Head-to-head comparisons of medication uses, side effects, warnings, and more.
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.
Activella (estradiol / norethindrone)
Evamist (estradiol)
Activella (estradiol / norethindrone)
Evamist (estradiol)
Summary of Activella vs. Evamist
Summary for Estrogen replacement / Progestin
Prescription only
Activella is a combination hormone replacement therapy (HRT) that contains estradiol (an estrogen) and norethindrone (a progestin). It's used to treat certain symptoms of menopause, such as night sweats and vaginal dryness, related to low estrogen levels. It can also help prevent bone loss (osteoporosis) in females who've reached menopause. The typical dose is 1 tablet by mouth once daily. Some side effects of this medication include breast pain and headache. Activella (estradiol / norethindrone), as well as other HRTs, isn't recommended for people who've had breast cancer.
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Activella is a brand-name medication. It also comes as a generic and branded generics, such as Mimvey.
Summary for Estrogen replacement
Prescription only
Evamist (estradiol) is a topical hormone spray that helps relieve the hot flashes and night sweats caused by menopause. It's a hormone replacement therapy (HRT) that's sprayed onto the skin of your inner forearm once a day. The typical dose ranges from 1 to 3 sprays daily, depending on your symptoms. Some potential side effects of this medication include headache, tender breasts, and back pain.