Compare Premarin vs. Estring

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

Premarin
(Conjugated Estrogens)

Estring
(Estradiol Vaginal Ring)

Treats low estrogen, relieves menopause symptoms, and lowers your risk of osteoporosis. Premarin (Conjugated Estrogens) relieves menopausal symptoms and prevents bone loss. It's an oral hormone replacement, so it can have a lot of side effects, and it's important to think through the benefits and potential hassles of this drug before using it.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.
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Reviews & ratings
Button Group. All currently active
Button Group. All currently active
4.779220779220779Premarin
Reviews for Premarin (Conjugated Estrogens)
50%
of people say Premarin (Conjugated Estrogens) is worth it
43%
say it works well
11%
say it's a big hassle
Reviews for Estring (Estradiol Vaginal Ring)
62%
+12% vs. Premarin (Conjugated Estrogens)
40%
3% vs. Premarin (Conjugated Estrogens)
18%
7% vs. Premarin (Conjugated Estrogens)
Side effects
PremarinEstring
  • Abdominal pain 5%
  • Back pain 4%
  • Muscle weakness 4%
  • Breast pain 4%
  • Passing gas 4%
  • Thick vaginal discharge 3%
  • Vaginal moniliasis 2%
  • Nervousness 2%
  • Itching 2%
  • Leg cramps 2%
More Premarin side effects »

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

More about Estring side effects »
How it works
PremarinEstring
Premarin (Conjugated Estrogens) is an oral medication that replaces estrogen hormones during and after menopause. Higher levels of estrogen lower menopause-related hot flashes, flushing, night sweats, vaginal problems, and bone loss.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.
Type of medication
PremarinEstring
Hormone replacement
Estrogen derivative
Prescription only
Hormone replacement
Estrogen derivative
Prescription only
Available as
PremarinEstring
  • Pill
  • Vaginal ring
Used for (click to learn more)
PremarinEstring
  • Hot flashes and night sweats
  • Vaginal dryness and inflammation
Risk factors for serious side effects
PremarinEstring
  • 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 (Conjugated Estrogens)
      • Women of childbearing age
      • High levels of triglycerides
      Detailed Premarin (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 Estring (Estradiol Vaginal Ring) risks & warnings »
      Pregnancy category
      PremarinEstring
      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
      • Does not expose your partner to estrogen during sexual acitivities like vaginal estrogen creams.
      • 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.
      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
      PremarinEstring
      • Premarin (Conjugated Estrogens) replenishes estrogen to your whole body and relieves multiple symptoms due to low estrogen (hot flashes, night sweats, vaginal dryness).
      • Lowers your risk of fractures by keeping your bones healthy. Make sure you also take enough calcium and Vitamin D.
      • Improves mood, energy, and mental alertness for some people.
      • Does not expose your partner to estrogen during sexual acitivities like vaginal estrogen creams.
      • Can help relieve symptoms of prostate cancer or advanced breast cancer in some people.
      • 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.
      Downsides and risks
      PremarinEstring
      • More potential side effects than estrogen creams since it exposes your whole body to estrogen.
      • Increases your risk of uterine and breast cancer.
      • If you have your uterus, you have to take Premarin (Conjugated Estrogens) 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.
      • Can be expensive since it's only available as a brand name product.
      • 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.
      Tips from our pharmacists for people taking the medication
      PremarinEstring
      • Take Premarin (Conjugated Estrogens) at the same time each day. If you miss a dose, take it as soon as possible, but if it’s almost time for your next dose, take only that dose.
      • Use the lowest dose possible of Premarin (Conjugated Estrogens) and take it only as long as needed. Talk to your doctor regularly to see if you still need treatment. If you’re taking Premarin (Conjugated Estrogens) only for vaginal symptoms or to prevent bone loss, there are other medicines that can work better with fewer side effects (like a vaginal cream for menopause symptoms, or non-estrogen medicine for bone loss).
      • Can cause nausea, dizziness, bloating and breast tenderness.
      • Get emergency care if you notice swelling or pain in your lower legs, sudden shortness of breath, or an unexplained severe headache.
      • Tell your doctor about any unusual vaginal bleeding.
      • 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.
      Learn more
      More about PremarinSide effectsReviews & ratingsAlternativesFDA package insert
      More about EstringSide effectsReviews & ratingsAlternativesFDA package insert