Key takeaways
Estradiol valerate (Delestrogen) injection and estradiol gel (Divigel) are both estrogen replacement therapies used to treat menopause symptoms like hot flashes and night sweats. They also share the off-label use of being part of gender-affirming hormone therapy. However, they differ in several ways. Delestrogen is an intramuscular injection, typically given every 1-4 weeks, while Divigel is a topical gel applied daily to the skin of the thigh. Delestrogen is also used for conditions such as low estrogen levels due to hypogonadism , whereas Divigel is only FDA-approved for menopausal symptoms. Both medications are available as lower-cost generics. Common side effects of Delestrogen include vaginal spotting and headaches, while Divigel may cause vaginal yeast infections and breast tenderness. Both medications raise the risk of certain cancers, blood clots, and strokes, but the risk of serious side effects may be lower with Divigel.
