Estring dosage: A detailed guide

This article describes Estring’s dosage and strength and gives details on how to use it. You’ll also find information on cost savings and coupon options for Estring. If you want to know more about Estring, talk with your doctor or pharmacist.

Estring is a brand-name medication that comes as a vaginal system with the active drug estradiol. It isn’t available in a generic version. This article describes dosages of Estring.

Boxed warnings

Estring has boxed warnings about the risk of endometrial cancer, heart and blood vessel problems, dementia, and breast cancer. A boxed warning is the most serious warning from the Food and Drug Administration (FDA).

See the end of this article for more information about these warnings.

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Form and strength of Estring

Estring comes as follows:

• Form: estradiol vaginal system, which you’ll insert into your vagina
• Strength: 2 milligrams (mg) of estradiol

Dosage of Estring

This article describes the recommended dosage for Estring. The drugmaker provides these dosages.

If your doctor prescribes this medication, you should follow the dosage they prescribe. Your doctor will determine the dosage that best meets your needs. Do not change your dosage of Estring without your doctor’s recommendation.

Usual recommended dosage of Estring in adults

Estring is used to treat symptoms caused by vaginal and vulvar changes in menopause.

Estring comes as a vaginal system. It’s a soft, flexible ring that comes in one strength. The ring releases a consistent amount of estradiol into the body over 90 days.

• Dose: Estring comes as one 2-mg vaginal system, which delivers 7.5 micrograms (mcg) of estradiol per day.
• Frequency: Insert it one time and leave it in place for 90 days. After 90 days, remove and discard it. If recommended by your doctor, insert a new ring one time and leave it in place for 90 days.

Missed dose of Estring

Estring is inserted in the vagina one time and left in place continuously for 90 days. If the ring is expelled totally from the vagina, rinse it in lukewarm water and then reinsert it again.

Estring should be removed after 90 days. For tips on how to remember to remove your Estring dose, read this article. You could also try:

• downloading a reminder app on your phone
• setting an alarm
• putting a note where you’ll see it, such as on your calendar, bathroom mirror, or bedside table

Frequently asked questions

Below are answers to some commonly asked questions about Estring and its dosage.

Is Estring used long term?

No, doctors don’t typically prescribe Estring as a long-term treatment. Instead, it’s usually recommended for 90 days of treatment. In some cases, your doctor may recommend a longer length of treatment.

If you have questions about how long you should use Estring, talk with your doctor.

How does the dose of Estring compare with the dose of Vagifem or Femring?

Estring, Vagifem, and Femring are vaginal inserts approved for menopausal symptoms.

Estring and Femring are both vaginal rings that are inserted for 90 days. However, Femring contains more active drug. This means that more estradiol is released into your body with a single dose of Femring than Estring.

Usually, doctors prescribe Estring to treat menopausal vaginal symptoms, such as dryness. Femring is usually prescribed to treat menopausal symptoms such as hot flashes, night sweats, and vaginal symptoms.

Vagifem is a vaginal tablet inserted daily for 2 weeks, then twice weekly. For comparison, each Vagifem tablet contains 10 mcg of active drug, whereas Estring contains 2 mg of active drug and slowly releases about 7.5 mcg per day.

Talk with your doctor about how these drugs compare and which is right for you.

Is it difficult to remove Estring?

No, Estring is not difficult to remove.

Before removing the ring, wash and dry your hands. Find a comfortable position, such as standing with one leg raised, lying down, or squatting. Remove Estring by hooking a finger through the ring inside your vagina and pulling it out. Then, discard the ring into the trash.

If you have any difficulty removing your Estring, call your doctor right away.

For step-by-step instructions on how to insert and remove Estring, watch this video from the drugmaker or read the prescribing information.

How Estring is inserted

You’ll insert Estring into the upper one-third of your vagina one time and leave it in place for 90 days:

1. Wash and dry your hands.
2. Choose a comfortable position, such as standing with one leg raised, lying down, or squatting.
3. Remove Estring from the package.
4. Hold Estring between your thumb and index finger, pressing the opposite sides of the ring together to compress it into an oval.
5. Insert the compressed ring as far as you can into the upper one-third of your vagina.

The exact position is not critical. But you should not feel it once it’s in place. If you feel discomfort, it’s likely Estring is not inserted far enough. Gently push it farther into the vagina.

For step-by-step instructions on how to insert and remove Estring, watch this video from the drugmaker or see the prescribing information.

After 90 days, you’ll remove the ring by washing and drying your hands, then hooking the ring with your finger and pulling it out. Discard the ring into the trash. If your doctor recommends that you continue treatment, you’ll insert a new ring and leave it in place for another 90 days.

To prevent infection and other vaginal problems, you should not leave Estring in place for more than 90 days.

During treatment, if the ring comes totally out of the vagina, rinse it in lukewarm water and then reinsert it again. If it becomes dislodged, you can gently push it in place with your finger.

If it’s hard for you to insert the ring, talk with your doctor or pharmacist for detailed instructions.

Estring coupon

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Overdose of Estring

It’s important that you do not use more Estring than your doctor prescribes. Doing so can lead to harmful effects.

Symptoms of Estring overdose

Symptoms of an overdose can include:

• nausea
• vomiting
• abdominal pain
• breast tenderness
• drowsiness
• fatigue

What to do if you use too much Estring

If you think you’ve used too much Estring, call your doctor or pharmacist right away. Or you could call 800-222-1222 to speak with someone at America’s Poison Centers. You can also use its online resource. If you have severe symptoms, call 911 or a local emergency number immediately. You can also go to the closest emergency room.

What to ask your doctor

This article describes the usual recommended dosage for Estring. If your doctor prescribes this medication, they’ll determine the dosage that’s best for you.

Do not change your dosage of Estring without your doctor’s recommendation. You should take Estring exactly as your doctor prescribes it. Let your doctor know if you have concerns or questions about your treatment plan.

Here’s a list of some possible questions you may want to ask your doctor:

• What if my menopausal vaginal symptoms don’t improve with my dosage of Estring?
• Will the length of my treatment change if I have certain medical conditions?
• Is oral estradiol used for menopausal vaginal symptoms? If so, how do the dosages of Estring and oral forms compare?

Boxed warnings for Estring

This drug has boxed warnings about the risk of endometrial cancer, heart and blood vessel problems, dementia, and breast cancer. A boxed warning is the most serious warning from the Food and Drug Administration (FDA).

Females that have undergone menopause and use Estring may have an increased risk of the following:

Endometrial cancer: Endometrial cancer is a type of cancer of the uterus. Symptoms may include spotting or bleeding without a known cause. Reoccurring vaginal bleeding may also occur. Talk with your doctor if these symptoms appear during your treatment.

Heart and blood vessel problems: Heart and blood vessel problems may include events such as stroke, heart attack, and blood clots. Symptoms may include:

• chest pain
• pain that radiates into your arms, legs, jaw, or neck
• disorientation (unable to identify your surroundings or think clearly)
• dizziness, lightheadedness, or fainting
• tingling or numbness in your face, arms, or legs
• loss of coordination or balance
• warmth, swelling, or pain in the leg
• trouble breathing

Dementia: Females ages 65 years and older are at an increased risk of dementia. In clinical studies, dementia was diagnosed in some women 4 to 5 years after they started estrogen (the active drug in Estring) treatment. The risk of dementia in females younger than 65 years is unknown.

Symptoms of dementia include difficulty with:

• focus
• memory
• reasoning
• language and communication
• multitasking
• performing familiar tasks

Breast cancer: Symptoms of breast cancer may include breast swelling, nipple discharge, breast lump(s), and thickening of the skin of the breast or nipple. Discuss your health history with your doctor before you start Estring. Your doctor may recommend you perform a breast self-exam during your treatment to monitor for any breast changes.

You can talk with your doctor to learn more about these warnings.

Note: Sex and gender exist on spectrums. In this article, we use the term “female” to refer to a person’s sex assigned at birth.

Disclaimer: Optum Perks has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.