Compare Premarin Vaginal Cream vs. Evamist

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

Premarin Vaginal Cream (Conjugated Estrogens)

Prescription only

Evamist (Estradiol Spray)

Prescription only
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.

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.

Upsides
  • 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).
  • 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
  • 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 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.
Used for
  • Vaginal dryness and inflammation
  • Painful intercourse from menopause
  • Hot flashes and night sweats
Dosage forms
  • Vaginal cream, gel, or ointment
  • Spray
Price
No pricing information available
Lowest price near you
$119.87
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Reviews
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Side effects
10possible side effects
  • Any side effect
    90%
  • Headache
    28%
  • Infection
    23%
  • Pain
    20%
  • Abdominal pain
    17%
  • Back pain
    13%
  • Pharyngitis
    12%
  • Dyspepsia
    11%
  • Flu syndrome
    10%
  • Rhinitis
    10%
See more detailed side effects
The Evamist (Estradiol Spray) FDA package insert doesn’t have numbers about how common side effects are.
Risks and warnings
  • Endometrial cancer

    Using estrogen for more than one year

  • Breast cancer

    Personal or family history of breast cancer

    ...and 1 more risk factors

  • Increased risk of blood clots and stroke

    Personal or family history of blood clots

    ...and 2 more risk factors

  • Increased risk of heart disease

    Smoking

    ...and 5 more risk factors

  • Serious allergic reaction

    Prior severe allergic reaction to Premarin Vaginal Cream (Conjugated Estrogens)

  • Harm to fetus

    Women of childbearing age

  • Pancreas swelling (pancreatitis)

    High levels of triglycerides

See more detailed risks and warnings
  • Endometrial cancer

    Using estrogen for more than one year

  • Breast cancer

    Personal or family history of breast cancer

    ...and 1 more risk factors

  • Increased risk of blood clots and stroke

    Personal or family history of blood clots

    ...and 2 more risk factors

  • Increased risk of heart disease

    Smoking

    ...and 5 more risk factors

  • Harm to fetus

    Women of childbearing age

See more detailed risks and warnings