Key takeaways
Premarin (conjugated estrogens) and Estrace (estradiol) are both estrogen replacement therapies, but they have some key differences. Premarin is available as an oral tablet and is used to treat a variety of conditions, including menopausal symptoms, low estrogen levels due to other conditions, and certain cancers in advanced stages. It is also used to prevent osteoporosis, but it is not the first choice. In contrast, Estrace is a vaginal cream specifically used to treat vaginal symptoms of menopause, such as dryness and itching. Premarin contains a mixture of different estrogens derived from the urine of pregnant horses, while Estrace contains man-made estradiol, a form of estrogen naturally found in the body. Premarin can be taken daily or in cycles, whereas Estrace is typically applied daily for a few weeks and then reduced to a few times a week. Both medications carry risks of serious side effects like certain cancers, blood clots, and strokes, but Estrace has a lower risk of these issues because it is applied locally, limiting the amount of estrogen the body absorbs. Additionally, Estrace is available as a lower-cost generic, while Premarin is only available as a brand-name medication.
