Description:

Chemical Name: ESTRADIOL (es-tra-DYE-ol)

ESTRING is a female hormone usually given to women who no longer are able to produce the proper amount of female hormone called estrogen. It is a very effective treatment for reducing vaginal menopause symptoms (dryness, burning, itching ( and urinary symptoms (frequent urges to urinate, painful urination).

ESTRING should not be used to prevent heart disease or dementia.

Directions:

Generally, ESTRING is left in place for 90 days and then replaced with a new ring if therapy is continued. Do not leave a ring in place for longer than 90 days. Follow the dosing schedule carefully. Learn all usage instructions in the product package and ask your doctor or pharmacist if you are unclear about any of the information. When placed properly, you should not feel the ring and it will not interfere with sexual intercourse. If the ring moves into the lower part of your vagina, push it back into place with your finger. If the ring falls out of the vagina, rinse the ring with lukewarm water and re-insert.

To insert the ESTRING, follow these instructions:

1. Holding ESTRING between your thumb & index finger, press the sides together. Insert ESTRING while lying down, squatting, or standing with one leg up-whatever is most comfortable for you.
2. Gently push the folded ring into your vagina. The exact position of ESTRING is not important for it to be effective. If you feel discomfort, it is probably not inserted back far enough into the vagina. Use your finger to gently push the ESTRING farther into your vagina.
3. The ring is removed by hooking your finger through the ring and gently pulling it out. Contact your doctor if you have trouble removing the ring.
4. Discard the used ring in the trash. Do not flush it down the toilet.

Vaginal and urinary symptoms should improve within 2-3 weeks of starting this medication. If symptoms persist, contact your doctor.

Cautions:

It is recommended that ESTRING should not be taken if you have:

• a bleeding or blood-clotting disorder
• a history of stroke or circulation problems
• abnormal vaginal bleeding that a doctor has not checked
• any type of breast, uterine, or hormone-dependent cancer

Patients who intend to take ESTRING should be aware of important safety information before they start taking this medication.

• ESTRING used after menopause has caused rare but very serious side effects. Discuss the risks and benefits of hormone treatment and your personal health history with your doctor.
• Use of estrogens has been reported to increase the chance of cancer of the uterus (endometrial cancer).
• Estrogens may also increase your risk of cancer of the ovaries, stroke, dementia, and serious blood clots in the legs.
• ESTRING given in combination with progestin can infrequently cause heart disease (e.g., heart attacks), stroke, serious blood clots (pulmonary embolism and deep venous thrombosis), dementia, and cancer of the breast.

Before taking ESTRING, patients should inform their doctor if they have any of the following conditions to ensure they can safely use this medication.

• high blood pressure, angina, or heart disease
• high cholesterol or triglycerides
• liver disease
• kidney disease
• asthma
• epilepsy or other seizure disorder
• migraines
• diabetes
• depression
• gallbladder disease
• if you have had your uterus removed (hysterectomy)

Side Effects:

Most medications can cause side effects which can be defined as an unwanted response to a medication when it is taken in normal doses. Side effects can range from mild or severe, temporary or permanent. Side effects are not experienced all patients who take this medication. Many side effects can be managed, and others may go away over time.

Common side effects may include vaginal irritation, dizziness, lightheadedness, stomach upset, bloating, nausea, weight changes, increased or decreased interest in sex and breast tenderness.

Serious side effects may include chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill feeling; sudden numbness or weakness, especially on one side of the body; sudden headache, confusion, problems with vision, speech, or balance; pain, swelling, warmth, or redness in one or both legs; abnormal vaginal bleeding; pain, swelling, or tenderness in your stomach; jaundice (yellowing of the skin or eyes); or a lump in your breast.

Get emergency medical attention if you have any signs of an allergic reaction (hives; difficulty breathing; swelling of your face, lips, tongue, or throat). Stop using ESTRING immediately and call your doctor at once if you experience any of the above noted serious side effects.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about additional side effects that you may experience.

Product Code: 1513