Compare Estradiol Norethindrone vs. Evamist

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

Activella
(estradiol / norethindrone)

Evamist
(estradiol spray)

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. Evamist (Estradiol Spray) is easy to use, absorbs well into your skin without needing to rub it in, and is a good option if you don’t want to use estrogen pills or patches.
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Reviews & ratings
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Reviews for Activella (estradiol / norethindrone)
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of people (All ages) say Activella (estradiol / norethindrone) is worth it
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say it works well
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say it's a big hassle
Have you used Activella (estradiol / norethindrone)?
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Reviews for Evamist (estradiol spray)
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Same vs. Activella (estradiol / norethindrone)
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Same vs. Activella (estradiol / norethindrone)
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Same vs. Activella (estradiol / norethindrone)
Have you used Evamist (estradiol spray)?
Worth itNot sureNot worth it
Side effects
Estradiol NorethindroneEvamist
  • Breast pain 24%
  • Ear, nose, or throat infection 18%
  • Headache 16%
  • Sinus inflammation 7%
  • Sleep difficulty 6%
  • Back pain 6%
  • Post-menopausal bleeding 5%
  • Uterine fibroid 5%
  • Infection viral 4%
  • Moniliasis genital 4%
More Estradiol Norethindrone side effects »
  • Headache 3%
  • Breast tenderness 4%
  • Nasopharyngitis (common cold) 3%
  • Nipple pain 2%
  • Back pain 1%
  • Nausea 1%
  • Arthralgia (joint pain) 3%
More Evamist side effects »
How it works
Estradiol NorethindroneEvamist
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.Evamist (Estradiol Spray) 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 NorethindroneEvamist
Prescription only
Prescription only
Available as
Estradiol NorethindroneEvamist
  • Pill
  • Spray
Used for
Estradiol NorethindroneEvamist
  • Hot Flashes And Night Sweats
  • Hot Flashes And Night Sweats
Risk factors for serious side effects
Estradiol NorethindroneEvamist
  • 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
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
Detailed Evamist (estradiol spray) risks & warnings »
Pregnancy

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.

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.

Alcohol
Estradiol NorethindroneEvamist
No alcohol related info.
  • The spray is alcohol-based and flammable, so you shouldn't smoke while applying it.
Weight
Estradiol NorethindroneEvamist
  • Can cause nausea, dizziness, bloating, and breast tenderness.
  • Activella (Estradiol / Norethindrone) is a mixture of estrogen and progestin. It could cause a higher risk of ovarian cancer, especially if you have a family history of it. Your doctor can help you weigh the risks versus the benefits of this medication.
  • Can cause nausea, dizziness, bloating, and breast tenderness.
Upsides and benefits
Estradiol NorethindroneEvamist
  • 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.
  • Improves mood, energy, and mental alertness for some people.
  • Mimvey brand is less expensive than other estrogen/progestin combination medicines.
  • Evamist (Estradiol Spray) replenishes estrogen to your whole body and relieves multiple symptoms due to low estrogen (hot flashes, vaginal dryness, low energy).
  • Dries faster than topical estrogen gels.
  • Good for people who don't want to take daily pills.
  • Fewer side effects than pills since lower amounts of estrogen are used in topical sprays.
  • Women in studies have seen the severity and number of hot flashes lower by half within 4 weeks of using Evamist (Estradiol Spray).
  • Very few women had skin irritation from the medicine.
  • Depending on your symptoms, your dose may change, but you can still use the same spray pump no matter what your dose is.
  • Can lower your risk of fractures by keeping your bones healthy. Make sure you also get enough calcium and Vitamin D.
Downsides and risks
Estradiol NorethindroneEvamist
  • More potential side effects since it exposes your whole body to two hormones, estrogen and norethindrone (a progestin).
  • Increases your risk of developing blood clots and stroke.
  • You may get irregular bleeding and spotting that can last a few months to a year.
  • Increases your risk of endometrial and breast cancer.
  • If you have your uterus, you have to use Evamist (Estradiol Spray) with another hormone called progestin to lower your risk of uterine cancer.
  • Increases your risk of developing blood clots and stroke.
  • 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.
Tips from our pharmacists for people taking the medication
Estradiol NorethindroneEvamist
  • 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.
  • Spray with the container upright and the cone flat against your skin on the inside of your forearm. If more than one spray is needed, always use a different area on your forearm.
  • Don't put it on your face, breasts, vagina, or irritated skin.
  • Don't rub it in. Let the spray dry for about 2 minutes before dressing, and don't get the application site wet for at least 1 hour.
  • 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.
  • The spray is alcohol-based and flammable, so you shouldn't smoke while applying it.
Learn more
More about Estradiol NorethindroneSide effectsReviews & ratingsAlternativesFDA package insert
Have you used Activella (estradiol / norethindrone)?
Worth itNot sureNot worth it
More about EvamistSide effectsReviews & ratingsAlternativesFDA package insert
Have you used Evamist (estradiol spray)?
Worth itNot sureNot worth it