Compare Premarin Vaginal Cream vs. estradiol / norethindrone

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

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Relieves vaginal dryness and pain due to menopause.

Premarin Vaginal Cream (Conjugated Estrogens) works well for vaginal problems caused by menopause, and it has fewer side effects than estrogen pills.

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.

Upsides
  • Premarin Vaginal Cream (Conjugated Estrogens) 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.
  • Premarin Vaginal Cream (Conjugated Estrogens) doesn't need to be used forever, so you can work with your doctor to see how long you’ll need to continue treatment.
  • For painful sex, it can work better than over-the-counter vaginal lubricants because Premarin Vaginal Cream (Conjugated Estrogens) treats the cause of the problem (low estrogen levels), not just the symptoms (dryness).
  • 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.
Downsides
  • Vaginal estrogens can weaken latex (rubber) condoms, cervical caps, and diaphragms, so you can't rely on these for birth control for 72 hours after using Premarin Vaginal Cream (Conjugated Estrogens).
  • If you have severe vaginal dryness, you might have pain, bleeding, or infections from repeatedly inserting the applicator.
  • Some of the medicine can be absorbed into your partner's skin, so you can’t have vaginal sex right after using Premarin Vaginal Cream (Conjugated Estrogens).
  • Even though Premarin Vaginal Cream (Conjugated Estrogens) is used in the vagina, it's possible some of the estrogens will get into the rest of your body and cause side effects that happen more often with estrogen pills.
  • 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.
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Used for
  • Vaginal dryness and inflammation
  • Painful intercourse from menopause
  • Hot flashes
  • Vaginal dryness and inflammation
  • Prevention of postmenopausal osteoporosis
Dosage forms
  • Vaginal cream, gel, or ointment
  • Pill
Price
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Reviews
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Side effects
31possible side effects
  • Any side effect
    90%
  • Headache
    28%
  • Infection
    23%
  • Pain
    20%
  • Abdominal pain
    17%
  • Back pain
    13%
  • Pharyngitis
    12%
  • Dyspepsia
    11%
  • Flu syndrome
    10%
  • Rhinitis
    10%
  • Myalgia
    9%
  • Upper respiratory infection
    9%
  • Asthenia
    8%
  • Arthralgia
    7%
  • Insomnia
    7%
  • Sinusitis
    7%
  • Breast pain
    7%
  • Accidental injury
    6%
  • Diarrhea
    6%
  • Flatulence
    6%
  • Nausea
    6%
  • Depression
    5%
  • Pruritus
    5%
  • Vaginal moniliasis
    5%
  • Vaginitis
    5%
  • Dizziness
    4%
  • Cough increased
    4%
  • Leukorrhea
    4%
  • Leg cramps
    3%
  • Nervousness
    2%
  • Vaginal hemorrhage
    2%
See more detailed 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
Risks and risk factors
  • 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
  • Memory loss
  • Gallbladder problems
  • Serious allergic reaction
    • Prior severe allergic reaction to Premarin Vaginal Cream (Conjugated Estrogens)
  • Harm to fetus
    • Women of childbearing age
  • Pancreas swelling (pancreatitis)
    • High levels of triglycerides
See more detailed risks and warnings
  • 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