Compare Premarin Vaginal Cream vs. Vivelle-Dot

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

Premarin Vaginal Cream
(Conjugated Estrogens)

Vivelle-Dot
(Estradiol Patch)

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.Treats low estrogen, relieves menopause symptoms, and lowers your risk of osteoporosis. The Vivelle-Dot (Estradiol Patch) needs to be replaced twice a week, but it comes in more strengths than other patches. It may have fewer side effects than oral estrogen pills.
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Side effects
Premarin Vaginal CreamVivelle-Dot
  • 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 »
  • Headache 26%
  • Low mood disorder 7%
  • Weight increased 7%
  • Vaginal bleeding between periods 6%
  • Sinus headache 6%
  • Common cold 5%
  • Ear, nose, or throat infection 5%
  • Back pain 5%
  • Neck pain 5%
  • Constipation 4%
More Vivelle-Dot side effects »
How it works
Premarin Vaginal CreamVivelle-Dot
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.The Vivelle-Dot (Estradiol Patch) replaces an estrogen hormone, estradiol, that your body loses during and after menopause. Higher levels of estradiol relieve symptoms of low estrogen and menopause and prevent bone loss.
Type of medication
Premarin Vaginal CreamVivelle-Dot
Hormone replacement
Estrogen derivative
Prescription only
Hormone replacement
Estrogen derivative
Prescription only
Available as
Premarin Vaginal CreamVivelle-Dot
  • Vaginal cream, gel, or ointment
  • Patch
Used for (click to learn more)
Premarin Vaginal CreamVivelle-Dot
  • Vaginal dryness and inflammation
  • Hot flashes and night sweats
Risk factors for serious side effects
Premarin Vaginal CreamVivelle-Dot
  • 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
      • High levels of triglycerides
      Detailed Vivelle-Dot (Estradiol Patch) risks & warnings »
      Pregnancy category
      Premarin Vaginal CreamVivelle-Dot
      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 CreamVivelle-Dot
      • 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).
      • Comes in 4 different strengths.
      • The Vivelle-Dot (Estradiol Patch) replenishes estrogen to your whole body and relieves multiple symptoms due to low estrogen, like hot flashes and vaginal dryness.
      • The patch is good for people who don't want to take daily pills.
      • Can be worn while swimming, bathing, and showering.
      • By using a patch instead of a pill, there's a lower risk of side effects such as blood clots and stroke since lower amounts of estrogen are used in patches.
      • 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.
      Downsides and risks
      Premarin Vaginal CreamVivelle-Dot
      • 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.
      • You need to replace the Vivelle-Dot (Estradiol Patch) twice a week, compared to other patches that are once a week.
      • Patch can fall off.
      • Increases your risk of uterine and breast cancer.
      • If you have your uterus, you have to use the Vivelle-Dot (Estradiol Patch) with another hormone called progestin to lower your risk of uterine cancer.
      • Increases your risk of developing blood clots and stroke.
      • Can worsen other health conditions, like high cholesterol, asthma, diabetes, fluid retention, and migraines.
      • Can't be used in people with liver problems.
      Tips from our pharmacists for people taking the medication
      Premarin Vaginal CreamVivelle-Dot
      • 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.
      • Remove the patch by tearing the package by hand and not with scissors. Never cut the patch.
      • Apply the sticky side of the patch to clean, dry, hairless skin below your waistline on areas as instructed by the manufacturer (never on your breast).
      • Replace the patch twice a week (every 3-4 days) on a different area of your skin to lower your risk of skin irritation.
      • Fold together the sticky sides of used patches before throwing them away to avoid exposing others to the medicine. Don't flush them down the toilet.
      • 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 Vivelle-DotSide effectsReviews & ratingsAlternativesFDA package insert