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Premarin vs. Elestrin

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

Key takeaways

Premarin vaginal cream (conjugated estrogens) and Elestrin (estradiol gel) are both estrogen replacement medications used to treat symptoms related to menopause, but they have some important differences. Premarin is a vaginal cream specifically used for vaginal symptoms, while Elestrin is a topical gel used to relieve hot flashes and night sweats. Premarin vaginal cream is applied directly into the vagina, either in cycles or twice a week, whereas Elestrin is applied once daily to the skin of the upper arm. Both medications are only available as a brand. Common side effects of Premarin include headache and pelvic pain, while Elestrin may cause breast tenderness and abnormal vaginal bleeding. Both medications carry risks of serious side effects like blood clots and certain types of cancer and may need to be taken with a progestin if you have a uterus. Elestrin has a higher risk of transferring the medication to others through skin-to-skin contact.

Premarin

 

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Elestrin

(estradiol gel)

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Summary for Premarin

Prescription only

Premarin (conjugated estrogens) is an oral estrogen hormone tablet that's used to treat various conditions in adults. Most commonly, it relieves menopausal symptoms such as vaginal dryness and hot flashes. The medication is also used for treating low estrogen levels, certain advanced stages of breast or prostate cancers, and osteoporosis after menopause. Depending on what you're using it for, the medication can be taken daily or in cycles. Side effects include headache, stomach pain, nausea, and breast pain.

Indications for Premarin

Pros and Cons for Premarin

Pros

  • Relieves multiple menopausal symptoms
  • Available in multiple strengths, allowing you to customize your dose
  • Comes as a tablet that you take by mouth

Cons

  • Raises your risk of certain cancers, blood clots, and strokes
  • Some people might need to take it with another hormone called progestin
  • Not a first-choice medication for treating bone loss after menopause

Common Side Effects for Premarin

  • Headache (13-14%)
  • Abnormal vaginal bleeding (2-13%)
  • Breast pain (7-12%)
  • Stomach pain (8-11%)
  • Passing gas (4-6%)
  • Vaginal discharge (4-5%)
  • Back pain (3-5%)
  • General pain (3-5%)
  • Nausea (3-5%)
  • Insomnia (3-5%)
  • Depression (3-5%)
  • Weakness (2-5%)

Warnings for Premarin

  • Uterine (endometrial) cancer
  • Breast cancer
  • Blood clots and stroke
  • Heart disease and heart attacks
  • Dementia
  • Gallbladder and liver problems
  • Vision problems
  • High triglycerides
  • Low thyroid hormone levels (hypothyroidism)
  • Fluid Retention
  • Changes in calcium levels in the blood
  • Worsening of other health conditions

Summary for Elestrin

Prescription only

Elestrin (estradiol gel) is a hormone replacement therapy used to relieve menopausal symptoms like hot flashes and night sweats. It comes as a pump bottle, and the dose is applied to the skin on your upper arm once a day. The gel is only available as a brand-name medication because there is no generic version. Common side effects include breast tenderness, abnormal vaginal bleeding, and upper respiratory infections.

Indications for Elestrin

Pros and Cons for Elestrin

Pros

  • Relieves bothersome menopausal symptoms, such as hot flashes and night sweats
  • Starts at a lower estrogen dose compared to other estrogen gel pumps
  • Applied directly to the skin on your upper 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 Elestrin

  • Common cold symptoms (9-10%)
  • Abnormal vaginal bleeding (4-9%)
  • Breast tenderness (7-8%)
  • Upper respiratory tract infection (4-6%)

Warnings for Elestrin

  • 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

Prices with our coupons for Premarin vs. Elestrin

Price Card Drug Icon
Premarin Vaginal Cream1 tube / 30g of 0.625mg/g
$236.65$570.98
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Price Card Drug Icon
Elestrin1 package / 2 gel pumps of 35g
$205.92$315.45
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