An off-white, soft flexible ring, the estradiol vaginal ring contains two mg of estradiol (a form of estrogen) at its center.

The hormone estradiol is a female sex hormone that is necessary for a number of bodily processes. And some of those processes include helping the vagina rebuild its walls more effectively.

Unfortunately, when menopause occurs, some women’s bodies can’t rebuild vaginal walls as effectively. When that happens, women can end up experiencing some unwanted side effects from menopause. These side effects are usually in or around the vaginal area. They can include dryness, burning, and itching around the vaginal area. Other side effects might be urgency or irritation with urination and pain during sexual intercourse.

So, to help you avoid some of the moderate or severe side effects, your doctor may offer you a prescription for an estradiol vaginal ring.

The estradiol vaginal ring should treat any of the previously mentioned side effects. But before you turn to use this medication, make sure you talk to your doctor thoroughly about any past and current conditions of yours.

You should not use the estradiol vaginal ring if you are currently dealing with the following: pregnancy, undiagnosed vaginal bleeding, liver disease, a bleeding disorder, or a planned major surgery.

Other conditions you may have had previously might also make you ineligible for an estradiol vaginal ring. These conditions include heart attacks, strokes, blood clots, and cancer of the breast, uterus/cervix, or vagina. Additionally, they may also include heart disease, liver problems, kidney disease, gallbladder disease, asthma, epilepsy, migraines, lupus, endometriosis, hereditary angioedema, porphyria, a thyroid disorder, or high or low levels of calcium in your blood.

To improve your chances of eliminating unwanted menopause side effects with the estradiol vaginal ring, follow the directions that your doctor and prescription label provide.

The directions will likely note that you should maintain proper hygiene when handling the estradiol vaginal ring. So wash your hands before and after inserting the ring.

To apply the estradiol vaginal ring, first, squeeze its sides together and insert it into the vagina for as far as it can go. The ring should go at least into the upper third area of the vagina. Once it’s in this area, you shouldn’t be able to feel the ring. But if you can, just use a finger to push the ring further into the vagina.

If you have concerns about this placement, do not worry. It is not possible for the estradiol vaginal ring to go too far or to become lost.

Once the ring is in place, leave it there for 90 days. If the ring falls out any time during those days, just rinse it with warm water and soap and reinsert it. If it only slides down a bit, just use a finger to push it back into place.

Please note that while you’re using the estradiol vaginal ring, you do not need to remove it for sexual intercourse. In fact, neither you nor your partner should feel the ring during sexual intercourse.

When those 90 days are up, be sure to remove the estradiol vaginal ring and replace it with a new one if you have been prescribed with a new one from your doctor.

To remove the ring, hook your finger around it and gently pull the ring from the vagina.

Throughout your treatment, your doctor should typically be checking your progress regularly. That way, your doctor can best determine if you should continue your treatment.

You should also make sure you self-examine your breasts for lumps on a monthly basis. And if possible, get a yearly mammogram for as long as you are on the estradiol vaginal ring treatment.

While using the estradiol vaginal ring, there are a few things you should avoid.

First, try to avoid smoking entirely. Smoking while using the estradiol vaginal ring can significantly increase your risk for several health concerns, including blood clots, strokes, and heart attacks.

Second, avoid consuming grapefruits, grapefruit juice, and grapefruit-related products. Having anything grapefruit-related could interact poorly with the medication from your estradiol vaginal ring. And if that does happen, you may encounter unwanted side effects.

Lastly, unless your doctor advises otherwise, avoid using other vaginal products. Chances are that they might interact poorly with the estradiol vaginal ring.

As you continue your treatment with the estradiol vaginal ring, you may encounter a number of unwanted side effects.

Common ones include nausea, vomiting, bloating, stomach cramps, headaches, hand swelling, foot swelling, weight gain, breast pain, vaginal itching, vaginal discharge, changes in menstruation, and breakthrough bleeding.

Conversely, you may experience less common, but more severe side effects. These can include heart attack symptoms, signs of a stroke, signs of a blood clot, stomach swelling, stomach tenderness, jaundice, memory problems, confusion, odd behavior, unusual vaginal bleeding, pelvic pain, a lump in the breast, or high levels of calcium in the blood. If you experience any of these symptoms, call your doctor as soon as possible. They could be a sign of a medical issue that needs urgent attention.

Other side effects could need faster attention. If you experience the following, remove the estradiol vaginal ring right away and seek emergency medical attention: fever with nausea, diarrhea, muscle pain, dizziness, fainting, or a sunburn-like skin rash.

Do the same if you notice that you’re having an allergic reaction to the estradiol vaginal ring. An allergic reaction will usually involve hives, difficulty breathing, and facial swelling.

What should I do if my Estring ring comes out?

If your Estring ring comes out at any time, you should rinse it with warm water before reinserting it as high as possible for the remaining time?

Can I have sex while using an Estring ring?

Yes, you do not need to remove Estring in order to have sexual intercourse and neither partner should be able to feel it. If it does become bothersome, you may remove the ring and reinsert it after intercourse. If you do remove Estring, wash it with warm water before reinserting.