Compare estradiol / norethindrone vs. Divigel

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

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Relieves menopause symptoms and lowers your risk of osteoporosis.

Activella (estradiol / norethindrone) helps relieve menopausal symptoms and prevent bone loss. There can be many side effects, so it's important to talk to your doctor about the benefits and potential hassles of this drug before using it.

Relieves hot flashes due to menopause.

Divigel (Estradiol gel) is an easy to use medicine that comes in 3 different strengths. It uses lower doses of estrogen than other hormone replacements.

Upsides
  • Replaces estrogen in your entire body and relieves multiple symptoms of menopause.
  • Lowers your risk of fractures by keeping your bones healthy.
  • Improves mood, energy, and mental alertness for some people.
  • Generic available, so cost is usually lower.
  • Replaces estrogen to your whole body and relieves multiple symptoms due to low estrogen, like hot flashes and vaginal dryness.
  • Good for people who don't want to or can't take daily pills.
  • Can take the easy to use, pre-measured packets anywhere.
  • Divigel (Estradiol gel) has fewer side effects than pills since there are lower amounts of estrogen in gels.
  • In studies, many women on the lowest dose started to feel better about a month after starting the medicine. People using the highest doses felt better in just 2 weeks.
Downsides
  • More potential side effects since Activella (estradiol / norethindrone) exposes your whole body to two hormones.
  • Raises your risk of developing a stroke and blood clots.
  • You may get irregular bleeding and spotting that can last a few months to a year.
  • Should only use if you still have a uterus.
  • 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.
  • 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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Used for
  • Hot flashes
  • Vaginal dryness and inflammation
  • Prevention of postmenopausal osteoporosis
Dosage forms
  • Pill
  • Gel
Price
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Reviews
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Side effects
10possible side effects
  • Breast pain
    21%
  • Headache
    17%
  • Nausea
    10%
  • Upper airway infection
    10%
  • Post-menopausal bleeding
    10%
  • Sinus infection
    7%
  • Ovarian cyst
    7%
  • Back pain
    3%
  • Difficulty sleeping
    3%
  • Accidental injury
    3%
See more detailed side effects
5possible side effects
  • Breast pain
    6%
  • Unusual vaginal bleeding
    6%
  • Common cold
    4%
  • Lung infection
    2%
  • Yeast infection
    2%
See more detailed side effects
Risks and risk factors
  • Endometrial cancer
    • Using estrogen for more than 1 year
  • Breast cancer
    • Personal or family history of breast cancer
    • Using estrogen for more than one year
  • Increased risk of blood clots and stroke
    • Personal or family history of blood clots
    • High blood pressure
    • Smoking
    • Obesity
    • High cholesterol
    • Systemic lupus erythematosus (SLE)
  • Dementia
    • Age 65 or older
  • Pancreas swelling (pancreatitis)
    • History of high 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
    • Using estrogen for more than one year
  • Increased risk of blood clots and stroke
    • Personal or family history of blood clots
    • Smoking
    • Obesity
    • Systemic lupus erythematosus (SLE)
  • Increased risk of heart disease
    • Smoking
    • Obesity
    • High blood pressure
    • High blood sugar
    • High cholesterol
    • Age 50 or older
  • Dementia
    • Age 65 or older
  • Pancreas swelling (pancreatitis)
    • High levels of triglycerides
See more detailed risks and warnings