The Estring Ring provides sustained release of estradiol hemihydrate over a three-month period, delivering relief from the symptoms of menopause. The ring is inserted into the vagina and left in place, providing continuous dosing and eliminating the need for daily pill taking. Estring Ring is a convenient, discreet, and easy-to-use vaginal delivery system that helps to reduce hot flashes, night sweats, vaginal dryness, and other symptoms associated with menopause.
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 Ring – Estradiol Vaginal Ring, the 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
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How to use ESTRING
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.
Product Information
What you need to know before you use ESTRING
Medical check-up
ESTRING may not be suitable for all women. Before you start using ESTRING, your doctor
should ask about your own and your family’s medical history. Your doctor may decide to
examine your breasts and/or your abdomen, and may do an internal examination – but only if
these examinations are necessary for you, or if you have any special concerns.
Once you’ve started on HRT, it is recommended that you see your doctor for regular checkups (at least once a year). At these check-ups, your doctor may discuss with you the benefits
and risks of continuing to take HRT.
Be sure to:
• go for regular breast screening and cervical smear tests
Page 2 of 10
• regularly check your breasts for any changes such as dimpling of the skin, changes
in the nipple, or any lumps you can see or feel
Do not use ESTRING if you have the following conditions:
• you are allergic to estradiol or similar medicines for hormone replacement therapy, or
any of the other ingredients of this medicine (listed in section 6)
• hereditary blood disorder (porphyria)
• cancer that is sensitive to oestrogen e.g. endometrial cancer (cancer of the womb) or
if you are suspected of having it
• previous or current history of an ‘embolus’ (blood clots that travel through the
bloodstream and block blood vessels in the leg or elsewhere, also called ‘deep vein
thrombosis’ (DVT))
• you have or have ever had breast cancer, or if you are suspected of having it
• vaginal bleeding which you have not made your doctor aware of
• previous or current liver disease where liver function tests are still abnormal
• overgrown lining of your womb (untreated endometrial hyperplasia)
• previous or a present case of blocked arteries that could cause cardiovascular diseases
like angina or a heart attack
• blood clotting disorder (thrombophilic disorder such as protein C, protein S or antithrombin deficiency).
Like all medicines, this medicine can cause side effects, although not everybody gets them.
The following diseases are reported more often in women using HRT medicines which
circulate in the blood compared to women not using HRT. These risks apply less to vaginally
administered treatments such as ESTRING:
• ovarian cancer;
• blood clots in the veins of the legs or lungs (venous thromboembolism);
• stroke;
• probable memory loss if HRT is started over the age of 65;
For more information about these side effects, see section 2.
If you develop any of the conditions listed under ‘Do not use ESTRING’ if you have the
following conditions’ or those listed under “ Stop taking ESTRING and see a doctor
immediately” or if you 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. This
occurs uncommonly (may affect up to 1 in 100 people using ESTRING)
Page 8 of 10
• persistent or severe vaginal discomfort, ulceration or swelling after the ring has been
inserted.
This occurs rarely (may affect up to 1 in 1000 people using ESTRING
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.
Common side effects may affect 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.
The active substance in ESTRING is estradiol hemihydrate 2 mg, corresponding to 1.94 mg
estradiol.
The other ingredients are silicone fluid, barium sulfate, silicone elastomer Q7-4735A, silicone
elastomer Q7-4735B.
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