What is Estring?
Estring is a brand-name vaginal ring containing estradiol, a form of estrogen hormone therapy. It treats moderate to severe menopausal symptoms like hot flashes, night sweats, and vaginal dryness or irritation by releasing a steady dose of estradiol locally in the vagina.[1]
How to insert Estring
Wash and dry your hands. Choose a comfortable position, such as squatting, standing with one leg raised, or lying down with knees bent. Hold the ring between your thumb and index finger, with the printed side facing away from your body. Gently push the narrower end into your vagina as far as it will comfortably go, using your other hand to separate the labia if needed. The ring should sit high in the vagina, similar to a tampon. You may feel it initially but should not after a few minutes. Insertion typically takes practice; use lubricant if dry.[1][2]
How long to leave Estring in and when to replace it
Keep the ring in place for 90 days (3 months). Replace it with a new ring on the same day of the week it was inserted, after removing the old one. After three 90-day cycles (9 months total), discard and start a new set if continuing therapy. It can stay in during sex, bowel movements, or bathing, but partners may feel it—use lubricant or remove temporarily if uncomfortable.[1]
How to remove Estring
Wash hands first. Hook your index finger into the ring and gently pull it out. It may slide out easily after a few weeks. Dispose of it like other used sanitary products—do not flush.[1][2]
What if Estring falls out?
If it falls out within 1-2 days, rinse with warm water and reinsert. No backup contraception needed if on hormones. If out longer than 3 days, consult your doctor; symptoms may return, and effectiveness drops.[1]
Common side effects and precautions
Vaginal irritation, discharge, or itching occur in some users. Serious risks include blood clots, stroke, or breast cancer—discuss with your doctor if you smoke, have high blood pressure, or history of clots. Do not use if pregnant, breastfeeding, or with undiagnosed vaginal bleeding. Check positioning monthly by feeling for it.[1][2]
Who should avoid Estring?
Avoid if you have breast/endometrial cancer, liver disease, unexplained vaginal bleeding, or active blood clots. Use lowest dose for shortest time; progestin may be added if you have a uterus to prevent endometrial hyperplasia.[1]
[1]: FDA Label for Estring
[2]: Estring Official Site