrogen-replacement medications, has the potential for common, mild side effects but also could cause rare, serious side effects.

Common, but usually mild side effects may include:

• Increased vaginal moisture
• Headache
• Breast pain
• Vaginal bleeding or spotting
• Stomach pain or bloating
• Nausea and vomiting
• Vaginal yeast infection

Rare, serious side effects may include:

• Heart attack
• Stroke
• Blood clots
• Dementia
• Breast, uterine, or ovarian cancer
• High blood pressure
• High blood sugar
• Gallbladder or liver problems 
• Thyroid hormone changes
• Uterus fibroids 

For more side effect information, talk with your doctor or pharmacist. 

Interactions

Some drug interactions can happen with Estring which can increase the risk of side effects. A few examples include:

• Clarithromycin
• Ketoconazole
• Ritonavir

Grapefruit and grapefruit juice can also increase the risk of side effects with Estring and should be avoided.

Talk with your doctor or pharmacist before taking any other medications or herbal supplements with Estring.

Storage

Store Estring at room temperature between 68°F and 77°F (20°C and 25°C). 

Pharmacists Tips

• The most common side effect of Estring is increased vaginal secretions (moisture). This vaginal moisture is similar to what naturally occurs before menopause, and it’s a sign that Estring is working.
• Estring is not safe for life-long use after menopause.  Talk with your healthcare provider every 3 to 6 months to discuss if it is safe for you to continue using Estring.  

Estring FAQs

How long does it take for Estring to work?

It typically takes 2 to 3 weeks for Estring to relieve your symptoms. If your symptoms don’t improve within a few weeks, talk with your healthcare provider. 

Will my partner feel Estring during sex?

You and your partner will probably not notice Estring during intercourse.  If you do, and it causes you or your partner any discomfort, you can remove Estring before sex.  Make sure to reinsert Estring as soon as possible.  Instructions to insert, remove, or reinsert the ring are included with Estring’s packaging.

What should I do if Estring falls out?

It is rare but possible for Estring to fall out.  If this occurs, rinse Estring with warm (not hot) water and reinsert it.  Instructions to insert, remove, or reinsert the ring are included with Estring’s packaging.

Related Products

• Climara
• Combipatch
• Divigel
• Premarin Vaginal Cream
• Premarin
• Prempro
• Vagifem
• Vivelle-Dot

References

1. ESTRING Prescribing Information.  New York, NY: Pfizer; 2017. http://labeling.pfizer.com/ShowLabeling.aspx?id=567 Accessed November 14, 2020.
2. Bleibel B, Nguyen H. Vaginal Atrophy. Treasure Island, FL: StatPearls Publishing; 2020. https://www.ncbi.nlm.nih.gov/books/NBK559297/ Accessed November 14, 2020.