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Compare Premarin 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
    Activella (estradiol / norethindrone)
  • Premarin
    Activella (estradiol / norethindrone)

  • Summary of Premarin vs. Activella

    Summary for Estrogen replacement
    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.

    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 vs. Activella

    Indications for
    •Hot flashes, night sweats, and flushes caused by menopause
    •Vaginal dryness caused by menopause
    •Low estrogen levels due to certain conditions
    •Certain advanced stages of breast cancer
    •Certain advanced stages of prostate cancer
    •Prevention of bone loss (osteoporosis) after 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 vs. Activella

    Pros and Const for Estrogen replacement
    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
    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 vs. Activella

    Common Side Effects for
    •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%)
    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 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 vs. Activella

    Learn more about Premarin
    Learn more about Activella

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