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Compare Prempro vs. Estrace

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

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.

  • Prempro
    Estradiol (Estrace) vaginal cream
  • Prempro
    Estradiol (Estrace) vaginal cream

  • Summary of Prempro vs. Estrace

    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 (Estrace) vaginal cream is used to lessen certain symptoms related to menopause, such as vaginal itching and dryness. It's a hormone replacement therapy that's made of estradiol, a form of estrogen. Estradiol (Estrace) vaginal cream is applied vaginally with an applicator. Typically, your gynecologist or healthcare professional (HCP) will prescribe it daily for a few weeks, and then lower the dose to a few times a week after that. Some side effects of estradiol (Estrace) vaginal cream include vaginal burning and irritation.

  • Indications of Prempro vs. Estrace

    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
    •Treatment of vaginal itching, dryness, and burning due to menopause

  • Pros and Cons of Prempro vs. Estrace

    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
    •Only need to use it 1 to 3 times per week after your symptoms improve
    •Applied directly to the vagina where symptoms are occurring
    •Available as a lower-cost generic
    Cons
    •Might be challenging and uncomfortable to use
    •Raises your risk for certain cancers, blood clots, and strokes
    •Some people might need to take it with another hormone called progestin

  • Common Side Effects of Prempro vs. Estrace

    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
    •Application site burning and irritation
    •Breast pain or tenderness
    •Headache
    •Irregular vaginal bleeding or spotting
    •Nausea or vomiting
    •Bloating
    •Hair loss
    •Vaginal yeast infection

  • Warnings of Prempro vs. Estrace

    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
    •Uterine (endometrial) cancer
    •Breast cancer
    •Blood clots and strokes
    •Heart disease and heart attacks
    •Dementia
    •Gallbladder and liver problems
    •Changes in calcium levels in the blood
    •Vision problems
    •High triglycerides
    •Low thyroid hormone levels (hypothyroidism)
    •Fluid retention (edema)
    •Worsening of other health conditions

  • Prices with our coupons for Prempro vs. Estrace

    Learn more about Prempro
    Learn more about Estradiol

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