Duavee vs. Divigel for Osteoporosis and Menopause: Important Differences and Potential Risks.

Duavee

(conjugated estrogens / bazedoxifene)

Estradiol gel

(Divigel)

Summary for Duavee

Prescription only

Duavee (conjugated estrogens / bazedoxifene) treats vasomotor symptoms of menopause like hot flashes and night sweats. It can also help prevent osteoporosis in people who've gone through menopause. This combination medication has two active ingredients. The estrogen helps restore estrogen levels in the body while the selective estrogen receptor modulator (SERM) helps protect against bone loss. The dosage is 1 tablet taken by mouth once every day. Side effects can include muscle spasms, nausea, and diarrhea.

Indications for Duavee

Treatment of moderate-to-severe vasomotor symptoms of menopause (e.g., hot flashes, night sweats)
Prevention of osteoporosis in people who've gone through menopause

Pros and Cons for Duavee

Pros

Relieves bothersome menopause symptoms, such as hot flashes and night sweats
Contains an ingredient (bazedoxifene) that helps lower the risk for uterine cancer (no need to take an additional progestin medication)

Cons

Not a first-choice option for preventing osteoporosis in people who've gone through menopause
Not recommended for people who haven't gone through menopause, people 75 years or older, or people with kidney problems

Common Side Effects for Duavee

Muscle spasms or twitching (9%)
Nausea (8%)
Diarrhea (8%)
Indigestion (7%)
Upper stomach pain (7%)
Throat pain (7%)
Dizziness (5%)
Neck pain (5%)

Warnings for Duavee

Risk for blood clots and related complications (e.g., heart attack, stroke)
Risk for uterine cancer (also called endometrial cancer)
Unknown risk for breast cancer or ovarian cancer
Risk for dementia
Gallbladder or liver problems in certain people
Changes in vision
High triglyceride (fat) levels
Low thyroid hormone levels in people who take thyroid hormone replacement therapy
Buildup of fluids in the body (fluid retention)
Worsening of other medical conditions

Summary for Divigel

Prescription only

Estradiol gel (Divigel) is a hormone replacement therapy used to treat symptoms of menopause, such as hot flashes and night sweats. It comes as single-use packets, and the dose is applied to the skin on your upper thigh once a day. The gel is available as both a brand-name and a generic medication. Common side effects include vaginal yeast infections, breast tenderness, and abnormal vaginal bleeding.

Indications for Divigel

Hot flashes and night sweats due to menopause

Pros and Cons for Divigel

Pros

Relieves bothersome menopausal symptoms, such as hot flashes and night sweats
Applied directly to the skin on the thighs
Only need to use once a day
Available in multiple strengths to customize your dose

Cons

Raises your risk of certain cancers, blood clots, and strokes
Risk of exposing others to estrogen through skin contact
Might also need to take a progestin medication if you have a uterus
Need to wait for the gel to dry completely before bathing, showering, or swimming