Key takeaways
Premarin vaginal cream (conjugated estrogens) and Divigel (estradiol) are both estrogen replacement therapies, but they have different uses and application methods. Premarin vaginal cream is used to treat vaginal symptoms of menopause, such as dryness and pain during sex, and is applied directly into the vagina. In contrast, Divigel is a gel applied to the skin, typically on the upper thigh or arm and is used to treat hot flashes and night sweats. Premarin is available only as a brand-name medication, while Divigel is available as a low-cost generic. Premarin is applied in cycles or twice a week, whereas Divigel is applied once daily. Both medications carry risks of serious side effects, including cancer and blood clots, but Divigel has the unique risk of transferring estrogen to others through skin contact.
