Safety Concerns With Estring

Specific Precautions and Warnings With Estring

Warnings and precautions to be aware of prior to using Estring include the following:
 
  • Studies have shown that estrogen hormone replacement therapy increases the risk of strokes and blood clots in the legs. It is thought that these risks are probably quite lower with Estring, which provides a low estrogen dose, compared to some other forms of estrogen. However, your healthcare provider should make sure you are appropriately treated for any risk factors for blood clots or heart disease (such as high blood pressure, high cholesterol, diabetes, obesity, or smoking) before you take Estring.
     
  • When possible, estrogen medications (including Estring) should be stopped at least four weeks before many surgeries in order to help prevent blood clots.
     
  • Let your healthcare provider know if you have abnormal vaginal bleeding, such as heavy bleeding or bleeding between periods, while taking Estring, as this may be a sign of precancerous or cancerous changes in the uterus. Your healthcare provider can perform the necessary tests to rule out cancer. Of course, if you have had a hysterectomy, you are not at risk for uterine cancer.
     
  • Estrogen drugs may increase the risk of breast cancer. Proper screening and monitoring (as determined by your healthcare provider), such as yearly mammograms and monthly self breast exams, are recommended.
     
  • Women who take estrogens such as Estring have an increased risk for gallbladder disease.
     
  • Let your healthcare provider know right away if you notice any vision changes. This can signal a blood clot in the retina, a possible side effect of Estring.
     
  • Estrogens can cause high blood pressure (hypertension) or high triglycerides in some women. Your healthcare provider should monitor you for these problems while you are using Estring.
     
  • Estring can make uterine fibroids worse.
     
  • Care should be taken when inserting the Estring ring, especially in women with irritated vaginal tissues.
     
  • Estrogens can cause fluid retention. This can be dangerous for people with certain medical conditions, such as congestive heart failure (CHF).
     
  • If you have had jaundice (yellowing of the whites of the eyes or skin) due to estrogens or pregnancy, Estring could cause similar problems to recur. If this happens, your healthcare provider will probably advise you to stop taking the medication.
     
  • Estrogen medications (such as Estring) may not be a good choice for people with liver disease, as the liver helps to metabolize estrogens.
     
  • Giving estrogens to people with breast cancer that has spread to the bone can lead to dangerously high blood calcium levels (hypercalcemia).
     
  • Estring may interact with a number of different medications (see Estring Drug Interactions).
     
  • The medication should not be used during pregnancy (see Estring and Pregnancy).
     
  • The hormone in Estring enters the bloodstream and passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to taking the drug (see Estring and Breastfeeding).
     
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