Premarin vs. Climara for Osteoporosis and Menopause: Important Differences and Potential Risks.

Key takeaways

Premarin (conjugated estrogens) and Climara (estradiol) are both estrogen replacement therapies used to treat menopausal symptoms like hot flashes and vaginal dryness, but they have some key differences. Premarin is an oral tablet, while Climara is a transdermal patch that you apply to your skin. Premarin can also be used to treat low estrogen levels due to other conditions and certain cancers in advanced stages, whereas Climara is also used to treat low estrogen levels due to genetic conditions. Premarin and Climara can both be taken for osteoporosis prevention, but they are usually not the first choice. Premarin is taken daily or in cycles, while Climara is applied once or twice a week. Both medications can cause headaches and weight gain and increase the risk of certain cancers, blood clots, and strokes. If you have a uterus, you will need to take an additional hormone called progestin with both medications to lower the risk of uterine cancer.

Premarin

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Climara

(estradiol patch)

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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

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

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 Climara

Prescription only

The Climara (estradiol patch) is a once-weekly hormonal patch that relieves menopause symptoms and treats low estrogen levels. It can also help prevent bone loss (osteoporosis) in people who have gone through menopause. The patch is a type of hormone replacement therapy (HRT) and typically has fewer side effects than oral estrogen pills. You'll apply one patch to the skin of your lower stomach or the upper buttocks once a week. Potential side effects of this hormone patch include breast pain, headaches, and stomach pain.

Indications for Climara

Hot flashes, night sweats, and flushes caused by menopause
Vaginal dryness and irritation caused by menopause
Low estrogen levels due to certain conditions
Prevention of osteoporosis after menopause

Pros and Cons for Climara

Pros

Relieves multiple menopause symptoms
Only need to apply once a week
Might have fewer side effects than oral estrogen pills
Available in different strengths, allowing you to customize your dose

Cons

Commonly causes breast pain, headaches, and stomach pain
Can cause skin irritation, redness, and itchiness at the patch site
Raises your risk of certain cancers, blood clots, and strokes
Might need to take it with another hormone called progestin if you have a healthy uterus