Prescription onlyNo lower cost generic available


(Estradiol Gel)

  • Cream, gel, or ointment
  • Hot flashes and night sweats
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Relieves hot flashes due to menopause.

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Prescription onlyNo lower cost generic available

Our bottom line

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.


  • 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.


  • 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.

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What to expect when you take Divigel (Estradiol Gel)

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Tips from our pharmacists
  • 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.
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Side effects for Divigel (Estradiol Gel)

From clinical trials of Divigel / Postmenopausal estrogen replacement (0.5 g/day)  ( 248)

  • Breast tendernessBreast tenderness6% for Divigel vs.2% for placebo
  • MetrorrhagiaMetrorrhagia6% for Divigel vs.2% for placebo
  • Common coldCommon cold4% for Divigel vs.4% for placebo
  • Ear, nose, or throat infectionEar, nose, or throat infection2% for Divigel vs.2% for placebo
  • Vaginal mycosisVaginal mycosis2% for Divigel vs.3% for placebo

Risks and Warnings for Divigel (Estradiol Gel)

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    • Higher risk if:
    • Using estrogen for more than one year

    Vaginal bleeding after menopause can be a warning sign of uterus (endometrial) cancer, so let your doctor know if you notice any unusual bleeding. When estrogen is prescribed to women after menopause who still have a uterus, progestin should be used with it to lower the risk of cancer. Low-dose vaginal estrogen products are often a better choice than oral pills for women 65 years or older who have vaginal symptoms.

    This is a black box warning. The FDA requires this warning when there is a significant risk of serious or life-threatening effects that anyone taking the drug should consider.

Means that some groups have a high risk of experiencing this side effect

Tips from pharmacists and people taking Divigel (Estradiol Gel)

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The FDA category for this medication is X. It is advised that you: Unsafe
  • Tips from our pharmacists
  • The gel is alcohol-based and flammable, so you shouldn't smoke while applying it.
  • my gyno didn't think it would help my insomnia since it was not related to night sweats or hot flashes. it worked wonders! I can sleep again & all my symptoms related to insomnia (depression, tiredness, anxiety) disappeared.