Key takeaways
Estradiol vaginal insert (Vagifem, Yuvafem) and estradiol gel (Divigel) are both estrogen replacement medications used to treat symptoms of menopause, but they differ in their specific uses and forms. Estradiol vaginal insert is only used for vaginal symptoms of menopause. It's inserted into the vagina once daily for 2 weeks, then twice a week thereafter. Divigel is effective for bodywide menopause symptoms, such as hot flashes, and is applied to the skin on the upper thigh tonce daily. Both medications require a prescription and are available as lower-cost generics. Common side effects of the estradiol vaginal insert include vaginal yeast infections and back pain, while Divigel may cause breast tenderness and abnormal vaginal bleeding. Both medications carry risks of serious side effects like blood clots and certain cancers, and they should be used with caution, especially if you have a history of these conditions. You may also need an additional progestin with these medications to protect against the risk of uterine cancer.
