Key takeaways
Prempro (conjugated estrogens/medroxyprogesterone) and Evamist (estradiol) are both used to relieve menopausal symptoms like hot flashes and night sweats, but they have some key differences. Prempro is a combination of estrogen and progestin taken orally, while Evamist is a topical spray that only contains estrogen. Prempro also helps prevent bone loss and protects the uterus from damage. Prempro has a broader range of side effects, including stomach pain and menstrual cramps, as well as more severe risks like blood clots and certain cancers. Evamist, on the other hand, generally has milder side effects, but it still raises the risk of cancers and blood clots. Additionally, Evamist can cause early puberty in children if it is transferred through skin contact. Evamist needs to be used with a progestin if you have a uterus to lower the risk of uterine cancer, while Prempro already includes a progestin. Both medications are only available as a brand-name medication.
