The drug Estring (or estradiol) helps older women relieve the symptoms of menopause. It comes in the form of a soft, flexible vaginal ring to be placed in the vaginal cavity, where it keeps releasing an estrogen hormone called estradiol). Users can insert it by themselves or ask a doctor to insert Estring.

It stays there for 90 days and helps with these symptoms:

  • Hot flashes
  • Urination issues
  • Vaginal dryness
  • Painful intercourse
  • Burning sensation in genitals

Precautions and Warnings with Estring

Taking too much estrogen or estradiol can increase the risk of developing different kinds of cancer, e.g., breast cancer or ovarian cancer.

These are the most important precautions for Estring users:

  • Avoid this medicine if you are pregnant.
  • Don’t smoke when you are using Estring.
  • Remove this ring if you get a vaginal infection.
  • Your vision can worsen after using this vaginal ring.
  • Avoid spending too much time in the sun if you use Estring.

Estring Side Effects

Some common, serious, and advanced side effects of Estring are:

Common Side Effects

  • Tender breasts
  • Abdominal pain
  • Vomiting (or nausea)
  • Headaches (or dizziness)
  • Vaginal discomfort

Serious Side Effects

  • Lumps on your breasts
  • Genital itching
  • Abdominal swelling
  • Pressure buildup in the vagina
  • Yellowing of skin/eyes
  • Thick vaginal discharge
  • Redness on genitals
  • Mental health problems (e.g., depression)

Advanced Side Effects

If you show these symptoms, please contact your doctor. Some women using Estring have reported Toxic Shock Syndrome (TSS). This disease stems from bacterial infection and is very rare. The symptoms of TSS include:

  • Chills
  • Headaches
  • Exhaustion
  • High Fever (over 102°F)
  • Rash that covers most of your body

Drug Interactions with Estring

Estring affects how your body processes other drugs. Also, different drugs may change the way your body uses Estring. For this reason, you should tell your caregiver which drugs you are on before getting an estradiol recommendation.

It would help if you did not mix grapefruit juice with Estring as well because grapefruits may disturb how much estradiol your body will absorb.

In general, Estring is known to interact with these medicines:

Cost of Estring in America

Estring can be a high-cost medication, especially for those without insurance coverage. The price of this vaginal ring ranges from $567 to $727 for the supply of one ring. However, coupons and discounts can reduce the price of a single ring significantly.

Why is Estring so Expensive?

Estring is an expensive form of Hormone Replacement Therapy (HRT). Manufacturers invest a lot of money in testing the efficacy of estradiol products. Since the testing phase costs a lot, drug manufacturers can legally sell this drug exclusively for the next twenty years. Then, other brands can develop and sell generic versions.

However, if you’re paying for Estring or other estradiol products out of pocket, you may turn to services like MyRx Outlet, where Estring is available at a considerably lower price than the average pharmacy.

Strengths and Dosages of Estring

This vaginal ring contains 2mg of estradiol that is released into the vaginal cavity and absorbed via your bloodstream for the next three months. It is only used for vaginal placement; swallowing the ring leads to medical complications.

Overdosing on estrogen can lead to tender breasts, drowsiness, pain in your abdomen, urine discoloration, and other side effects.

Estring comes as a slightly opaque ring with a whitish center. Users place it inside the vagina (preferably in the upper third section) for 90 days. Its dimensions are:

  • Core diameter: 2mm
  • Outer diameter: 55mm
  • Cross-sectional diameter: 9mm

Estring Alternatives

Estring is available primarily as a name-brand drug. However, you can also buy estrogen options other than this particular vaginal ring if they cost less than the branded version.

Some doctor-approved Estring (estradiol) alternatives are:

  • Femring (estradiol)
  • Imvexxy (estradiol)
  • Vagifem (estradiol)
  • Premarin (conjugated estrogen)
  • Estrace Vaginal Cream (estradiol)

Estring FAQs

What is Estring?

Estring is an estrogen which comes as a soft, flexible vaginal ring. It relieves the symptoms of menopause in women by continuously releasing estrogen as a part of hormone therapy. There is around 2mg of estradiol in the center of this ring.

What is Estring made of?

Estring contains estrogen and is used in estrogen therapy. Estradiol, silicone polymers, barium sulfate, and other ingredients contribute to the chemical makeup of this vaginal ring.

What is Estring’s tier level?

Pharmacists put Estring on Tier 4 based on their formulary. Tier 4 medicines are some of the costliest drugs available in the market.

How do I insert Estring?

You’ll take Estring out of the packaging. Then, you’ll use your thumb and forefinger to gently squish its two sides together so the ring’s center disappears momentarily. Then you’ll need to push the ring as far up your vagina as possible.

If you don’t want to insert it yourself, then you may ask your primary caregiver or healthcare provider to do it.

What happens if I insert Estring the wrong way?

There’s no wrong way to insert Estring. So, don’t panic if you have inserted it deep into the vagina because the cervix will prevent it from going any further. Even if Estring gets lost inside the vagina, there’s no reason to panic.

Can I remove Estring for the time being?

Yes, you can remove Estring if you and your partner want to have intercourse, but they’re not comfortable with the ring. In this case, you may remove the ring for a while and then reinsert it immediately after the intercourse is over.

How long is it safe to use Estring?

Estring stays effective for 3 months (90 days). You should remove the ring after 90 days and use a new one.

When should I stop using Estring?

You should stop using Estring or similar product/s if you have:

  • Blood clots
  • Vaginal bleeding
  • Liver problems or other conditions
  • Stroke, heart attack, or other ailments
  • You should also stop using Estring if you think you’re pregnant.

How should I remove Estring?

If you are having trouble taking it out, then contact your healthcare provider.

The manufacturer Pfizer recommends removing Estring after 3 months. This is how you will remove this ring (before replacing it with a new one):

  1. Wash your hands and dry them thoroughly
  2. Sit, stand, squat, or lie down in a comfortable position
  3. Loop your finger through the ring to pull it out
  4. Throw Estring safely, and please don’t flush it

How long does it take for Estring to work?

Estring starts showing its effects in 2 to 3 weeks. That’s because 14 to 21 days are necessary for the ring to your damaged vaginal tissues and to restore the condition of your urinary tract. If you do not find relief from your symptoms after 3 weeks, then contact your doctor right away.

What is the difference between Femring and Estring?

TypeHormone therapy taken vaginallyVaginal estrogen therapy
DoseHigher dosesLower doses
Duration3 months (90 days)3 months (90 days)
InsertionDeep inside the vaginaAnywhere inside the vagina (upper third recommended)
RemovalLeft in place for 3 monthsMay be removed temporarily for sexual intercourse
AbsorptionSystemic absorption (via your bloodstream)Local absorption (via your bloodstream)
Side EffectsHair loss, joint pain, acne, etc.Yellowing of skin/eyes, dementia, polydipsia, etc.
ConvenienceIt’s better if a doctor inserts itThe user can insert it herself
Breast Cancer PatientsNot recommendedRecommended


IMPORTANT NOTE: The information provided here is for educational purposes only and is not intended to serve as medical advice, diagnosis, or treatment recommendations. It should not be taken as an endorsement of any specific medication or treatment. Individual health conditions and responses to treatment can vary greatly; therefore, this information should not be seen as a guarantee of safety, suitability, or effectiveness for any particular individual. Always consult with a healthcare professional for personalized medical advice and before making any decisions regarding your health or treatment plans.

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