Do not use Oestring:<\/p>\n\n\n\n
- if you have or have had breast cancer<\/strong> , or you are suspected of having breast cancer<\/li><\/ul>\n\n\n\n
- if you have or have had cancer that is sensitive to estrogen ,<\/strong> such as cancer of the uterine lining (endometrium) or if there is a suspicion of such cancer<\/li>
- if you have any unexplained genital bleeding<\/strong><\/li>
- if you have severe thickening of the uterine lining<\/strong> ( endometrial hyperplasia ) and have not been treated for it<\/li>
- if you have or have had a blood clot in a vein<\/strong> (venous thromboembolism ), for example in the legs (deep vein thrombosis ) or the lungs ( pulmonary embolism )<\/li>
- if you have a coagulation disorder<\/strong> (eg protein C, protein S or antithrombin deficiency)<\/li>
- if you have or have recently had a disease caused by blood clots in your arteries , such as a heart attack , stroke<\/strong> or angina<\/strong><\/li>
- if you have or have had a liver disease<\/strong> and your liver values \u200b\u200bhave not returned to normal<\/li>
- if you have “porphyria”, a rare inherited blood disorder<\/li>
- if you are allergic to estradiol or any of the other ingredients of this medicine (see section 6)<\/li><\/ul>\n\n\n\n
Note that Oestring is a drug that has an effect locally in the abdomen and that the amounts of estradiol that are absorbed by the body are very low. If any of the above conditions occur for the first time while you are taking Oestring, stop using it immediately and consult a doctor.<\/p>\n\n\n\n
Medical history and regular check-ups<\/strong><\/p>\n\n\n\n
The use of HRT carries risks that you should consider before deciding whether to start treatment or continue ongoing treatment.<\/p>\n\n\n\n
There is only limited experience of treatment for women where menstruation has stopped prematurely (due to ovarian failure or surgery). If your period has stopped prematurely, the risks of HRT may be different. Talk to your doctor.<\/p>\n\n\n\n
Before starting treatment (or resuming treatment), your doctor will ask about your own, and your family’s, medical history.\u00a0Your doctor may do a general medical and gynecological examination, which also includes an examination of your breasts.<\/p>\n\n\n\n
Once you have started treatment with Oestring, you should have regular medical check-ups (at least once a year). During these check-ups, you should discuss with your doctor the benefits and risks of continuing treatment with Oestring.<\/p>\n\n\n\n
Perform regular examinations of the breasts according to the doctor’s recommendations.<\/p>\n\n\n\n
Warnings and cautions<\/h2>\n\n\n\n
Tell your doctor if you have ever had any of the following problems before starting treatment, as they may come back or get worse during treatment with Oestring. Should this occur, have more frequent check-ups with a doctor. <\/p>\n\n\n\n
- muscle knots ( fibroids ) inside the uterus<\/li><\/ul>\n\n\n\n
- uterine lining that grows outside the uterus ( endometriosis ) or a previous strong growth of the uterine lining ( endometrial hyperplasia )<\/li>
- increased risk of developing blood clots (see “Blood clot in a vein ( thrombosis )”)<\/li>
- increased risk of developing estrogen-sensitive cancer (if, for example, your mother, sister or grandmother had breast cancer)<\/li><\/ul>\n\n\n\n
- ovarian cancer<\/li>
- high blood pressure<\/li>
- liver disease, such as a benign liver tumor<\/li>
- diabetes <\/li>
- gallstone<\/li>
- migraine or severe headache<\/li>
- a disease of the immune system that affects many organs in the body (systemic lupus erythematosus, SLE )<\/li>
- epilepsy<\/li>
- asthma<\/li>
- a disease that affects the eardrum and hearing (otosclerosis)<\/li>
- a very high level of fat in the blood ( triglycerides er)<\/li>
- fluid retention due to heart or kidney problems<\/li><\/ul>\n\n\n\n
It has happened that the ring is attached to the vaginal wall and has been difficult to remove, contact a doctor if this occurs.<\/p>\n\n\n\n
You should contact your doctor immediately and discontinue treatment with Oestring if any of the following occur:<\/strong><\/p>\n\n\n\n
- any of the conditions mentioned in the section “Do not use Oestring”<\/li>
- skin or whites of the eyes turn yellow (jaundice); it may be a sign of liver disease<\/li>
- your blood pressure rises sharply (symptoms may include headache, fatigue, dizziness)<\/li>
- if you are experiencing migraine-like headaches for the first time<\/li>
- if you become pregnant<\/li>
- if you notice signs of a blood clot, such as:
- painful swelling and redness of the legs<\/li>
- sudden chest pain<\/li>
- breathing difficulties<\/li><\/ul><\/li><\/ul>\n\n\n\n
For more information, see below “Blood clots in a vein ( thrombosis )”.<\/p>\n\n\n\n
Note:<\/strong>\u00a0Oestering is not a contraceptive.\u00a0If it has been less than 12 months since you had your last period or you are younger than 50 years, you may need to use additional contraception to prevent pregnancy.\u00a0Ask your doctor for advice.<\/p>\n\n\n\n
HRT and cancer<\/strong><\/p>\n\n\n\n
Severe thickening of the uterine lining ( endometrial hyperplasia ) and cancer of the uterine lining (endometrial cancer).<\/strong><\/p>\n\n\n\n
Use of HRT in tablet form with estrogen alone for a long time may increase the risk of developing cancer of the uterine lining (endometrium).<\/p>\n\n\n\n
It is unclear whether there is a corresponding risk when Oestring is used for repeated or long-term (over a year) treatment.\u00a0However, it has been shown that Oestring has a very low\u00a0absorption\u00a0into the blood and therefore no addition of\u00a0a progestin\u00a0is required.<\/p>\n\n\n\n
If you have a breakthrough or splash bleeding, there is usually nothing to worry about, but you should contact your doctor. It may be a sign that your uterine lining has become thicker.<\/p>\n\n\n\n
The following risks apply to hormone replacement therapy ( HRT ) circulating in the blood. Oestering, on the other hand, is used topically in the vagina and the uptake into the blood is very low. The conditions described below are unlikely to worsen or return during treatment with Oestring, but you should consult a doctor if you are concerned.<\/em><\/p>\n\n\n\n
Breast cancer<\/strong><\/p>\n\n\n\n
There are indications that the use of Oestring does not increase the risk of breast cancer in women who have not had breast cancer before. It is unknown whether Oestring can be used safely in women who have had breast cancer before.<\/p>\n\n\n\n
For women without a uterus who have therefore only taken\u00a0estrogen, there is no, or small, increased risk of breast cancer.<\/p>\n\n\n\n
Check your breasts regularly. Contact a doctor if you notice changes such as:<\/strong><\/p>\n\n\n\n
- pits in the skin<\/li>
- changes of the nipple<\/li>
- nodules that you can see or feel.<\/li><\/ul>\n\n\n\n
It is also recommended that you participate in all mammography examinations when called upon to do so.<\/p>\n\n\n\n
Ovarian cancer ( ovarian cancer )<\/strong><\/p>\n\n\n\n
Ovarian cancer is uncommon – much rarer than breast cancer. The use of HRT with estrogen alone has been associated with a slightly increased risk of ovarian cancer.<\/p>\n\n\n\n
The risk of ovarian cancer varies with age.\u00a0Of, for example, women aged 50 to 54 who do not take\u00a0HRT, approximately 2 women out of 2,000 will be diagnosed with ovarian cancer over a 5-year period.<\/p>\n\n\n\n
For women who take HRT for 5 years, there will be about 3 cases per 2,000 users (ie about 1 extra case).<\/p>\n\n\n\n
How HRT affects the heart and blood circulation<\/strong><\/p>\n\n\n\n
Blood clot in a friend ( thrombosis )<\/strong><\/p>\n\n\n\n
The risk of blood clots in the veins<\/strong> is about 1.3 to 3 times higher for women who use HRT than those who do not, especially during the first year of treatment.<\/p>\n\n\n\n
Blood clots can be serious.\u00a0If a blood clot ends up in the lungs, it can cause\u00a0chest pain, shortness of breath, and lead to fainting or even death.<\/em><\/p>\n\n\n\n
You are more likely to get a blood clot if you are older and if any of the following apply to you. Tell your doctor if any of the following apply to you:<\/p>\n\n\n\n
- you can not walk for a long time due to a major operation, injury or illness (see also section 3, “If you need surgery”)<\/li>
- you are severely overweight ( BMI over 30 kg \/ m 2<\/sup> )<\/li>
- you have a coagulation disorder that requires long-term treatment with drugs to prevent blood clots<\/li>
- one of your close relatives has had a blood clot in your leg, lung or other organ<\/li>
- you have systemic lupus erythematosus ( SLE )<\/li>
- you have cancer <\/li><\/ul>\n\n\n\n
The section “You should contact a doctor immediately and discontinue treatment with Oestring if any of the following occur” describes signs of a blood clot.<\/p>\n\n\n\n
Comparison<\/em><\/p>\n\n\n\n
For women in their 50s who do not take\u00a0HRT, over a 5-year period, an average of 4 to 7 women out of 1,000 are expected to get a blood clot in a vein.<\/p>\n\n\n\n
For women in their 50s who have taken HRT with estrogen alone for more than 5 years, 5 to 8 cases per 1,000 users are expected to have a blood clot in a vein (ie 1 extra case).<\/p>\n\n\n\n
Heart disease (heart attack)<\/strong><\/p>\n\n\n\n
For women who receive treatment with\u00a0estrogen\u00a0alone, there is no increased risk of developing heart disease.<\/p>\n\n\n\n
Stroke _<\/strong><\/p>\n\n\n\n
The risk of stroke is about 1.5 times higher for women who use HRT compared to those who do not. The risk of stroke is age-dependent, therefore the number of cases of stroke increases due to the use of HRT with increasing age.<\/p>\n\n\n\n
Comparison<\/em><\/p>\n\n\n\n
For women in their 50s who do not take\u00a0HRT, an average of 8 out of 1,000 are expected to have a\u00a0stroke\u00a0over a 5-year period.\u00a0For women in their 50s who have taken\u00a0HRT\u00a0for more than 5 years, 11 out of 1,000 users are expected to have a\u00a0stroke\u00a0(ie 3 extra cases).<\/p>\n\n\n\n
Other conditions<\/strong><\/p>\n\n\n\n
- Using HRT does not prevent memory loss. The risk of memory loss may be slightly higher in women who start taking HRT after the age of 65. Consult your doctor.<\/li>
- Use of systemic HRT may cause or worsen the symptoms of angioedema , especially if you have hereditary angioedema (hereditary form of angioedema ). Contact a doctor immediately if you get any of the following symptoms ( angioedema ):
- swelling of the face, tongue or throat<\/li>
- difficulty swallowing<\/li>
- hives and difficulty breathing<\/li><\/ul><\/li><\/ul>\n\n\n\n
Other medicines and Oestring<\/h2>\n\n\n\n
Tell your doctor or pharmacist if you are taking, have recently taken, or might take any other medicines, including medicines obtained without a prescription, herbal medicines, or other natural products.<\/p>\n\n\n\n
Because Oestring is used for topical treatment in the\u00a0vagina, it is unlikely that Oestring will affect the effectiveness of other medicines.\u00a0Registration can affect the effectiveness of other treatments given vaginally.<\/p>\n\n\n\n
Pregnancy, breastfeeding and fertility<\/h2>\n\n\n\n
Oestering is intended for women whose menstruation has stopped. If you become pregnant, stop using Oestring and consult a doctor.<\/p>\n\n\n\n
If you are pregnant or breastfeeding, think you may be pregnant, or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine.<\/p>\n\n\n\n
Driving and using machines<\/h2>\n\n\n\n
Oestering has no known effects on the ability to drive or use machines.<\/p>\n\n\n\n
How to use Oestring<\/h2>\n\n\n\n
Always use this medicine exactly as your doctor or pharmacist has told you. Ask your doctor or pharmacist if you are unsure.<\/h2>\n\n\n\n
Your doctor will strive to prescribe the lowest dose that treats your symptoms, for as short a time as possible. Talk to your doctor if you think your dose is too high or too low.<\/p>\n\n\n\n
The ring is compressed into an oval shape and inserted into the vagina, follow the instructions for use below.<\/p>\n\n\n\n
After a couple of weeks, the ring works with full effect. The ring is allowed to remain for 90 days and must then be replaced and replaced with a new one. This is repeated every three months. Treatment with Oestring can continue as long as you find it meaningful and your doctor agrees.<\/p>\n\n\n\n
Instructions for use<\/strong><\/p>\n\n\n\n
To insert the ring:<\/strong><\/p>\n\n\n\n
Insert the ring into the vagina as follows:<\/p>\n\n\n\n
Stand with one foot on a chair, squat, or lie on your back in bed with your legs apart.<\/p>\n\n\n\n
![\"Stand](\"https:\/\/www.fass.se\/res\/RootMedia\/Pfizer20AB\/Media\/Oestring\/Oestring2dbild2d1.jpg\" "\\"Stand")
<\/a><\/figure>\n\n\n\nSqueeze the ring into an oval<\/p>\n\n\n\n
![\"Oval](\"https:\/\/www.fass.se\/res\/RootMedia\/Pfizer20AB\/Media\/Oestring\/Oestring2dbild2d2.jpg\" "\\"Oval")
<\/a><\/figure>\n\n\n\nInsert the ring inside the vaginal opening<\/p>\n\n\n\n
![\"Insert](\"https:\/\/www.fass.se\/res\/RootMedia\/Pfizer20AB\/Media\/Oestring\/Oestring2dbild2d3.jpg\" "\\"Insert")
<\/a><\/figure>\n\n\n\nIf the ring falls out?<\/strong><\/p>\n\n\n\n
The ring can slide down the vagina and become noticeable after, for example, visiting the toilet. If the ring falls out, rinse it in lukewarm water (not hot) and then insert it into the vagina, as described on the previous page.<\/p>\n\n\n\n
How should the ring be removed?<\/strong><\/p>\n\n\n\n
After 90 days, the ring should be replaced.<\/p>\n\n\n\n
You should remove the ring as follows:<\/p>\n\n\n\n
- if you have any unexplained genital bleeding<\/strong><\/li>
- if you have or have had cancer that is sensitive to estrogen ,<\/strong> such as cancer of the uterine lining (endometrium) or if there is a suspicion of such cancer<\/li>
![\"Take](\"https:\/\/www.fass.se\/res\/RootMedia\/Pfizer20AB\/Media\/Oestring\/Oestring2dbild2d4.jpg\" "\\"Take")
<\/a><\/figure>\n\n\n\n