Compare estradiol / norethindrone vs. Evamist

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.

Evamist (Estradiol Spray) is easy to use, absorbs well into your skin without needing to rub it in, and is a good option if you don’t want to use estrogen pills or patches.

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.
  • Evamist (Estradiol Spray) replenishes estrogen to your whole body and relieves multiple symptoms due to low estrogen (hot flashes, vaginal dryness, low energy).
  • Dries faster than topical estrogen gels.
  • Good for people who don't want to take daily pills.
  • Fewer side effects than pills since lower amounts of estrogen are used in topical sprays.
  • Women in studies have seen the severity and number of hot flashes lower by half within 4 weeks of using Evamist (Estradiol Spray).
  • Very few women had skin irritation from the medicine.
  • Depending on your symptoms, your dose may change, but you can still use the same spray pump no matter what your dose is.
  • Can lower your risk of fractures by keeping your bones healthy. Make sure you also get enough calcium and Vitamin D.
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 Evamist (Estradiol Spray) 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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Used for
  • Hot flashes
  • Vaginal dryness and inflammation
  • Prevention of postmenopausal osteoporosis
  • Hot flashes and night sweats
Dosage forms
  • Pill
  • Spray
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
  • Headache
    7%
  • Breast tenderness
    4%
  • Nasopharyngitis (common cold)
    4%
  • Nipple pain
    2%
  • Back pain
    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
    • Duration of use
  • Increased risk of blood clots and stroke
    • Personal or family history of blood clots
    • Obesity
    • Systemic lupus erythematosus (SLE)
  • Increased risk of heart disease
    • Smoking
    • Obesity
    • High blood pressure
    • High blood sugar
    • High cholesterol
    • Age 50 or older
  • Harm to fetus
    • Women of childbearing age
  • Early puberty in children
See more detailed risks and warnings