Estring

About Estring

Estring is classed as a hormone replacement therapy (HRT). It contains estradiol, which acts in the same way as the female sex hormone oestrogen and is used to treat the symptoms of menopause. It is used in postmenopausal women to treat vulvar and vaginal atrophy due to menopause. This includes vaginal dryness, soreness, itching, pain during sexual intercourse and thrush or urinary tract infections.

If levels of oestrogen only are increased during HRT treatment, the endometrium would grow excessively, causing an increased risk of endometrial cancer. If you have not had a hysterectomy you will be prescribed a progestogen with Estring.

NowPatient offers Estring as a treatment for HRT only, following an online consultation with a prescribing clinician.

Key facts of Estring

• Estring has some common side effects which include nausea and headaches
• Estring will not prevent pregnancy in otherwise fertile women
• Do not use a hormonal contraceptive when treated with a HRT
• It can be dangerous if you use Estring with certain medications. If you’re not sure if it is safe, discuss this with the prescribing clinician

Who is Estring not suitable for?

Estring may not be suitable for some people. To make sure it’s safe for you, speak to the prescribing clinician before using Estring if you:

• Have hypersensitivity to the active ingredients estradiol
• Have ever had breast cancer
• Have cancer sensitive to oestrogen
• Have untreated endometrial hyperplasia (an excessively thick womb lining)
• Suffer from a blood clots
• Suffer from porphyria
• Have had a heart attack, angina, stroke, high blood pressure, or angioedema
• Have unusual vaginal bleeding
• Have liver disease or any other liver problems
• Are pregnant or breastfeeding
• Have fibroids
• Have uterine problems such as endometriosis or endometrial hyperplasia
• Have diabetes
• Suffer from migraines
• Have gallbladder disease
• Have asthma
• Have epilepsy
• Have fluid retention
• Have high cholesterol levels in the blood
• Are obese
• Have a hereditary ear disorder

How and where to get Estring?

You can buy Estring safely and securely from NowPatient. You can start a consultation today for free and if you qualify for treatment, you only pay for the cost of the medication. Delivery is made to your home or office from our registered pharmacy.

Our service is certified, safe and effective, and we only ever treat conditions. If you book a consultation with a prescribing clinician for the treatment of HRT, you can discuss if Estring is a suitable treatment option for you.

At the end of the consultation, the clinician will decide if a treatment plan is suitable for you. If it is, the clinician will issue you with a prescription which can then be ordered, paid for and delivered directly to your chosen address by NowPatient.

Dosage and strength for Estring for HRT

The Estring vaginal ring contains 2mg of the estrogen hormone estradiol as the active ingredient.

Information about how to use Estring for HRT

Estring is a soft flexible ring, placed in the upper 3rd of the vagina. It releases estradiol into the vagina for 90 days. Estring should be removed after 90 days, but replaced with a new ring if therapy is to be continued. Read the patient information leaflet provided or speak to a healthcare professional for further information.

What happens if you use too much Estring?

If you use more than prescribed, then it can lead to some unpleasant side effects. You should talk to your doctor or reach out to one of our prescribing clinicians, if you have used too much Estring and you experience any of the following side effects:

What are the side effects of Estring?

Side effects of Estring are split into common and serious.

Common adverse events include:

• Nausea
• Headache, dizziness
• Breast tenderness, breast pain
• Change in sex drive
• Anxiety, insomnia
• Stomach pain, indigestion, flatulence, diarrhoea
• Irregular bleeding
• Acne, skin irritation, rash
• Vaginal discharge
• Fluid retention, weight gain, bloating

Serious side effects include:

• Blood clots (deep vein thrombosis, pulmonary embolism)
• Stroke
• Heart disease – chest pain passing into the neck or arm
• Liver disease – jaundice (yellowing of the skin or eyes), abdominal pain

If you experience any serious side effects, you should contact NHS 111.

If you experience a serious allergic reaction with the signs shown below you should contact emergency services on 999.

• Your lips, mouth, throat or tongue suddenly become swollen
• You’re breathing very fast or struggling to breathe (you may become very wheezy or feel like you’re choking or gasping for air)
• Your throat feels tight or you’re struggling to swallow
• Your skin, tongue or lips turn blue, grey or pale (if you have black or brown skin, this may be easier to see on the palms of your hands or soles of your feet)
• You suddenly become very confused, drowsy or dizzy
• Someone faints and cannot be woken up

Always report adverse effects to the MHRA yellow card reporting system. You can read more about this here How and where do I report side effects of my medication? – NowPatient

Information about using Estring at the same time as other medications or herbal supplements

There is not enough evidence to suggest there are any drug interactions between herbal supplements and Estring. In any event, you should let your prescribing clinician know if you are taking any herbal supplements or other prescription drugs, such as:

• Phenytoin or carbamazepine
• Rifampicin
• Ritonavir or nelfinavir
• Warfarin
• St John’s Wort

Can Estring used for HRT be used long-term?

HRT should only be used as a short-term treatment for the menopause. Women who use HRT for more than 5 years may be at an increased risk of ovarian cancer. Speak to your GP to review your treatment at least once each year and have regular checkups.

Is there a herbal Estring?

No. Herbal Estring does not exist. If you have been marketed such a formulation, it may be fake.

Should I avoid any particular food or drink when using Estring?

You can eat and drink normally when using Estring.

What lifestyle changes can I make to help me with HRT?

You modify your lifestyle in a number of ways, and this may have a positive impact on your symptoms:

• Using a fan
• Cool showers
• Light clothing
• Lubricants
• Healthy diet
• Regular exercise
• Quit smoking
• Alternatives to Estring

Alternative HRT treatments include Estraderm, Evorel, Vagifem, and Vagirux

Sources

• Menopause – NHS
• labeling.pfizer