Prescription onlyLower-cost generic available


(Estradiol / Norethindrone)

  • Pill
  • Hot flashes and night sweats
  • Vaginal dryness and inflammation
  • Prevention of postmenopausal osteoporosis
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Relieves menopause symptoms and lowers your risk of osteoporosis.

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Prescription onlyLower-cost generic available

Our bottom line

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.


  • 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.


  • 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.

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What to expect when you take Activella (Estradiol / Norethindrone)

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Tips from our pharmacists
  • 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.
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Side effects for Activella (Estradiol / Norethindrone)

From clinical trials of Estradiol Norethindrone / Postmenopausal endometrial hyperplasia  ( 295)

  • Breast painBreast pain24% for Estradiol/Norethindrone vs.0% for placebo
  • Ear, nose, or throat infectionEar, nose, or throat infection18% for Estradiol/Norethindrone vs.0% for placebo
  • HeadacheHeadache16% for Estradiol/Norethindrone vs.0% for placebo
  • Sinus inflammationSinus inflammation7% for Estradiol/Norethindrone vs.0% for placebo
  • Sleep difficultySleep difficulty6% for Estradiol/Norethindrone vs.0% for placebo
  • Back painBack pain6% for Estradiol/Norethindrone vs.0% for placebo
  • Post-menopausal bleedingPost-menopausal bleeding5% for Estradiol/Norethindrone vs.0% for placebo
  • Uterine fibroidUterine fibroid5% for Estradiol/Norethindrone vs.0% for placebo
  • Infection viralInfection viral4% for Estradiol/Norethindrone vs.0% for placebo
  • Moniliasis genitalMoniliasis genital4% for Estradiol/Norethindrone vs.0% for placebo

Risks and Warnings for Activella (Estradiol / Norethindrone)

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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 Activella (Estradiol / Norethindrone)

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The FDA category for this medication is X. It is advised that you: Unsafe