Inserting Femring:

1. Wash your hands.
   
   
2. Take Femring out of the pouch.
   
   
3. Squeeze the ring into an oval shape.
   
   
4. Gently insert it into the vaginal canal, similar to a tampon.
   
   
5. Push it up until it feels comfortable.
   
   
6. Once inside, you should not feel it.
   
   

Removing Femring:

• After 90 days, remove the ring by hooking a finger under the edge and gently pulling it out.
  
  
• Dispose of it properly (do not flush).
  
  
• Insert a new ring if continuing treatment.
  
  

Notes:

• Femring does not need to be removed during bathing, urination, or sex.
  
  

If it falls out, rinse it with warm water and reinsert it.

During menopause, a woman’s ovaries stop making estrogen, which can cause many symptoms like hot flashes and vaginal discomfort.

Femring works by:

• Releasing estradiol (estrogen) directly into the vaginal area
  
  
• Increasing estrogen levels in the blood
  
  
• Helping reduce symptoms caused by low estrogen
  
  
• Supporting bone strength by slowing down bone thinning
  
  

Because the ring is placed in the vagina, it delivers estrogen more directly and steadily, without needing a pill every day.

Like all hormone therapies, Femring can cause side effects. Most are mild and improve over time, but some can be serious.

Common Side Effects:

• Headache
  
  
• Vaginal irritation or discharge
  
  
• Breast tenderness
  
  
• Nausea
  
  
• Mood swings
  
  
• Bloating
  
  

Serious Side Effects (rare but possible):

• Blood clots
  
  
• Stroke
  
  
• Heart attack
  
  
• Breast or uterine cancer
  
  
• High blood pressure
  
  
• Liver problems
  
  

Seek immediate medical help if you notice:

• Chest pain or shortness of breath
  
  
• Leg pain or swelling
  
  
• Vision problems
  
  
• Yellowing of skin or eyes
  
  
• Unusual vaginal bleeding
  
  

Femring is not for everyone. It’s important to discuss your medical history with your doctor before starting treatment.

Do NOT use Femring if you:

• Have or had breast cancer or uterine cancer
  
  
• Have liver disease
  
  
• Have a history of blood clots, stroke, or heart attack
  
  
• Are pregnant or could become pregnant
  
  
• Have unexplained vaginal bleeding
  
  

Use with caution if you:

• Smoke, especially if over 35
  
  
• Have diabetes, high cholesterol, or high blood pressure
  
  
• Have gallbladder disease or migraines
  
  
• Have a family history of cancer or blood clots
  
  

Before using Femring, your doctor may recommend:

• A pelvic exam
  
  
• A Pap test
  
  
• Mammogram
  
  
• Blood pressure check
  
  

Regular check-ups are important while using hormone therapy.

Femring may interact with other medications, including:

• Seizure drugs (e.g., phenytoin, carbamazepine)
  
  
• HIV medications
  
  
• Certain antibiotics
  
  
• Herbal supplements like St. John’s wort
  
  

These can affect how estrogen works in your body. Always tell your doctor about all medications and supplements you’re using.

Femring is available in:

• 0.05 mg/day estradiol
  
  
• 0.10 mg/day estradiol
  
  

Your doctor will start you on the lowest effective dose to reduce your menopause symptoms.

Usage Guidelines:

• Insert one ring into the vagina every 90 days
  
  
• Replace the ring every 3 months
  
  
• If you stop using it, your symptoms may return
  
  

Do not remove the ring unless your doctor tells you to. If it falls out accidentally, rinse and reinsert it.

Follow your doctor’s directions carefully, and do not change the dose or frequency without medical advice.

Femring is a prescription-only medication, which means you need a doctor’s approval to use it.

Before giving you Femring, your doctor will:

• Ask about your menopause symptoms
  
  
• Review your medical history
  
  
• Check for any health risks
  
  
• Possibly perform tests like:
  
  
  • Pelvic exam
    
    
  • Pap smear
    
    
  • Breast exam or mammogram
    
    
  • Bone density scan
    
    

Because hormone therapy can have serious side effects, it is important to:

• Use it under medical supervision
  
  
• Attend regular check-ups
  
  
• Report any side effects or concerns

• What is Femring used for?
  It is a vaginal estrogen ring used to treat moderate to severe menopausal symptoms, including:

  • Hot flashes and night sweats (vasomotor symptoms)

  • Vaginal dryness, itching, and burning associated with menopause

• What is the active ingredient?
  Estradiol acetate, a form of estrogen hormone.

• How does Femring work?
  The ring releases a steady dose of estrogen through the vaginal wall into the bloodstream, helping restore hormonal balance and relieve menopausal symptoms.

• How is Femring used?

  • It is a soft, flexible vaginal ring inserted into the vagina by hand.

  • The ring stays in place continuously for 90 days (3 months) and is then replaced with a new one.

• What strengths are available?

  • Femring 0.05 mg/day

  • Femring 0.10 mg/day
    Both provide systemic estrogen therapy.

• Is Femring a local or systemic therapy?
  Systemic — unlike low-dose local rings (like Estring), Femring releases enough estrogen to treat whole-body symptoms such as hot flashes.

• What are the common side effects?
  Headache, breast tenderness, nausea, bloating, vaginal discharge, and mild irritation at the site of insertion.

• Are there serious side effects?
  Yes — Femring carries boxed warnings for risks associated with systemic estrogen therapy, including:

  • Stroke and blood clots

  • Heart attack

  • Breast cancer

  • Endometrial cancer (if uterus is present and no progestin is used)

  • Dementia in older women

• Who should not use Femring?

  • Women with breast or uterine cancer

  • Those with blood clots, stroke, or heart disease history

  • Liver disease or undiagnosed vaginal bleeding

  • Women who are pregnant or may become pregnant

• Can Femring be used after hysterectomy?
  Yes — women without a uterus can safely use estrogen-only therapy without progestin.

• Can I remove Femring for cleaning?
  Yes — it can be removed, rinsed with lukewarm water, and reinserted immediately.

• Can I have sex while using Femring?
  Yes — most partners do not feel it, though it can be removed temporarily if uncomfortable.

• Can Femring fall out?
  Rarely — if it does, rinse and reinsert promptly.

• Does Femring affect menstruation?
  It may cause light spotting in the first months, but regular periods do not occur in postmenopausal women.

• Can Femring prevent osteoporosis?
  It helps reduce bone loss but is not the first-line treatment for osteoporosis prevention.

• Can Femring be used during pregnancy?
  No — it is contraindicated during pregnancy.

• Can I use Femring while breastfeeding?
  Not recommended — estrogen may reduce milk production.

• Does Femring interact with other medications?
  Yes — it may interact with drugs that affect estrogen metabolism, including:

  • Rifampin

  • Carbamazepine

  • Phenytoin

  • St. John’s wort

• What’s the difference between Femring and Estring?

  • Femring: Systemic estrogen for hot flashes and vaginal symptoms.

  • Estring: Local estrogen for vaginal dryness only.

• How should Femring be stored?
  Store at room temperature (20°C–25°C / 68°F–77°F), away from direct heat and sunlight.

• Is there a generic available?
  No — Femring is currently available as brand only.

• Where can I get Femring?
  Available by prescription only from pharmacies.