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Vivelle-Dot vs. Estring

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

Key takeaways

Climara (estradiol) and Estring (estradiol) are both estrogen replacement therapies, but they differ in their forms and uses. Climara is a transdermal patch applied to the skin once or twice a week, while Estring is a vaginal ring that you replace every three months. Climara treats multiple menopause symptoms, including hot flashes and night sweats, and can also help prevent osteoporosis. In contrast, Estring specifically targets vaginal symptoms like dryness and burning. Climara may require you to avoid swimming if you use the once-weekly patch, whereas Estring does not have such restrictions. Additionally, Climara is available in multiple strengths, allowing for dose customization, while Estring is only available in one strength. Both treatments carry risks of serious side effects, such as blood clots and certain cancers, but Estring might not require a progestin if used at a low dose.

Vivelle-Dot

(estradiol patch)

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Estring

(estradiol)

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Summary for Vivelle-Dot

Prescription only

Vivelle-Dot (estradiol patch) is a twice-weekly hormonal patch used to treat menopause symptoms and low estrogen levels. It also helps prevent bone loss (osteoporosis) in people who have gone through menopause. The patch is a form of hormone replacement therapy. The usual dose is one patch applied to the lower stomach or buttocks twice a week, or every 3 to 4 days. Side effects include headache, breast pain, and sinus swelling.

This twice weekly patch is also available as a generic called Dotti.

Indications for Vivelle-Dot

Pros and Cons for Vivelle-Dot

Pros

  • Typically has fewer side effects than oral estrogen pills
  • Relieves multiple menopause symptoms
  • Good option if you have trouble swallowing pills
  • Available in different strengths, allowing you to customize your dose

Cons

  • Commonly causes headache, breast pain, and sinus swelling
  • Need to apply a new patch twice a week
  • Raises your risk of certain cancers, blood clots, and strokes
  • Might need to take it with another hormone called progestin if you have a healthy uterus

Common Side Effects for Vivelle-Dot

  • Headache (up to 50%)
  • Common cold symptoms (up to 20%)
  • Breast tenderness (up to 17%)
  • Sinus swelling (up to 13%)
  • Bleeding in-between periods (up to 11%)
  • Depression (up to 11%)
  • Back pain (up to 11%)
  • Sinus headache (up to 10%)
  • Indigestion (up to 9%)
  • Weight gain (up to 9%)
  • Joint pain (up to 9%)

Warnings for Vivelle-Dot

  • Blood clots and related complications (e.g., heart attack, stroke)
  • Uterine (endometrial) cancer
  • Breast cancer
  • Ovarian cancer
  • Dementia
  • Gallbladder and liver problems
  • Vision problems
  • High triglycerides
  • Low thyroid hormone levels (hypothyroidism)
  • Fluid Retention
  • Severe allergic reactions
  • Worsening of other health conditions

Summary for Estring

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 for Estring

Pros and Cons for Estring

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

Common Side Effects for Estring

  • 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 for Estring

  • 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 Vivelle-Dot vs. Estring

Price Card Drug Icon
Estradiol3 cartons / 8 twice-weekly patches of 0.05mg/day
$84.47$98.07
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Price Card Drug Icon
Estring1 ring / 2mg
$249.00$683.02
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