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Compare Prempro vs. Estring

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

Key takeaways

Prempro (conjugated estrogens/medroxyprogesterone acetate) and Estring (estradiol) are both used to treat symptoms of menopause, but they have some key differences. Prempro is an oral medication that combines estrogen and progestin. It treats hot flashes, night sweats, and vaginal dryness. Estring, on the other hand, is a vaginal ring that only contains estrogen and is specifically for vaginal dryness and burning. Unlike Prempro, Estring doesn't treat hot flashes or night sweats. Prempro requires daily dosing, while Estring is replaced every three months, potentially making it more convenient. Both medications carry a higher risk of serious side effects, including certain cancers, blood clots, and stroke. If you have a uterus, you need to take a progestin with Estring to lower the risk of uterine cancer, while Prempro already includes a progestin. Both medications are brand-name only and can be expensive.

  • Prempro
    Estring (estradiol)
  • Prempro
    Estring (estradiol)

  • Summary of Prempro vs. Estring

    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

    Estring (estradiol) is an estrogen vaginal ring used as part of hormone replacement therapy (HRT) to treat moderate-to-severe menopause symptoms in and around the vagina, such as vaginal dryness, burning, and irritation. The ring is inserted into the vagina and stays in place for 3 months, releasing a steady dose of estrogen directly where it's needed. Common side effects include headache, vaginal discharge, and vaginal yeast infections.

  • Indications of Prempro vs. Estring

    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
    •Vaginal dryness, burning, and irritation due to menopause

  • Pros and Cons of Prempro vs. Estring

    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
    •Can be inserted by you or a healthcare professional
    •Only needs to be changed every 3 months
    •Works directly at the site of application to relieve vaginal symptoms
    Cons
    •Can cause vaginal yeast infections
    •Doesn't treat other menopause symptoms like hot flashes or night sweats
    •Must take a progestin if you have a uterus to lower your risk of uterine cancer

  • Common Side Effects of Prempro vs. Estring

    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
    •Headache (13%)
    •Vaginal discharge (7%)
    •Vaginal yeast infection (6%)
    •Back pain (6%)
    •Vaginal inflammation (5%)
    •Vaginal discomfort or pain (5%)
    •Upper respiratory infection (5%)
    •Vaginal bleeding (4%)
    •Bacterial growth in the vagina (4%)
    •Arthritis (4%)
    •Trouble sleeping (4%)
    •Stomach pain (4%)
    •Sinus inflammation (4%)
    •Nausea (3%)
    •Flu-like symptoms (3%)
    •Joint pain (3%)

  • Warnings of Prempro vs. Estring

    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 for blood clots and related complications
    •Risk for uterine cancer (also called endometrial cancer)
    •Risk for breast cancer
    •Risk for ovarian cancer
    •Risk for dementia
    •Gallbladder or liver problems in certain people
    •High triglyceride (fat) levels
    •Changes in calcium levels in certain people
    •Low thyroid hormone levels
    •Buildup of fluids in your body (fluid retention)
    •Worsening of certain other health conditions
    •Vaginal irritation and infections

  • Prices with our coupons for Prempro vs. Estring

    Learn more about Prempro
    Learn more about Estring

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