Estring Vaginal Ring
(Estradiol)

Prescription Settings Edit

Brand Name Choices

Estring 2mg (0.0075mg/24Hr)
Estring 2mg (0.0075mg/24Hr) Extended Release Vaginal Insert

Manufactured by Pfizer Canada Inc

Product of Canada

Dispensed by an approved Canadian pharmacy partner

Prescription Required

Generic Choices

No generic medication is available for Estring Vaginal Ring (Estradiol)

What Estring Vaginal Ring is and what it is used for

Estring vaginal delivery system is a vaginal ring which contains the active ingredient estradiol hemihydrate, which is a naturally occurring form of the main female sex hormone, oestrogen. Women’s ovaries gradually produce less oestrogen as they approach menopausal age (also referred to as “the change”). Low levels of oestrogen can cause symptoms such as vaginal dryness, inflammation or itching, and this in turn can lead to sore or painful sexual intercourse, and an increased susceptibility to vaginal or urinary infections. Estring vaginal delivery system is part of hormone replacement therapy (HRT) that acts locally in the vagina to maintain the adequate levels of oestrogen to relieve these symptoms in post menopausal women. It does not treat other symptoms of menopause such as hot flushes and sweats. Tell your doctor if you also have these problems.

How to take Estring Vaginal Ring

Always use this medicine exactly as your doctor has told you. Check with your doctor or pharmacist if you are not sure. Please follow the instructions below carefully. You should wash your hands thoroughly before inserting Estring vaginal delivery system. To insert Estring vaginal delivery system into your vagina
• Relax and find a position which feels comfortable for you.
• Either stand with one foot on a chair or lie on your back with your knees bent up.
• With one hand, open the folds of skin around the vagina.
• With the other hand, press the ring into an oval.
• Push the ring into your vagina as far as it will go
•upwards and backwards towards the small of the back.
• Finally, wash your hands. If the ring falls out, it should be rinsed in lukewarm (not hot) water and then reinserted. While using Estring vaginal delivery system You may be aware of the ring at first but this feeling should go away. The ring may take several weeks to have the full effect. As the ring begins to work you may notice an increase in vaginal lubrication (wetness), this is normal and should be the same as you experienced before the menopause. Most women and their partners have found it acceptable for the ring to stay in place during sexual intercourse. If you or your partner finds the ring uncomfortable or unacceptable it may be removed. The ring may move down in the vagina and become noticeable during straining to empty your bowels. If this happens the ring can be easily pushed back into position with your finger. If you know that you are constipated or need to strain to empty your bowels then you should remove the ring first. To take out Estring vaginal delivery system from your vagina
• Relax and find a position which feels comfortable for you.
• Either stand with one foot on a chair or lie on your back with your knees bent up.
• With one hand, open the folds of skin around the vagina.
• With the other hand, hook your finger around the ring.
• Pull the ring gently downwards and forward.
• Finally, wash your hands. How long you should use your ring for Each ring should be worn continuously for 3 months, and then replaced by a new ring, as appropriate. The maximum recommended duration of continuous therapy is two years. Your doctor will try to give you the lowest effective dose possible, and HRT should only be continued as long as the benefit in relief of severe symptoms outweighs the risk. Routine examinations whilst using Estring vaginal delivery system It is recommended that you have regular screening through the National Breast Cancer Screening Programme and National Cervical Cancer Screening Programme. Your doctor can provide details. You are also recommended to report any changes in your breasts to your doctor as soon as possible. If you stop using your ring Your symptoms may return after about 3 weeks. Use in children Estring vaginal delivery system is not recommended for use in children. If you have any further questions on the use of this medicine, ask your doctor or pharmacist.

Possible side effects

Like all medicines, this medicine can cause side effects, although not everybody gets them. If you develop any of the conditions listed under ‘Do not use Estring’ or have any of the following side–effects, remove Estring vaginal delivery system and see your doctor straight away. If you experience difficulty or pain when trying to remove the vaginal ring please do not continue and see your doctor:
• Symptoms of an allergic reaction. This may include skin rash, hives, itching.
• jaundice (yellowing of the skin and whites of the eyes)
• significant increase in blood pressure
• migraine-type headache
• if you become pregnant
• painful swelling of the leg
• sudden pain in the chest
• shortness of breath (dyspnoea)
• persistent or severe vaginal discomfort, ulceration or swelling after the ring has been inserted. There have been rare reports of the vaginal ring becoming attached to the vaginal wall, making ring removal difficult. Some women have needed surgery to remove the vaginal ring. If any of the following side effects gets serious, or if you notice any side effects not listed in this leaflet, tell your doctor:

Common side effects may effect up to 1 in 10 people using the Estring vaginal delivery system:
• Urinary tract infection
• Infection and itching inside and around the vagina
• Discomfort/pain in the stomach area (abdomen)
• Any persistent feeling of the ring in the vagina or pressing on the bladder/rectum (back passage)
• Pain on passing urine
• Generalised itching
• Increased sweating The symptoms mentioned above occur more frequently in untreated post-menopausal women.

Other side effects reported during treatment of patients with other forms of oestrogen therapy include:
• abdominal uterine bleeding such as breakthrough bleeding or spotting, changes in menstrual flow, vaginal inflammation and vaginal discharge
• a tendency to get thrush
• breast pain, breast tenderness, swollen breasts, discharge from the nipples
• feeling sick, a feeling of being bloated, abdominal pain
• headache or migraine
• dizziness
• changes in mood including anxiety and depression
• joint pain, leg cramps
• changes in your interest in sex (increased or decreased libido)
• visible swelling of the face or ankles
• rash, itchiness and dark or red patches on the skin
• changes in hair growth (loss or increase)
• difficulty wearing contact lenses
• changes in weight (increase or decrease)
• changes in your triglyceride levels (fatty substances in the blood)
• memory loss (dementia)
• gallbladder disease (e.g. gallstones)

Reporting of side effects If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme at: www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store. By reporting side effects you can help provide more information on the safety of this medicine.

How to Store Estring Vaginal Ring

Do not store above 25°C. Keep this medicine out of the sight and reach of children. Do not use this medicine after the expiry date which is stated on the carton and also on the foil pouch after EXP. The expiry date refers to the last day of that month. Do not use Estring vaginal delivery system if it is discoloured, misshapen, or does not have a smooth surface. Used rings still contain some of the active hormonal ingredient. The used ring should be placed within the original pouch or in a plastic bag, then sealed and discarded safely, out of the reach and sight of children. Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment

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