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Compare Estring vs. Activella

Head-to-head comparisons of medication uses, side effects, warnings, and more.

Key takeaways

Estring (estradiol) and Activella (estradiol/norethindrone) are both used to treat menopausal symptoms, but they have some key differences. Estring is a vaginal ring that releases a steady amount of estrogen directly to the vaginal area, making it effective for treating vaginal dryness, burning, and irritation. It needs to be replaced every three months and is only available as a brand-name medication. On the other hand, Activella is an oral tablet that combines estradiol, an estrogen, with norethindrone, a progestin, to treat a wider range of menopausal symptoms, including hot flashes and night sweats. It can also help prevent osteoporosis, but isn't usually the first choice. Activella is available in generic form, making it a more cost-effective option. While Estring focuses on local symptoms, Activella affects the whole body and includes a progestin to protect the uterus, which Estring does not. Both medications carry risks of serious side effects like blood clots and cancer, but Activella can cause more systemic side effects due to its oral route.

  • Estring (estradiol)
    Activella (estradiol / norethindrone)
  • Estring (estradiol)
    Activella (estradiol / norethindrone)

  • Summary of Estring vs. Activella

    Summary for Estrogen replacement
    Prescription only

    Estring (estradiol) is an estrogen vaginal ring used as part of hormone replacement therapy (HRT) to treat moderate-to-severe menopause symptoms in and around the vagina, such as vaginal dryness, burning, and irritation. The ring is inserted into the vagina and stays in place for 3 months, releasing a steady dose of estrogen directly where it's needed. Common side effects include headache, vaginal discharge, and vaginal yeast infections.

    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. <br> Activella is a brand-name medication. It also comes as a generic and branded generics, such as Mimvey.

  • Indications of Estring vs. Activella

    Indications for
    •Vaginal dryness, burning, and irritation due to menopause
    Indications for

    In females who have a healthy uterus:

    •Moderate-to-severe vasomotor symptoms (VMS) of menopause, like hot flashes and night sweats
    •Moderate-to-severe symptoms of vulvar and vaginal atrophy, like vaginal dryness
    •Prevention of osteoporosis in females who've reached menopause

  • Pros and Cons of Estring vs. Activella

    Pros and Const for Estrogen replacement
    Pros
    •Can be inserted by you or a healthcare professional
    •Only needs to be changed every 3 months
    •Works directly at the site of application to relieve vaginal symptoms
    Cons
    •Can cause vaginal yeast infections
    •Doesn't treat other menopause symptoms like hot flashes or night sweats
    •Must take a progestin if you have a uterus to lower your risk of uterine cancer
    Pros and Const for Estrogen replacement / Progestin
    Pros
    •Taken by mouth once daily
    •Includes a progestin to protect against endometrial cancer
    •Available as a lower-cost generic medication
    Cons
    •Raises your risk of blood clots, heart attack, and stroke
    •Not for people who've had breast cancer
    •Not a first-choice option for vaginal symptoms of menopause or for preventing osteoporosis

  • Common Side Effects of Estring vs. Activella

    Common Side Effects for
    •Headache (13%)
    •Vaginal discharge (7%)
    •Vaginal yeast infection (6%)
    •Back pain (6%)
    •Vaginal inflammation (5%)
    •Vaginal discomfort or pain (5%)
    •Upper respiratory infection (5%)
    •Vaginal bleeding (4%)
    •Bacterial growth in the vagina (4%)
    •Arthritis (4%)
    •Trouble sleeping (4%)
    •Stomach pain (4%)
    •Sinus inflammation (4%)
    •Nausea (3%)
    •Flu-like symptoms (3%)
    •Joint pain (3%)
    Common Side Effects for
    •Breast pain (17-24%)
    •Headache (11-17%)
    •Accidental injury (3-17%)
    •Upper respiratory tract infection, like cough, cold, sore throat, congestion (10-15%)
    •Sinus infection (7-15%)
    •Postmenopausal bleeding (10-11%)
    •Nausea (10-11%)
    •Weight gain (up to 9%)
    •Ovarian cyst (up to 7%)
    •Stomach flu (up to 6%)
    •Viral infection (up to 6%)
    •Vaginal yeast infection (up to 6%)
    •Mood swings (up to 6%)
    •Back pain (3-6%)

  • Warnings of Estring vs. Activella

    Common Side Effects for
    •Risk for blood clots and related complications
    •Risk for uterine cancer (also called endometrial cancer)
    •Risk for breast cancer
    •Risk for ovarian cancer
    •Risk for dementia
    •Gallbladder or liver problems in certain people
    •High triglyceride (fat) levels
    •Changes in calcium levels in certain people
    •Low thyroid hormone levels
    •Buildup of fluids in your body (fluid retention)
    •Worsening of certain other health conditions
    •Vaginal irritation and infections
    Common Side Effects for
    •Blood clots, heart attacks, and strokes
    •Breast cancer
    •Uterine or endometrial cancer
    •Dementia
    •Ovarian cancer
    •Liver or gallbladder problems
    •Changes in calcium levels in the blood
    •Vision problems
    •High triglyceride (fat) levels
    •Low thyroid hormone levels
    •Buildup of fluids in your body (fluid retention)
    •Worsening of other medical conditions

  • Prices with our coupons for Estring vs. Activella

    Learn more about Estring
    Learn more about Activella

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