Femring

Generic name: Estradiol acetate vaginal ring

What is Femring?

Femring is a vaginal ring that helps reduce moderate to severe menopausal symptoms such as hot flashes, night sweats, and vaginal dryness.

What is the most important information I should know about Femring?

Estrogens increase the chances of getting cancer of the uterus. You should report any unusual vaginal bleeding you experience while taking estrogens right away. Vaginal bleeding after menopause may be a warning sign of cancer of the uterus (womb).

Do not use estrogens with or without progestins to prevent heart disease, heart attacks, strokes, or dementia. Using estrogens with or without progestins may increase your changes of getting heart attacks, strokes, breast cancer, and blood clots. Using estrogens with or without progestins may also increase your risk of dementia.

Who should not take Femring?

Do not use Femring if you currently have or have ever had certain cancers, blood clots, or liver problems. Also, do not use Femring if you had a stroke or heart attack in the past year; have unusual vaginal bleeding; are allergic to Femring or any of its ingredients; or think you may be pregnant.

What should I tell my doctor before I take the first dose of Femring?

Tell your doctor about all prescription, over-the-counter, and herbal medication you are taking before beginning treatment with Femring. Also, talk to your doctor about your complete medical history, especially if you use tobacco, are breastfeeding, are going to have surgery or will be on bed rest, or if you are overweight. Make sure to tell your doctor if you have any of the following conditions: asthma, endometriosis, epilepsy, high blood pressure, high blood sugar, high calcium levels in your blood, high cholesterol, lupus, migraines, problems with your heart, liver, thyroid, or kidneys, seizures, or wheezing.

What is the usual dosage?

The information below is based on the dosage guidelines your doctor uses. Depending on your condition and medical history, your doctor may prescribe a different regimen. Do not change the dosage or stop taking your medication without your doctor's approval.

Adults: There are 2 doses of Femring available: 0.05 milligrams (mg) a day and 0.10 mg a day. Each ring should remain in the vagina for 3 months. You should be started at the lowest dose.

How should I take Femring?

Femring is inserted into your vagina by you or your healthcare provider. Femring should stay in your vagina for 3 months. After 3 months, the Femring should be removed and a new Femring should be inserted.

To insert Femring into your vagina, wash and dry your hands and remove Femring from its pouch. Choose the position that is most comfortable for you (for example, lying down or standing with one leg up).

Use your thumb and pointer finger to press the sides of the ring together so it is in a figure-of-eight shape. Use your other hand and hold open the folds of skin around your vagina.

Place the tip of the ring in the vaginal opening and then use your index finger to push the folded ring gently into your vagina. Push it up towards your lower back as far as you can. If the ring feels uncomfortable, you probably did not push it into your vagina far enough. There is no danger of Femring being pushed too far up in the vagina or getting lost. The exact position of Femring in the vagina is not important for it to work.

If your Femring comes out of your vagina before 3 months, clean it with warm water and put it back in your vagina. If Femring comes out often, tell your healthcare provider. Femring may not be right for you.

You may leave Femring in place if you need to use medicine for a vaginal infection. You may leave Femring in place during intercourse. If you take Femring out during intercourse or it comes out, clean it with warm water and put it back in your vagina.

If you lose your Femring, a new Femring should be put in place for 3 months.

What should I avoid while taking Femring?

Avoid smoking while using Femring.

Do not leave Femring in your vagina for more than 3 months.

Do not use Femring during pregnancy.

What are possible food and drug interactions associated with Femring?

If Femring is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Femring with the following: carbamazepine, clarithromycin, erythromycin, itraconazole, ketoconazole, phenobarbital, rifampin, ritonavir, and St. John's wort.

Also, drinking large amounts of grapefruit juice could alter the effects of Femring.

What are the possible side effects of Femring?

Side effects cannot be anticipated. If any develop or change in intensity, tell your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking this drug.

Side effects may include: abdominal cramps, back pain, bloating, breast tenderness, hair loss, headache, high blood pressure, high blood sugar, irregular vaginal bleeding or spotting, liver problems, nausea and vomiting, uterine pain (due to enlargement of benign tumors known as fibroids), vaginal yeast infections, water retention

Can I receive Femring if I am pregnant or breastfeeding?

Femring should not be used during pregnancy. Notify your doctor immediately if you are pregnant or plan to become pregnant.

The estrogens in Femring can show up in breast milk. Because estrogens may decrease the quantity and quality of breast milk, your doctor may advise you not to breastfeed while using Femring.

What should I do if I miss a dose of Femring?

If the ring is not replaced after 90 days, the dose of estrogen will gradually decline and your symptoms are likely to return.

How should I store Femring?

Store at room temperature.