Key takeaways
Prempro (conjugated estrogens/medroxyprogesterone) and Estrace (estradiol) are both used to treat menopausal symptoms, but they have some key differences. Prempro is a combination of estrogen and progestin, taken orally, and is used to relieve hot flashes, night sweats, and vaginal dryness, as well as to prevent osteoporosis. Estrace, on the other hand, is a vaginal cream that contains only estradiol, a form of estrogen, and is specifically used to treat vaginal symptoms like dryness and itching. Prempro is taken daily, while Estrace is applied daily at first and then reduced to a few times a week. Prempro has no generic version and can be expensive, whereas Estrace is available as a lower-cost generic. Both medications carry risks of serious side effects, such as cancer and blood clots, but Estrace has a lower risk of these issues because it is applied locally rather than taken systemically.
