Key takeaways
Activella (estradiol/norethindrone) and Evamist (estradiol) are both used to treat menopausal symptoms like hot flashes and night sweats, but they have some key differences. Activella is a combination of estradiol and norethindrone, taken as a daily oral tablet, and can also be used to prevent osteoporosis. Evamist, on the other hand, is a topical spray containing only estradiol, applied to the forearm once a day. While Activella includes a progestin to protect the uterus, Evamist requires an additional progestin if you have a uterus to lower the risk of uterine cancer. Activella is available in generic form, making it potentially more affordable, whereas Evamist is only available as a brand name. Both medications carry risks of serious side effects like blood clots, strokes, and certain cancers, but Evamist has a unique risk of transferring the medication to others through skin contact.
