Compare Premarin vs. Vivelle-Dot

Premarin vaginal cream (conjugated estrogens) and Vivelle-Dot (estradiol patch) are both estrogen replacement medications used to treat symptoms of menopause. But they differ in several ways. Premarin is a vaginal cream that's inserted daily in cycles or twice a week, while Vivelle-Dot is a transdermal patch applied to the skin twice weekly. Premarin is FDA-approved for vaginal symptoms of menopause, whereas Vivelle-Dot is approved for a broader range of menopause symptoms, including hot flashes and night sweats, and also for preventing osteoporosis. Premarin does not have a generic version, but Vivelle-Dot is available as a lower-cost generic. Common side effects of Premarin include headache and pelvic pain, while Vivelle-Dot may cause headaches and breast tenderness. Both medications carry risks of serious side effects like blood clots and cancer, but the risk may be higher with Vivelle-Dot than with Premarin vaginal cream. You'll also need o take a progestin with Vivelle-Dot to reduce your risk of uterine cancer, but you may not need a progestin with Premaring vaginal cream, since it isn't well absorbed into your bloodstream.