Estring and/or Equivalent Estradiol Vaginal Ring Prescription Information
Estring is a soft and flexible vaginal ring which contains the Active Ingredient Estradiol. This opaque ring, made with a combination of silicone polymers and barium sulfate, contains 2 mg of Estrogen in its white drug reservoir. Estring gradually releases estradiol at a rate of 7.5 mcg per 24 hours over a 90-day period. Its outer diameter is 55 mm, cross-sectional diameter is 9 mm and core diameter is 2 mm. Estring is inserted in the upper third of the vaginal chamber and is effective for 90 days.
Estring contains Estradiol which is used as hormone replacement therapy in the treatment of Vaginal and Urinary Menopausal Symptoms. More specifically, it is indicated for the treatment of moderate to severe urogenital symptoms which may occur due to postmenopausal atrophy. These symptoms are as follows:
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Generic Drug for Estring: Estradiol Vaginal Ring
Vaginal dryness, burning, irritation, pruritus, itching, and dyspareunia,
Lower urinary tract symptoms like urinary urgency, painful urination, and dysuria.
Dose, Administration and Dosage forms:
Estring is a ring-shaped medical device intended to be inserted in the vagina. It is available in 2 mg strength which is released as 7.5 mcg of estradiol in 24 hours over a 90-day period. Estring can be easily inserted or removed with or without the help of a physician. It should be stored at temperatures between 15 to 30o C (59-86o F) and kept away from sunlight and moisture.
Mechanism of action:
The active ingredient of Estring is estradiol, which is the main estrogen hormone produced during the pre-menopausal period in women. Estradiol is more potent than its metabolites, estrone and estriol. After menopause, most endogenous estrogen is obtained from the conversion of androstenedione to estrone by peripheral tissues. Therefore, estrone is the circulating estrogen in most post-menopausal women.
Estrogen effects its benefits by binding to nuclear receptors and by suppressing the increased Follicle Stimulating Hormone (FSH), luteinizing hormone (LH), and gonadotropin levels. This is accomplished by negative feedback mechanisms in post-menopausal women.
Side-effects and safety profile:
A number of side-effects with varying frequencies have been reported during clinical trials of Estring. The most commonly observed side-effects include vaginal discomfort, excessive vaginal discharge, stomach upset, bloating, nausea, light-headedness, weight alteration, altered sexual interest, and occasional breast tenderness. Patients should consult with a gynecologist if experiencing any persisting side-effects.
Serious side-effects reported with Estring include: mood changes, memory issues, vision loss, swelling of the hands or feet, breast lumps, abnormal vaginal bleeding, excessive itching, discharge with bad odor, severe headaches, pelvic pain, yellowing of the eyes or skin, chest pain, problems breathing, weakness on one side of the body, slurred speech and fetal bacterial infections. Patients should consult with a physician immediately if experiencing any of the above serious side-effects.
Although allergic reactions to Estring are rare, immediate medical attention should be sought at the first sign of severe rash, itching, or swelling of the face, throat or tongue.
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