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Prescribing Information, including BOXED WARNINGPatient Information Indication Patient Site
Reach for the Ring

Estring® (estradiol vaginal system) is a soft, flexible ring used after menopause that continuously releases an estrogen over 3 months. Estring is for the treatment of moderate to severe symptoms of vulvar and vaginal atrophy due to menopause.

 Live Pfizer Connect Health & Science Representatives

Personalized support and resources, call 1-833-WMN-HLTH       
(1-833-966-4584) 9 AM - 7 PM ET.

Call NowLoading Insertion & Removal Guide

In addition to the Instructions for Use in the Patient Information, this guide will help your patients learn how to insert and remove Estring.

Download GuideLoading Patient Education Brochure 

Help your patients learn more about moderate to severe symptoms of postmenopausal vaginal atrophy and Estring with this informative brochure.

Download Patient BrochureLoading Savings for eligible patients

Co-pay assistance may be available*

Download Savings CardsLoading*Terms and conditions apply.Resources for you and
your patientsMaterials

View materials for you and your patients

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LoadingReferencesTerms and ConditionsReferencesBy using the Estring Co-Pay Card, you acknowledge that you currently meet the eligibility criteria and will comply with the terms and conditions described below:References
  • Patients are not eligible to use this card if they are enrolled in a state or federally funded insurance program, including but not limited to Medicare, Medicaid, TRICARE, Veteran Affairs health care, a state prescription drug assistance program, or the Government Health Insurance Plan available in Puerto Rico (formerly known as “La Reforma de Salud”).
  • Patient must have private insurance. Offer is not valid for cash paying patients. The value of this Co-Pay Card is limited to $100 per use or the amount of your co-pay, whichever is less.
  • Maximum savings of $400 per calendar year. 
  • This Co-Pay Card is not valid when the entire cost of your prescription drug is eligible to be reimbursed by your private insurance plan or other private health or pharmacy benefit programs. 
  • You must deduct the value of this Co-Pay Card from any reimbursement request submitted to your private insurance plan, either directly by you or on your behalf. 
  • You are responsible for reporting use of the Co-Pay Card to any private insurer, health plan, or other third party who pays for or reimburses any part of the prescription filled using the Co-Pay Card, as may be required. You should not use the Co-Pay Card if your insurer or health plan prohibits use of manufacturer Co-Pay Card. 
  • You must be 18 years of age or older to redeem the Co-Pay Card. 
  • This Co-Pay Card is not valid where prohibited by law. 
  • The benefit under the Co-Pay Card program is offered to, and intended for the sole benefit of, eligible patients and may not be transferred to or utilized for the benefit of third parties, including, without limitation, third party payers, pharmacy benefit managers, or the agents of either. 
  • Co-Pay Card cannot be combined with any other external savings, free trial or similar offer for the specified prescription (including any program offered by a third party payer or pharmacy benefit manager, or an agent of either, that adjusts patient cost-sharing obligations, through arrangements that may be referred to as “accumulator” or “maximizer” programs).
  • Third party payers, pharmacy benefit managers, or the agents of either, are prohibited from assisting patients with enrolling in the Co-Pay Card program. 
  • Co-Pay Card will be accepted only at participating pharmacies. 
  • This Co-Pay Card is not health insurance. 
  • Offer good only in the U.S. and Puerto Rico. 
  • Co-Pay Card is limited to 1 per person during this offering period and is not transferable. 
  • A Co-Pay Card may not be redeemed more than once per 90 days per patient. 
  • No other purchase is necessary. 
  • Data related to your redemption of the Co-Pay Card may be collected, analyzed, and shared with Pfizer, for market research and other purposes related to assessing Pfizer’s programs. Data shared with Pfizer will be aggregated and de-identified; it will be combined with data related to other Co-Pay Card redemptions and will not identify you.
  • Pfizer reserves the right to rescind, revoke or amend this offer without notice.
  • Offer expires 12/31/2025.
ReferencesNo membership fees apply. For help with the Estring Savings Card, call 1‑800‑631‑1181, or write: Pfizer Inc, 66 Hudson Boulevard East, New York, NY 10001-2192, or visit www.pfizer.com.

To report an adverse event, please call 1-800-438-1985

Pfizer for Professionals 1-800-505-4426

This site is intended only for U.S. healthcare professionals. The products discussed in this site may have different product labeling in different countries. The information provided is for educational purposes only.

© 2024 Pfizer Inc. All rights reserved.

PP-EST-USA-0623
Indication Estring® (estradiol vaginal system) is indicated for the treatment of moderate to severe symptoms of vulvar and vaginal atrophy due to menopause.
Important Safety Information There is an increased risk of endometrial cancer in a woman with a uterus who uses unopposed estrogens. Adding a progestin to estrogen therapy has been shown to reduce the risk of endometrial hyperplasia, which may be a precursor to endometrial cancer. Adequate diagnostic measures, including directed or random endometrial sampling when indicated, should be undertaken to rule out malignancy in postmenopausal women with undiagnosed persistent or recurring abnormal genital bleeding. 

Estrogens with or without progestins should not be used for the prevention of cardiovascular disease or dementia.

The Women’s Health Initiative (WHI) estrogen-alone substudy reported increased risks of stroke and deep vein thrombosis (DVT) in postmenopausal women with daily oral conjugated estrogens (CE) 0.625mg alone relative to placebo. The WHI estrogen plus progestin substudy reported increased risks of DVT, pulmonary embolism, stroke, and myocardial infarction in postmenopausal women with daily oral CE 0.625mg combined with medroxyprogesterone acetate (MPA) 2.5mg relative to placebo.

The WHI Memory Study (WHIMS) reported an increased risk of developing probable dementia in postmenopausal women 65 years of age or older, in both the estrogen alone and estrogen plus progestin arms. It is unknown whether these findings apply to younger postmenopausal women.

The WHI estrogen plus progestin substudy demonstrated an increased risk of invasive breast cancer.

In the absence of comparable data, these risks should be assumed to be similar for other doses of CE or CE and MPA, and other dosage forms of estrogens or combinations and dosage forms of estrogens and progestins.

Estrogens with or without progestins should be prescribed at the lowest effective dose and for the shortest duration consistent with treatment goals and risks for the individual woman.

Estring should not be used in women with any of the following conditions: undiagnosed abnormal genital bleeding; known, suspected, or a history of breast cancer; known or suspected estrogen-dependent neoplasia; active deep vein thrombosis, pulmonary embolism, or a history of these conditions; active arterial thromboembolic disease (e.g., stroke, myocardial infarction), or a history of these conditions; anaphylactic reaction, angioedema, or hypersensitivity to Estring; liver impairment or disease; thrombophilic disorders; pregnancy.

Consistent with the WHI clinical trials, observational studies have also reported an increased risk of breast cancer for estrogen plus progestin therapy, and a smaller increased risk for estrogen-alone therapy, after several years of use. One large meta-analysis of prospective cohort studies reported increased risks that were dependent upon duration of use and could last up to >10 years after discontinuation of estrogen plus progestin therapy and estrogen‑alone therapy. Extension of the WHI trials also demonstrated increased breast cancer risk associated with estrogen plus progestin therapy.

The WHI estrogen plus progestin sub-study reported a statistically non-significant increased risk of ovarian cancer. A meta-analysis of 17 prospective and 35 retrospective epidemiology studies found that women who used hormonal therapy for menopausal symptoms had an increased risk for ovarian cancer. The exact duration of hormone therapy use associated with an increased risk of ovarian cancer, however, is unknown.

Estrogens increase the risk of gallbladder disease. Discontinue estrogen if severe hypercalcemia, loss of vision, severe hypertriglyceridemia or cholestatic jaundice occurs. Monitor thyroid function in women on thyroid replacement therapy, because estrogens may be associated with increased thyroid binding globulin (TBG) levels.

The most frequently (≥ 5 percent) reported adverse events associated with Estring were headache, leukorrhea, back pain, genital moniliasis, upper respiratory tract infection, vaginitis, and vaginal discomfort/pain. IndicationEstring is indicated for the treatment of moderate to severe symptoms of vulvar and vaginal atrophy due to menopause.

Please see full Prescribing Information, including BOXED WARNING and Patient Information.
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