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Compare Premarin Vaginal Cream vs. Activella

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

Key takeaways

Premarin vaginal cream (conjugated estrogens) and Activella (estradiol/norethindrone) are both used to treat symptoms of menopause, but they have some key differences. Premarin vaginal cream is applied directly into the vagina and is specifically used for vaginal symptoms like dryness and pain during sex. In contrast, Activella is an oral tablet that treats a broader range of menopausal symptoms, including hot flashes, night sweats, and vaginal dryness, and also helps prevent bone loss. Premarin is only available as a brand-name medication, while Activella has generic versions. Premarin works by replacing estrogen locally in the vagina, whereas Activella combines estrogen and progestin to balance hormonal changes throughout the body. Both medications can cause side effects like breast pain and headaches, but Activella has a higher risk of causing blood clots, heart attacks, and strokes. Additionally, Premarin can be messy to apply and requires careful adherence to dosing cycles, while Activella is taken once daily.

  • Premarin vaginal cream
    Activella (estradiol / norethindrone)
  • Premarin vaginal cream
    Activella (estradiol / norethindrone)

  • Summary of Premarin Vaginal Cream vs. Activella

    Summary for Estrogen replacement
    Prescription only

    Premarin (conjugated estrogens) vaginal cream is an estrogen hormone cream used to treat adults with vaginal symptoms due to menopause, such as vaginal dryness and pain during sex. Depending on what you're taking the vaginal cream for, the dosage can be different. You might apply it in cycles (daily for 3 weeks, then no cream for 1 week) or simply just twice a week. Common side effects include headache, pelvic pain, and breast pain.

    Summary for Estrogen replacement / Progestin
    Prescription only

    Activella is a combination hormone replacement therapy (HRT) that contains estradiol (an estrogen) and norethindrone (a progestin). It's used to treat certain symptoms of menopause, such as night sweats and vaginal dryness, related to low estrogen levels. It can also help prevent bone loss (osteoporosis) in females who've reached menopause. The typical dose is 1 tablet by mouth once daily. Some side effects of this medication include breast pain and headache. Activella (estradiol / norethindrone), as well as other HRTs, isn't recommended for people who've had breast cancer. <br> Activella is a brand-name medication. It also comes as a generic and branded generics, such as Mimvey.

  • Indications of Premarin Vaginal Cream vs. Activella

    Indications for
    •Vaginal dryness and irritation
    •Pain during sex caused by menopause
    Indications for

    In females who have a healthy uterus:

    •Moderate-to-severe vasomotor symptoms (VMS) of menopause, like hot flashes and night sweats
    •Moderate-to-severe symptoms of vulvar and vaginal atrophy, like vaginal dryness
    •Prevention of osteoporosis in females who've reached menopause

  • Pros and Cons of Premarin Vaginal Cream vs. Activella

    Pros and Const for Estrogen replacement
    Pros
    •Is applied directly into the vagina to relieve symptoms locally
    •Good option if for those who have trouble swallow pills
    •Smaller amounts are absorbed into the body compared to tablets or injections
    Cons
    •Applying the cream can be messy
    •Need to remember stop taking it for a week if your dosage is in cycles
    •Can take several weeks to improve symptoms
    Pros and Const for Estrogen replacement / Progestin
    Pros
    •Taken by mouth once daily
    •Includes a progestin to protect against endometrial cancer
    •Available as a lower-cost generic medication
    Cons
    •Raises your risk of blood clots, heart attack, and stroke
    •Not for people who've had breast cancer
    •Not a first-choice option for vaginal symptoms of menopause or for preventing osteoporosis

  • Common Side Effects of Premarin Vaginal Cream vs. Activella

    Common Side Effects for
    •Breast pain (2-5%)
    •Headache (2-4%)
    •Pelvic pain (3%)
    •Vaginal discharge (2-3%)
    Common Side Effects for
    •Breast pain (17-24%)
    •Headache (11-17%)
    •Accidental injury (3-17%)
    •Upper respiratory tract infection, like cough, cold, sore throat, congestion (10-15%)
    •Sinus infection (7-15%)
    •Postmenopausal bleeding (10-11%)
    •Nausea (10-11%)
    •Weight gain (up to 9%)
    •Ovarian cyst (up to 7%)
    •Stomach flu (up to 6%)
    •Viral infection (up to 6%)
    •Vaginal yeast infection (up to 6%)
    •Mood swings (up to 6%)
    •Back pain (3-6%)

  • Warnings of Premarin Vaginal Cream vs. Activella

    Common Side Effects for
    •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
    Common Side Effects for
    •Blood clots, heart attacks, and strokes
    •Breast cancer
    •Uterine or endometrial cancer
    •Dementia
    •Ovarian cancer
    •Liver or gallbladder problems
    •Changes in calcium levels in the blood
    •Vision problems
    •High triglyceride (fat) levels
    •Low thyroid hormone levels
    •Buildup of fluids in your body (fluid retention)
    •Worsening of other medical conditions

  • Prices with our coupons for Premarin Vaginal Cream vs. Activella

    Learn more about Premarin vaginal cream
    Learn more about Activella

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