Compare Premarin Vaginal Cream vs. Divigel

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

Premarin Vaginal Cream
(Conjugated Estrogens)

Divigel
(Estradiol Gel)

Relieves vaginal dryness and pain due to menopause. Premarin Vaginal Cream (Conjugated Estrogens) works well for vaginal problems caused by menopause, and it has fewer side effects than estrogen pills.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
Premarin Vaginal CreamDivigel
  • Any side effect 8%
  • Abdominal pain 6%
  • Vaginitis 6%
  • Leg cramps 5%
  • Passing gas 4%
  • Thick vaginal discharge 4%
  • Vaginal moniliasis 4%
  • Sinus inflammation 4%
  • Headache 4%
  • Cough increased 3%
More Premarin Vaginal Cream 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
Premarin Vaginal CreamDivigel
Premarin Vaginal Cream (Conjugated Estrogens) is a topical medication that replaces estrogen hormones in the vagina to rebuild vaginal tissue and make vaginal sex more comfortable.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
Premarin Vaginal CreamDivigel
Hormone replacement
Estrogen derivative
Prescription only
Hormone replacement
Estrogen derivative
Prescription only
Available as
Premarin Vaginal CreamDivigel
  • Vaginal cream, gel, or ointment
  • Cream, gel, or ointment
Used for (click to learn more)
Premarin Vaginal CreamDivigel
  • Vaginal dryness and inflammation
  • Hot flashes and night sweats
Risk factors for serious side effects
Premarin Vaginal CreamDivigel
  • 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
      • Prior severe allergic reaction to Premarin Vaginal Cream (Conjugated Estrogens)
      • Women of childbearing age
      • High levels of triglycerides
      Detailed Premarin Vaginal Cream (Conjugated Estrogens) 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
        Premarin Vaginal CreamDivigel
        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
        • Some of the medicine can be absorbed into your partner's skin, so you can’t have vaginal sex right after using Premarin Vaginal Cream (Conjugated Estrogens).
        • Premarin Vaginal Cream (Conjugated Estrogens) relieves vaginal dryness and irritation to make sex more enjoyable.
        • For painful sex, it can work better than over-the-counter vaginal lubricants because Premarin Vaginal Cream (Conjugated Estrogens) treats the cause of the problem (low estrogen levels), not just the symptoms (dryness).
        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
        Premarin Vaginal CreamDivigel
        • Premarin Vaginal Cream (Conjugated Estrogens) 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.
        • Premarin Vaginal Cream (Conjugated Estrogens) doesn't need to be used forever, so you can work with your doctor to see how long you’ll need to continue treatment.
        • For painful sex, it can work better than over-the-counter vaginal lubricants because Premarin Vaginal Cream (Conjugated Estrogens) treats the cause of the problem (low estrogen levels), not just the symptoms (dryness).
        • 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
        Premarin Vaginal CreamDivigel
        • Vaginal estrogens can weaken latex (rubber) condoms, cervical caps, and diaphragms, so you can't rely on these for birth control for 72 hours after using Premarin Vaginal Cream (Conjugated Estrogens).
        • If you have severe vaginal dryness, you might have pain, bleeding, or infections from repeatedly inserting the applicator.
        • Some of the medicine can be absorbed into your partner's skin, so you can’t have vaginal sex right after using Premarin Vaginal Cream (Conjugated Estrogens).
        • Even though Premarin Vaginal Cream (Conjugated Estrogens) is used in the vagina, it's possible some of the estrogens will get into the rest of your body and cause side effects that happen more often with estrogen pills.
        • 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
        Premarin Vaginal CreamDivigel
        • Your doctor will tell you how often to use Premarin Vaginal Cream (Conjugated Estrogens). If you're taking Premarin Vaginal Cream (Conjugated Estrogens) regularly, use it around the same time each day.
        • Attach the applicator to the tube. Once the dose is measured, insert the applicator deeply into your vagina, and press the plunger to release all the medicine. Clean the applicator after each use.
        • More effective if you use it at bedtime.
        • Consider wearing a panty liner after use.
        • Most people don't have many side effects, but temporary nausea, dizziness, bloating, and breast tenderness are possible.
        • 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 Premarin Vaginal CreamSide effectsReviews & ratingsAlternativesFDA package insert
        More about DivigelSide effectsReviews & ratingsAlternativesFDA package insert