Compare Premarin Vaginal Cream vs. Estradiol Norethindrone

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

Premarin Vaginal Cream
(Conjugated Estrogens)

Activella
(Estradiol / Norethindrone)

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 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.
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Side effects
Premarin Vaginal CreamEstradiol Norethindrone
  • 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 »
  • 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 »
How it works
Premarin Vaginal CreamEstradiol Norethindrone
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.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.
Type of medication
Premarin Vaginal CreamEstradiol Norethindrone
Hormone replacement
Estrogen derivative
Prescription only
Hormone replacement
Estrogen
Progestin
Prescription only
Available as
Premarin Vaginal CreamEstradiol Norethindrone
  • Vaginal cream, gel, or ointment
  • Pill
Used for (click to learn more)
Premarin Vaginal CreamEstradiol Norethindrone
  • Vaginal dryness and inflammation
  • Hot flashes and night sweats
Risk factors for serious side effects
Premarin Vaginal CreamEstradiol Norethindrone
  • 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)
      • Women of childbearing age
      • High levels of triglycerides
      • Family history of ovarian cancer
      Detailed Activella (Estradiol / Norethindrone) risks & warnings »
      Pregnancy category
      Premarin Vaginal CreamEstradiol Norethindrone
      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.No specific alcohol-related info.
      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 CreamEstradiol Norethindrone
      • 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).
      • 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.
      Downsides and risks
      Premarin Vaginal CreamEstradiol Norethindrone
      • 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.
      • 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.
      Tips from our pharmacists for people taking the medication
      Premarin Vaginal CreamEstradiol Norethindrone
      • 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.
      • 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.
      Learn more
      More about Premarin Vaginal CreamSide effectsReviews & ratingsAlternativesFDA package insert
      More about Estradiol NorethindroneSide effectsReviews & ratingsAlternativesFDA package insert