Compare Estradiol Norethindrone vs. Divigel

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

Activella
(Estradiol / Norethindrone)

Divigel
(Estradiol Gel)

Relieves menopause symptoms and lowers your risk of osteoporosis. Activella (Estradiol / Norethindrone) is effective at treating symptoms related to menopause and preventing bone loss. The estrogen/progestin combo is a good options for women with an intact uterus.Relieves hot flashes due to menopause. Divigel (Estradiol Gel) comes in 3 different strengths. It uses lower doses of estrogen than other hormone replacements and is easy to use and apply.
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Side effects
Estradiol NorethindroneDivigel
  • Excessive vaginal bleeding 14%
  • Injury accidental 13%
  • Endometrial thickening 6%
  • Back pain 6%
  • Sinus inflammation 5%
  • Common cold 3%
  • Headache 3%
  • Weight increase 3%
  • "stomach flu" 2%
  • Other events 2%
More Estradiol Norethindrone side effects »
  • Metrorrhagia 8%
  • Breast tenderness 7%
  • Ear, nose, or throat infection 4%
  • Vaginal mycosis 3%
  • Common cold 2%
More Divigel side effects »
How it works
Estradiol NorethindroneDivigel
Activella (Estradiol / Norethindrone) contains two hormones that work to balance hormone changes in your body during and after menopause. Estradiol (an estrogen) reduces hot flashes and night sweats and prevents bone loss, but can also harm cells in the uterus after menopause. Norethindrone (a progestin) protects the uterus from damage.Divigel (Estradiol Gel) replaces estrogen hormones in your vagina that your body loses during menopause. Estrogen helps relieve symptoms of menopause, such as hot flashes, night sweats, and vaginal problems.
Type of medication
Estradiol NorethindroneDivigel
Hormone replacement
Estrogen
Progestin
Prescription only
Hormone replacement
Estrogen derivative
Prescription only
Available as
Estradiol NorethindroneDivigel
  • Pill
  • Cream, gel, or ointment
Used for (click to learn more)
Estradiol NorethindroneDivigel
  • Hot flashes and night sweats
  • Hot flashes and night sweats
Risk factors for serious side effects
Estradiol NorethindroneDivigel
  • Using estrogen for more than one year
  • Personal or family history of breast cancer
  • Duration of use
  • Personal or family history of blood clots
  • Obesity
  • Systemic lupus erythematosus (SLE)
  • Women of childbearing age
  • High levels of triglycerides
  • Family history of ovarian cancer
Detailed Activella (Estradiol / Norethindrone) risks & warnings »
  • Using estrogen for more than one year
  • Personal or family history of breast cancer
  • Duration of use
  • Personal or family history of blood clots
  • Obesity
  • Systemic lupus erythematosus (SLE)
  • Smoking
  • Obesity
  • High blood pressure
  • High blood sugar
  • High cholesterol
  • Age 50 or older
  • Women of childbearing age
    Detailed Divigel (Estradiol Gel) risks & warnings »
    Pregnancy category
    Estradiol NorethindroneDivigel
    XFDA pregnancy category (Unsafe)

    Research studies with real people or animals found harmful effects on unborn babies. If you’re pregnant, the risks to your unborn baby outweigh the benefits.

    See the FDA package insert
    XFDA pregnancy category (Unsafe)

    Research studies with real people or animals found harmful effects on unborn babies. If you’re pregnant, the risks to your unborn baby outweigh the benefits.

    See the FDA package insert
    Alcohol
    No specific alcohol-related info.
    • The gel is alcohol-based and flammable, so you shouldn't smoke while applying it.
    Food
    No specific food-related info.No specific food-related info.
    Kidneys and liver
    No specific kidneys and liver-related info.No specific kidneys and liver-related info.
    Sex
    No specific sex-related info.No specific sex-related info.
    Sleep
    No specific sleep-related info.No specific sleep-related info.
    Weight
    No specific weight-related info.No specific weight-related info.
    Upsides and benefits
    Estradiol NorethindroneDivigel
    • Activella (Estradiol / Norethindrone) replenishes estrogen to your whole body and relieves multiple symptoms due to low estrogen (hot flashes, night sweats, vaginal dryness).
    • Good choice for women with intact uterus. The norethindrone (a progestin) protects against the risk of cancer in the uterus from estrogen treatment.
    • Lowers your risk of fractures by keeping your bones healthy. Make sure you also get enough calcium and Vitamin D.
    • Mimvey brand is less expensive than other estrogen/progestin combination medicines.
    • Improves mood, energy, and mental alertness for some people.
    • Divigel (Estradiol Gel) replenishes estrogen to your whole body and relieves multiple symptoms due to low estrogen (hot flashes, vaginal dryness).
    • Good for people who don't want to take daily pills.
    • The pre-measured packets are easy to use and can be taken anywhere.
    • Fewer side effects than pills since there are lower amounts of estrogen in topical gels.
    • In studies, when people used low doses of Divigel (Estradiol Gel), their symptoms started to improve in 5 weeks and they felt continued improvement over 8 to 12 weeks. People using the highest doses of Divigel (Estradiol Gel) felt better in just 2 weeks.
    • Divigel (Estradiol Gel) is available in 3 strengths.
    • Very few women (less than 1%) had skin irritation from the medicine.
    • Can lower your risk of fractures by keeping your bones healthy. Make sure you also get enough calcium and Vitamin D.
    • Improves mood, energy, and mental alertness for some people.
    Downsides and risks
    Estradiol NorethindroneDivigel
    • More potential side effects since it exposes your whole body to two hormones, estrogen and norethindrone (a progestin).
    • You may get irregular bleeding and spotting that can last a few months to a year.
    • Increases your risk of developing blood clots and stroke.
    • Increases your risk of endometrial and breast cancer.
    • If you have your uterus, you have to use Divigel (Estradiol Gel) with another hormone called progestin to lower your risk of uterine cancer.
    • Can't be used in people with liver problems.
    • It's possible to expose other people to the estrogen before it's absorbed by your skin.
    • Can be expensive since it's only available as a brand name product.
    • Increases your risk of developing blood clots and stroke.
    Tips from our pharmacists for people taking the medication
    Estradiol NorethindroneDivigel
    • Shouldn't be used forever. Talk to your doctor regularly to see if you still need treatment.
    • Can cause nausea, dizziness, bloating, and breast tenderness.
    • Tell your doctor about any unusual vaginal bleeding.
    • Get emergency care if you notice unexplained swelling and pain in your limbs, shortness of breath, chest pain, severe headache, or changes in vision.
    • Apply all of the gel in the packet to dry, clean, unbroken skin on the right or left upper thigh, alternating each day.
    • Don't put it on your face, breasts, vagina, or irritated skin.
    • Don't rub it in. Let the gel dry before dressing, and don't wash the application site for at least an hour.
    • Wash your hands well after applying the gel.
    • The gel is alcohol-based and flammable, so you shouldn't smoke while applying it.
    • Can cause nausea, dizziness, bloating, and breast tenderness.
    • Tell your doctor about any unusual vaginal bleeding.
    • Get emergency care if you notice unexplained swelling and pain in your limbs, shortness of breath, chest pain, severe headache, or changes in vision.
    Learn more
    More about Estradiol NorethindroneSide effectsReviews & ratingsAlternativesFDA package insert
    More about DivigelSide effectsReviews & ratingsAlternativesFDA package insert