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EstroGel vs. Prefest

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

Key takeaways

Estradiol gel (EstroGel) and Prefest (estradiol/norgestimate) are both medications used to relieve menopausal symptoms like hot flashes and vaginal dryness. However, they have some important differences. Estradiol gel is an estrogen replacement therapy applied topically, while Prefest is a combination of estrogen and progestin taken by mouth. Estradiol gel is available in both brand-name and generic forms, whereas Prefest is only available as a brand-name medication. Estradiol gel is applied once daily to the arm, while Prefest involves alternating between two different tablets every three days. Common side effects of estradiol gel include headaches and breast pain, while Prefest may cause headaches, cold-like symptoms, and joint pain. Both medications carry risks of serious side effects like blood clots and certain cancers, but Prefest also includes progestin to help protect the uterus.

Estradiol gel

(EstroGel)

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Prefest

(estradiol / norgestimate)

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Summary for EstroGel

Prescription only

Estradiol gel (EstroGel) is a hormone replacement therapy used to relieve menopausal symptoms like hot flashes and night sweats. Unlike some other estrogen gels, it's also FDA approved to treat vaginal symptoms from menopause, such as vaginal dryness and irritation. It comes as a pump bottle, and the dose is applied to the skin on your entire arm once a day. The gel is available in both brand-name and generic forms. Common side effects include headache, passing gas, and breast pain.

Indications for EstroGel

Pros and Cons for EstroGel

Pros

  • Relieves bothersome menopausal symptoms, such as hot flashes and night sweats
  • Also FDA approved to treat vaginal symptoms due to menopause
  • Applied directly to the skin on your entire arm
  • Only need to use once a day

Cons

  • Raises your risk of certain cancers, blood clots, and strokes
  • Risk of exposing others to estrogen through skin contact
  • Might also need to take a progestin medication if you have a uterus
  • Need to wait for the gel to dry completely before bathing, showering, or swimming

Common Side Effects for EstroGel

  • Breast pain (11%)
  • Headache (10%)
  • Passing gas (5%)

Warnings for EstroGel

  • Risk of blood clot
  • Uterine (endometrial) cancer
  • Breast cancer
  • Dementia
  • Gallbladder and liver problems
  • Changes in calcium levels in the blood
  • Vision problems
  • High triglycerides
  • Low thyroid hormone levels (hypothyroidism)
  • Fluid Retention
  • Worsening of other medical conditions
  • Potential skin-to-skin transfer

Summary for Prefest

Prescription only

Prefest (estradiol / norgestimate) is a combination medication that works well to relieve menopausal symptoms and prevent bone loss, but the directions on the package might be a little tricky to follow when you first start it.

Indications for Prefest

  • Hot flashes, night sweats, and flushes caused by menopause
  • Vaginal dryness and burning caused by menopause
  • Prevention of postmenopausal osteoporosis (not a first-choice)

Pros and Cons for Prefest

Pros

  • Only needs to be taken once a day
  • Relieves multiple menopausal symptoms
  • Includes a medication that helps protect your uterus
  • Lowers your risk of fractures by keeping your bones healthy

Cons

  • Not safe if you have liver problems
  • Brand-name only — might be expensive
  • Directions might be a little complicated for some people
  • Raises your risk of certain cancers, blood clots, and strokes

Common Side Effects for Prefest

  • Headaches (23%)
  • Cold- or flu-like symptoms (up to 21%)
  • Breast pain (16%)
  • Stomach or back pain (12%)
  • Vaginal bleeding (9%)
  • Joint pain (9%)
  • Menstrual cramps (8%)
  • Sinus pain or swelling (8%)

Warnings for Prefest

  • BREAST CANCER
  • BLOOD CLOTS, HEART ATTACKS, AND STROKES
  • DEMENTIA
  • ENDOMETRIAL CANCER
  • GALLBLADDER PROBLEMS
  • HIGH BLOOD CALCIUM LEVELS
  • VISION PROBLEMS

Prices with our coupons for EstroGel vs. Prefest

Price Card Drug Icon
Estradiol3 pumps / 50g of 0.06%
$169.38$439.46
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Price Card Drug Icon
Prefest1 package / 30 tablets
$197.57$219.41
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