Key takeaways
Estrace (estradiol) and Divigel (estradiol) gel are both estrogen replacement therapies, but they are used differently and treat different symptoms of menopause. Estrace is a vaginal cream applied directly inside the vagina to relieve vaginal symptoms like itching, dryness, and burning. In contrast, Divigel is a topical gel applied to the skin, typically on the upper thigh or arm, to treat hot flashes and night sweats. Both medications are available as a lower-cost generic. Estrace is used every day initially then reduced to a few times a week based on how well it controls vaginal symptoms, whereas Divigel is always applied once daily. Both medications carry risks of serious side effects, such as blood clots, strokes, and certain cancers. Divigel carries the unique risk of transferring estrogen to others through skin contact, whereas Estrace does not. Additionally, if you have a uterus, you might need to take a progestin-based medication with either medication to lower the risk of uterine cancer.
