Key takeaways
Premarin (conjugated estrogens) and Divigel (estradiol) are both estrogen replacement medications used to treat menopausal symptoms, such as hot flashes and night sweats. However, they differ in several ways. Premarin is an oral tablet with no generic version available, while Divigel is a topical gel that comes in both brand-name and generic forms. Premarin is also used for other conditions, such as low estrogen levels, certain cancers, and osteoporosis prevention, whereas Divigel is only approved for menopausal symptoms. Premarin can be taken daily or in cycles, with doses ranging from 0.3 mg to 10 mg daily depending on the condition. Divigel is applied once daily to the upper thigh, with doses ranging from 0.25 grams to 1.25 grams. Common side effects of Premarin include headache, stomach pain, and nausea, while Divigel may cause breast tenderness and vaginal yeast infections. Additionally, Divigel has a risk of transferring estrogen to others through skin contact, which is not a concern with Premarin. Both medications share a risk of causing certain cancers, blood clots, and strokes. And in most cases you'll take a progestin along with them to help reduce the chance of uterine cancer.
