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Prempro vs. Elestrin

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

Key takeaways

Prempro (conjugated estrogens/medroxyprogesterone) and Elestrin (estradiol gel) are both medications used to relieve menopausal symptoms like hot flashes and night sweats. They belong to the estrogen replacement class, but they have some key differences. Prempro can also be used to prevent osteoporosis after menopause and is a combination of estrogen and progestin. Common side effects include breast pain, headaches, and menstrual cramps. Prempro includes a progestin, which is important for people with a uterus to help protect against uterine cancer. Elestrin, on the other hand, is a topical gel applied to the skin once a day and contains only estradiol, a type of estrogen. Both medications are only available in a branded version. Common Elestrin side effects include breast tenderness and abnormal vaginal bleeding. Both medications can increase the risk of blood clots and certain cancers. Elestrin requires careful application to avoid transferring the gel to others through skin contact. If you have a uterus, you might need to take a progestin with Elestrin to protect the uterus.

Prempro

 

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Elestrin

(estradiol gel)

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Summary for Prempro

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.

Indications for Prempro

Pros and Cons for Prempro

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

Common Side Effects for Prempro

  • 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%)

Warnings for Prempro

  • 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

Summary for Elestrin

Prescription only

Elestrin (estradiol gel) is a hormone replacement therapy used to relieve menopausal symptoms like hot flashes and night sweats. It comes as a pump bottle, and the dose is applied to the skin on your upper arm once a day. The gel is only available as a brand-name medication because there is no generic version. Common side effects include breast tenderness, abnormal vaginal bleeding, and upper respiratory infections.

Indications for Elestrin

Pros and Cons for Elestrin

Pros

  • Relieves bothersome menopausal symptoms, such as hot flashes and night sweats
  • Starts at a lower estrogen dose compared to other estrogen gel pumps
  • Applied directly to the skin on your upper arm
  • Only need to use once a day

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 for Elestrin

  • Common cold symptoms (9-10%)
  • Abnormal vaginal bleeding (4-9%)
  • Breast tenderness (7-8%)
  • Upper respiratory tract infection (4-6%)

Warnings for Elestrin

  • 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. Elestrin

Price Card Drug Icon
Prempro1 package / 28 tablets of 0.3mg/1.5mg
$98.84$303.04
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Price Card Drug Icon
Elestrin1 package / 2 gel pumps of 35g
$208.05$315.44
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