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Compare Prempro vs. Evamist

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

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.

  • Prempro
    Evamist (estradiol)
  • Prempro
    Evamist (estradiol)

  • Summary of Prempro vs. Evamist

    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

    Evamist (estradiol) is a topical hormone spray that helps relieve the hot flashes and night sweats caused by menopause. It's a hormone replacement therapy (HRT) that's sprayed onto the skin of your inner forearm once a day. The typical dose ranges from 1 to 3 sprays daily, depending on your symptoms. Some potential side effects of this medication include headache, tender breasts, and back pain.

  • Indications of Prempro vs. Evamist

    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
    •Moderate-to-severe vasomotor symptoms of menopause, like hot flashes and night sweats

  • Pros and Cons of Prempro vs. Evamist

    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
    •Dries within 2 minutes, doesn't need to be rubbed in
    •Possible option if you can't swallow pills
    •Only needs to be applied once a day
    Cons
    •Raises your risk of certain cancers, blood clots, and strokes
    •Need to use with progestin to lower your risk of uterine cancer (in females who have uterus)
    •Must cover with clothing to prevent exposure to others

  • Common Side Effects of Prempro vs. Evamist

    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 (up to 12%)
    •Breast tenderness (up to 7%)
    •Nipple pain (up to 7%)
    •Cold-like symptoms (up to 5%)
    •Back pain (up to 5%)
    •Joint pain (up to 4%)

  • Warnings of Prempro vs. Evamist

    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 or endometrial cancer
    •Breast cancer
    •Blood clots, heart attacks, and strokes
    •Risk of dementia
    •Risk of harm in children (accidental contact with medication)
    •Gallbladder problems
    •Higher risk of side effects
    •Vision problems
    •High triglycerides
    •Changes in calcium levels in the blood
    •Low thyroid hormone levels (hypothyroidism)
    •Swelling from fluids
    •Worsening of other medical conditions

  • Prices with our coupons for Prempro vs. Evamist

    Learn more about Prempro
    Learn more about Evamist

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