Estring Vaginal Ring (Estradiol)

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Estring (Estradiol Vaginal Ring) – Canada Product Information

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What is Estring?

Estring is a small, flexible vaginal ring that contains 17β-estradiol, a form of estrogen hormone used to treat menopausal symptoms. It is specifically designed for women experiencing vaginal discomfort due to low estrogen levels after menopause. Common symptoms that Estring can help relieve include vaginal dryness, itching, irritation, painful intercourse, and urinary symptoms like urgency and discomfort. Estring releases a low dose of estrogen directly to the vaginal tissues, helping restore and maintain vaginal health.

How to Use Estring

Using Estring is simple and convenient. Insert the ring into your vagina as instructed by your healthcare provider. Estring should be placed as deeply as possible into the upper third of the vaginal vault. The exact position isn’t critical, but you should not feel discomfort. If you do, gently push the ring further inside. The ring remains in place for 90 days, continuously releasing estrogen to alleviate your symptoms. After 90 days, remove the ring by hooking your finger through it and gently pulling it out, then replace it with a new one if treatment continues. If Estring falls out, rinse it with lukewarm water and reinsert it. Always follow your healthcare provider’s guidance on how to insert, remove, and replace Estring.

Who Should Not Use Estring?

Estring is not suitable for everyone. Do not use Estring if you:

• Have or suspect you have breast cancer or other estrogen-dependent cancers.
• Have abnormal genital bleeding that has not been diagnosed by your doctor.
• Are pregnant, trying to become pregnant, or breastfeeding.
• Have a history of blood clots, stroke, heart disease, or liver problems.
• Have any allergies to estradiol or other components of the ring.

Always discuss your full medical history with your doctor before using Estring to ensure it is safe for you.

Possible Side Effects of Estring

As with all medications, Estring may cause some side effects. Common side effects include vaginal discomfort, irritation, or discharge. Some women may experience mild abdominal pain, nausea, or headache. In rare cases, the ring may adhere to the vaginal wall, making removal difficult. If you experience any severe pain, unusual or heavy vaginal bleeding, persistent discomfort, or signs of infection such as fever or severe irritation, contact your healthcare provider immediately.

Important Safety Information and Warnings

• Estring should be used under the supervision of a healthcare provider, who will assess your treatment periodically to ensure it remains the best option for you. Regular check-ups, including breast exams and mammograms, are recommended while using Estring.
• Do not use Estring for longer than recommended by your doctor. Continuous use of estrogen without a break could increase the risk of serious conditions like endometrial hyperplasia, which can lead to cancer.
• If you have any conditions that worsen with estrogen use, such as fibroids, endometriosis, or certain liver conditions, be sure to inform your doctor.

Frequently Asked Questions about Estring

1. Can I have sex with Estring in place?
   Yes, Estring is designed to stay in place during sexual intercourse. Most users and their partners do not feel the ring during sex. If the ring becomes displaced, you can reinsert it after rinsing with lukewarm water.

2. What should I do if Estring falls out?
   If Estring falls out during bowel movements or physical activities, rinse it with lukewarm water and reinsert it as soon as possible. If you cannot replace the ring, contact your healthcare provider for guidance.

3. How quickly will Estring work?
   It may take 2 to 3 weeks to feel the full effect of Estring. Many women notice significant improvement in vaginal and urinary symptoms during this time.

4. Can Estring affect my overall estrogen levels?
   Estring releases a low dose of estrogen directly to the vaginal tissues, resulting in minimal absorption into the bloodstream. This reduces the risk of systemic side effects often associated with oral or transdermal estrogen therapies.

Storage and Handling

Store Estring at room temperature, between 59°F and 86°F (15-30°C), and keep it out of the reach of children and pets. Do not use the ring past its expiration date. Dispose of used rings safely, and never flush them down the toilet.

When to Contact Your Doctor

Contact your healthcare provider if you experience any severe or persistent symptoms, such as unexplained vaginal bleeding, severe abdominal pain, or if you suspect that Estring is causing any unwanted effects. Regular medical check-ups are essential to ensure that the benefits of Estring outweigh any risks.

Conclusion

Estring offers an effective, low-dose estrogen treatment for women suffering from postmenopausal vaginal symptoms. By releasing estrogen directly to the affected tissues, Estring helps restore vaginal health with minimal systemic exposure. Always follow your healthcare provider’s instructions and attend regular check-ups to ensure that Estring continues to be the right choice for your needs. For more information or to discuss your treatment options, consult your healthcare provider today.

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Reference: Estring Canada product monograph

To use Estring, squeeze the ring into an oval shape and insert it deeply into the upper part of the vagina. It should remain in place for 90 days, continuously releasing estrogen. If Estring falls out, rinse it with lukewarm water and reinsert it. After 90 days, remove the ring by hooking a finger through it and pulling gently, then replace it with a new ring if needed.