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Compare Prempro vs. Divigel

Head-to-head comparisons of medication uses, side effects, warnings, and more.

Key takeaways

Prempro (conjugated estrogens/medroxyprogesterone) and Divigel (estradiol) are both used to treat menopausal symptoms, but they have some key differences. Prempro is a combination of estrogen and progestin, taken orally once a day, and is specifically for those with a uterus to prevent uterine cancer. It also helps with hot flashes, night sweats, and vaginal dryness, but it has serious risks like breast cancer and blood clots if used long-term. Divigel, on the other hand, is a topical gel applied to the skin once a day and only contains estrogen. It also treats hot flashes and night sweats, but if you have a uterus, you’ll need to take an additional progestin to lower the risk of uterine cancer. Divigel can be messy to apply and has the risk of transferring estrogen to others through skin contact. Divigel is available as a low-cost generic medication, whereas Prempro is only available as a brand-name medication, making it potentially expensive.

  • Prempro
    Estradiol gel (Divigel)
  • Prempro
    Estradiol gel (Divigel)

  • Summary of Prempro vs. Divigel

    Summary for Estrogen replacement / Progestin
    Prescription only

    Prempro is a combination estrogen/progestin medication that relieves menopausal symptoms like vaginal dryness and hot flashes. It's also used for preventing osteoporosis after menopause. This hormone replacement therapy is an option for people with a uterus. The medication is brand only since there is no generic available. Follow your prescriber's instructions for the correct dose. Prempro is taken by mouth once a day with the same dose each day. Premphase is also taken daily but contains two types of tablets: one with estrogen and one with conjugated estrogens plus medroxyprogesterone, taken on different days. Common side effects include breast pain, headaches, and menstrual cramps.

    Summary for Estrogen replacement
    Prescription only

    Estradiol gel (Divigel) is a hormone replacement therapy used to treat symptoms of menopause, such as hot flashes and night sweats. It comes as single-use packets, and the dose is applied to the skin on your upper thigh once a day. The gel is available as both a brand-name and a generic medication. Common side effects include vaginal yeast infections, breast tenderness, and abnormal vaginal bleeding.

  • Indications of Prempro vs. Divigel

    Indications for
    •Moderate-to-severe vasomotor symptoms (VMS) of menopause, like hot flashes and night sweats
    •Moderate-to-severe vaginal symptoms due to menopause, like vaginal dryness and irritation
    •Prevention of bone loss (osteoporosis) after menopause
    Indications for
    •Hot flashes and night sweats due to menopause

  • Pros and Cons of Prempro vs. Divigel

    Pros and Const for Estrogen replacement / Progestin
    Pros
    •Only need to take once a day by mouth
    •Relieves multiple menopausal symptoms
    •Includes a progestin which helps protect your uterus
    •Lowers your risk of fractures by keeping your bones healthy
    Cons
    •Raises your risk of certain cancers, blood clots, and strokes
    •Has more possible side effects than similar alternatives
    •Not safe if you have liver problems
    •Can't be used if you have a history of breast cancer
    Pros and Const for Estrogen replacement
    Pros
    •Relieves bothersome menopausal symptoms, such as hot flashes and night sweats
    •Applied directly to the skin on the thighs
    •Only need to use once a day
    •Available in multiple strengths to customize your dose
    Cons
    •Raises your risk of certain cancers, blood clots, and strokes
    •Risk of exposing others to estrogen through skin contact
    •Might also need to take a progestin medication if you have a uterus
    •Need to wait for the gel to dry completely before bathing, showering, or swimming

  • Common Side Effects of Prempro vs. Divigel

    Common Side Effects for
    •Breast pain (up to 36%)
    •Headaches (up to 19%)
    •Stomach pain (up to 17%)
    •Menstrual cramps (up to 13%)
    •Gas (up to 8%)
    •Nausea (up to 8%)
    •Depression (up to 8%)
    •More vaginal discharge than usual (up to 8%)
    Common Side Effects for
    •Abnormal vaginal bleeding (4-10%)
    •Breast tenderness (3-9%)
    •Common cold symptoms (4-6%)
    •Upper respiratory tract infection (2-6%)
    •Vaginal yeast infection (1-6%)

  • Warnings of Prempro vs. Divigel

    Common Side Effects for
    •Risk of blood clot
    •Breast cancer
    •Uterine (endometrial) cancer
    •Dementia
    •Gallbladder and liver problems
    •Changes in calcium levels in the blood
    •Vision problems
    •High triglycerides
    •Low thyroid hormone levels (hypothyroidism)
    •Fluid Retention
    •Severe allergic reaction
    •Worsening of other medical conditions
    Common Side Effects for
    •Risk of blood clot
    •Uterine (endometrial) cancer
    •Breast cancer
    •Dementia
    •Gallbladder and liver problems
    •Changes in calcium levels in the blood
    •Vision problems
    •High triglycerides
    •Low thyroid hormone levels (hypothyroidism)
    •Fluid Retention
    •Worsening of other medical conditions
    •Potential skin-to-skin transfer

  • Prices with our coupons for Prempro vs. Divigel

    Learn more about Prempro
    Learn more about Estradiol gel

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