Key takeaways
Prempro (conjugated estrogens/medroxyprogesterone) and Vivelle-Dot (estradiol) are both hormone replacement medications used to treat menopause symptoms like hot flashes and vaginal dryness, as well as to prevent bone loss (osteoporosis) after menopause. However, they differ in several ways. Prempro is a combination of estrogen and progestin, taken orally once a day, and is available only as a brand-name medication. In contrast, Vivelle-Dot is an estrogen-only patch applied to the skin twice a week and is available as a generic called Dotti. Prempro includes a progestin, which is important for people with a uterus to help protect against uterine cancer. Vivelle-Dot does not contain a progestin, so if you have a uterus you may need to take progestin separately. Both medications can cause headaches and breast pain or tenderness and increase the risk of serious side effects like blood clots and certain cancers. However, Vivelle-Dot is generally considered to have fewer side effects than oral hormone replacement medications.
