Provera vs. Divigel for Endometriosis and Menopause: Important Differences and Potential Risks.

Key takeaways

Medroxyprogesterone (Provera) and estradiol (Divigel) are both hormone therapy medications, but they belong to different drug classes and have important differences. Medroxyprogesterone is a progestin used to regulate menstrual cycles and protect the uterus in postmenopausal women taking estrogen. Estradiol, on the other hand, is an estrogen replacement used to treat menopausal symptoms like hot flashes and night sweats. While medroxyprogesterone is taken orally, estradiol is applied topically as a gel. Medroxyprogesterone is available as a lower-cost generic, while estradiol is only available as a brand-name medication. Common side effects of medroxyprogesterone include spotting, breast tenderness, and nausea, while estradiol can cause vaginal yeast infections and breast tenderness. Both medications carry risks of blood clots and certain cancers, especially when used together. Estradiol also has a risk of transferring the medication to others through skin-to-skin contact, since it is applied topically.

Medroxyprogesterone

(Provera)

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Estradiol gel

(Divigel)

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Summary for Provera

Prescription only

Medroxyprogesterone (Provera) can help make your menstrual cycles more regular. It also helps protect the uterus from harm in people who've gone through menopause and are taking estrogen replacement medications. When taken with estrogen therapy, it has some serious risks that you should consider if you need treatment for a long time.

Indications for Provera

Lack of menstrual periods due to hormone imbalance
Irregular periods due to hormone imbalance
Protection of the uterus in postmenopausal women who are taking estrogen medications

Pros and Cons for Provera

Pros

Taken once a day
Helps protect the uterus from damage if taking estrogen medications after menopause
A good alternative to progesterone (Prometrium) if you have a peanut allergy

Cons

Need to remember to take on certain days of the month
Can have spotting or breakthrough bleeding, even if you've gone through menopause
Shouldn't be used in people with liver problems

Common Side Effects for Provera

Spotting or breakthrough bleeding
Heavier or lighter periods
Breast tenderness
Nausea

Warnings for Provera

When taken with estrogen medications:
Blood clots and their complications (heart attack, stroke)
Breast cancer
Dementia
Uterine and ovarian cancer
Vision problems
Higher blood pressure and cholesterol levels
Swelling (fluid buildup)

Summary for Divigel

Prescription only

Estradiol gel (Divigel) is a hormone replacement therapy used to treat symptoms of menopause, such as hot flashes and night sweats. It comes as single-use packets, and the dose is applied to the skin on your upper thigh once a day. The gel is available as both a brand-name and a generic medication. Common side effects include vaginal yeast infections, breast tenderness, and abnormal vaginal bleeding.

Indications for Divigel

Hot flashes and night sweats due to menopause

Pros and Cons for Divigel

Pros

Relieves bothersome menopausal symptoms, such as hot flashes and night sweats
Applied directly to the skin on the thighs
Only need to use once a day
Available in multiple strengths to customize your dose

Cons

Raises your risk of certain cancers, blood clots, and strokes
Risk of exposing others to estrogen through skin contact
Might also need to take a progestin medication if you have a uterus
Need to wait for the gel to dry completely before bathing, showering, or swimming