Compare Estring vs. Divigel

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

Estring
(Estradiol Vaginal Ring)

Divigel
(Estradiol Gel)

Relieves vaginal dryness due to menopause. Estring (Estradiol Vaginal Ring) is a vaginal ring that may be less of a hassle than estrogen pills, gels, patches, or vaginal creams, but comes with the same side effects.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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Reviews & ratings
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4.4Estring
Reviews for Estring (Estradiol Vaginal Ring)
62%
of people say Estring (Estradiol Vaginal Ring) is worth it
40%
say it works well
18%
say it's a big hassle

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Side effects
EstringDivigel

The Estring FDA package insert doesn’t have numbers about how common side effects are.

More about Estring 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
EstringDivigel
Estring (Estradiol Vaginal Ring) is a vaginal ring that replaces estrogen hormones in your vagina that your body loses during menopause. Estrogen helps rebuild and maintain vaginal tissue, relieving symptoms of vaginal dryness, soreness, irritation, and painful sex.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
EstringDivigel
Hormone replacement
Estrogen derivative
Prescription only
Hormone replacement
Estrogen derivative
Prescription only
Available as
EstringDivigel
  • Vaginal ring
  • Cream, gel, or ointment
Used for (click to learn more)
EstringDivigel
  • Vaginal dryness and inflammation
  • Hot flashes and night sweats
Risk factors for serious side effects
EstringDivigel
  • 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
  • High levels of triglycerides
Detailed Estring (Estradiol Vaginal Ring) 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
    EstringDivigel
    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
    • Estring (Estradiol Vaginal Ring) relieves vaginal dryness and irritation to make sex more enjoyable.
    • You don’t have to remove Estring (Estradiol Vaginal Ring) to treat a vaginal infection or have sex.
    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
    EstringDivigel
    • Estring (Estradiol Vaginal Ring) relieves vaginal dryness and irritation to make sex more enjoyable.
    • Works locally in the vagina and doesn't expose the rest of your body to estrogen like pills do.
    • Good option for people who don't want to take oral pills.
    • Generally works well with fewer side effects.
    • Many women think Estring (Estradiol Vaginal Ring) is easy to insert and comfortable to use.
    • In a 12-week study, Estring (Estradiol Vaginal Ring) worked well to improve vaginal problems, reduced pain during urination, and sudden urges to urinate.
    • Estring (Estradiol Vaginal Ring) slowly releases estrogen over the 90 days the ring is in place, so you only have to remove and insert a new one every three months.
    • 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
    EstringDivigel
    • Estring (Estradiol Vaginal Ring) may not be the best estrogen product if you have a narrow vagina or frequent vaginal infections.
    • The ring can fall out without you noticing it.
    • Increases your risk of endometrial (uterine cancer).
    • If you have your uterus, you might need to use Estring (Estradiol Vaginal Ring) with another hormone called progestin to lower your risk of uterine cancer.
    • Can be expensive since it's only available as a brand name product.
    • 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.
    • 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
    EstringDivigel
    • Insert the ring as deeply as possible into your vagina. You shouldn't feel the ring once it's inserted.
    • The ring is good for 90 days in your vagina. If it falls out before the 90 days are up, just clean it with warm water and reinsert.
    • You don’t have to remove Estring (Estradiol Vaginal Ring) to treat a vaginal infection or have sex.
    • It can take up to 2 to 3 weeks to feel the full benefits.
    • Most people don't have many side effects, but temporary nausea, dizziness, bloating, and breast tenderness are possible.
    • Tell your doctor about any unusual vaginal bleeding.
    • 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.
    • Get emergency care if you notice unexplained swelling and pain in your limbs, shortness of breath, chest pain, severe headache, or changes in vision.
    • Tell your doctor about any unusual vaginal bleeding.
    Learn more
    More about EstringSide effectsReviews & ratingsAlternativesFDA package insert
    More about DivigelSide effectsReviews & ratingsAlternativesFDA package insert