This medication should not be used during pregnancy. If you become pregnant or think you may be pregnant, tell your doctor right away. The urinary excretion of total estradiol in the 24-hour urine, 4 and 12 weeks post-application of estradiol vaginal ring in a Phase 1 study was 7.23 ± 4.82 nmoles and 8.20 ± 5.45 nmoles, respectively. Removal of ESTRING vaginal delivery system should be considered when using other vaginal preparations (see section 4.4). you may need emergency contraception if you've had sex in the days before changing the rings over – see a GP or nurse for advice Some women have temporary side effects, including more vaginal discharge, breast tenderness and headaches.

The WHIMS ancillary study enrolled 4,532 predominantly healthy postmeno Therapy should be discontinued in case a contra-indication is discovered and in the following situations: For women in their 50s who have been taking oestrogen-only HRT , for over 5 years, there will be 5 to 8 cases in 1000 users (i.e. 1 extra case). if you develop yellowing of your skin or the whites of your eyes (jaundice). These may be signs of a If you're under 16 and want contraception, the doctor, nurse or pharmacist won't tell your parents (or carer) as long as they believe you fully understand the information you're given, and the decisions you're making.The relationship between pre-existing hypertriglyceridaemia and low dose local vaginal oestrogen therapy is unknown. Postmarketing reports: Palpitations, ventricular extrasystoles, chest discomfort, increased heart rate [ Ref] Oncologic

Additionally, you are advised to join mammography screening programs when offered to you. Ovarian cancer

Getting Familiar

if you were not planning to have a ring-free break, take out the ring and insert a new ring straight away Estradiol is mainly metabolized in the liver. Its main metabolites are estriol, estrone, and their conjugates. The plasma half life of estradiol is 1-2 hours. Metabolic plasma clearance varies between 450-625 ml/min/m 2. The metabolites are mainly excreted via the kidneys as glucuronides and sulfates. Oestrogens also undergo enterohepatic circulation. The vaginal delivery of oestrogens avoids first-pass metabolism and there is limited systemic absorption.

Taking oestrogen-only HRT tablets for a long time can increase the risk of developing cancer of the womb lining (the endometrium). 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:It is uncertain whether there is a similar risk with Estring which is used for repeated or long term (more than one year) treatments. However, Estring has been shown to have very low absorption into the blood, therefore the addition of a progestagen is not necessary. Note: Estring is not a contraceptive. If it is less than 12 months since your last menstrual period or you are under 50 years old, you may still need to use additional contraception to prevent pregnancy. Speak to your doctor for advice. tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue,

Wash and dry your hands before handling the ring. Insert the ring high into the vagina as directed. The ring is usually left in place for 90 days and then removed and replaced with a new ring if treatment is to be continued. Do not leave a ring in place for longer than 90 days. Follow the dosing schedule carefully. You may report side effects to the FDA at 1-800-332-1088. You may also report side effects at https://www.fda.gov/medwatch. If you have a short narrow vagina from previous surgery or the effect of a condition called vaginal atrophy Frequency not reported: Increase or decrease in weight, reduced carbohydrate tolerance, aggravation of porphyria, hypocalcemia, increased triglycerides Aromatase inhibitors like aminoglutethimide, anastrozole, exemestane, letrozole, testolactone, vorozoleif you experience a large rise in your blood pressure (symptoms may be headache, tiredness, dizziness); Signs of liver problems like dark urine, feeling tired, not hungry, upset stomach or stomach pain, light-colored stools, throwing up, or