Preparation (United States trade name) | Available strengths | Recommended regimen |
Vaginal ring | ||
Estring | 7.5 mcg estradiol daily, released over 90 days | Ring is inserted into the vagina by the patient or clinician. Ring is removed and replaced with a new ring every 90 days. |
Vaginal insert | ||
Imvexxy | 4 mcg estradiol per vaginal insert | Insert 1 tablet intravaginally daily for 2 weeks, followed by twice weekly. Dose may be increased to the 10 mcg insert according to clinical response. |
Imvexxy, Vagifem, Yuvafem | 10 mcg estradiol per vaginal insert | Insert 1 tablet intravaginally daily for 2 weeks, followed by twice weekly. |
Vaginal cream¶ | ||
Premarin | 0.625 mg conjugated estrogens per g of cream | 0.5 g of cream intravaginally administered daily for 2 weeks, then reduce to twice weekly*; dose may be adjusted according to patient's symptoms and clinical response (range 0.5 to 2 g of cream). |
Estrace | 100 mcg estradiol per g of cream | 0.5 g of cream intravaginally administered daily for 2 weeks, then reduce to twice weekly*; dose may be adjusted according to patient's symptoms and clinical response (initial range: 0.5 to 4 g of cream; maintenance range: 0.5 to 1 g of cream). |
* Our practice differs from the manufacturer's product information; refer to UpToDate topic for further information.
¶ Vaginal estrogen creams are supplied with an applicator marked with dose calibrations so the patient can measure the prescribed amount of cream.Do you want to add Medilib to your home screen?