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Estring
Estring is a vaginal ring that contains estradiol, a form of estrogen, used to treat vaginal atrophy and vaginal dryness associated with menopause. The ring delivers a low dose of estrogen directly to the vaginal tissues, helping to relieve symptoms such as dryness, itching, and painful intercourse.
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Frequently Asked Questions
How long can I use Estring?
Estring can be used for up to 90 days at a time. After 90 days, it should be removed and replaced if continued treatment is necessary.
Does Estring cause systemic side effects?
Because Estring delivers a low dose of estrogen directly to the vaginal tissues, the risk of systemic side effects is lower than with oral or transdermal estrogen therapies.
Can I use Estring for urinary symptoms?
Yes, Estring can help alleviate urinary symptoms related to vaginal atrophy, such as urinary urgency or burning.
What should I do if Estring falls out?
If Estring falls out, rinse it with lukewarm water and reinsert it as soon as possible.
Is Estring safe for long-term use?
Long-term use of Estring may be safe for some women, but regular check-ups with your healthcare provider are necessary to monitor for potential risks like cancer or blood clots.
Comprehensive Drug Guide
How Does Estring Work?
Estring works by releasing a low dose of estradiol into the vaginal tissues. This helps replenish local estrogen levels, reducing symptoms of vaginal atrophy such as dryness, burning, and discomfort during intercourse.
Common Dosages
- Estradiol 2 mg (released at approximately 7.5 mcg/day over 90 days)
Typical Dosing
- Estring is inserted into the vagina by the patient or healthcare provider and remains in place for up to 90 days, after which it should be replaced if continued treatment is necessary.
Typical Dosing
FDA Approved Indications
- Treatment of vaginal atrophy and vaginal dryness due to menopause.
Who Shouldn't Take Estring?
- Known hypersensitivity to estradiol.
- Breast cancer (except in select cases).
- Undiagnosed vaginal bleeding.
- Active or history of blood clots.
Advice From The Pharmacist
- Insert Estring into the vagina as directed by your healthcare provider. You should not feel discomfort once it is properly inserted.
- If Estring falls out, rinse it with lukewarm water and reinsert it.
- Do not use tampons while Estring is in place.
Side Effects of Estring
Common Side Effects
- Vaginal irritation
- Headache
- Breast tenderness
Uncommon/Severe Side Effects
- Blood clots
- Stroke
- Breast cancer
Risks and Warnings of Estring
- Blood Clot Risk: Like other forms of estrogen, Estring increases the risk of blood clots, stroke, and heart attack, especially in women who smoke or have cardiovascular conditions.
- Cancer Risk: Long-term use of Estring may increase the risk of breast cancer or endometrial cancer.
Interactions with Estring
Common Drug Interactions
- Anticonvulsants: Medications like phenytoin or carbamazepine may reduce the effectiveness of Estring.
- Grapefruit juice: May increase estradiol levels, leading to potential side effects.
Alternatives to Estring
- Premarin Vaginal Cream (conjugated estrogens)
- Vagifem (estradiol vaginal tablets)
- Femring (estradiol vaginal ring)
