Compare Premarin vaginal cream vs. Evamist

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

ADVERTISEMENT
Relieves vaginal dryness and pain during sex due to menopause.

Premarin vaginal cream (conjugated estrogens) has less side-effects than estrogen pills, but only works for localized symptoms of menopause.

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
  • Works locally in the vagina, so it has less side effects than estrogen pills.
  • Works better than over-the-counter lubricants to relieve pain during sex caused by menopause.
  • Can be dosed twice a week to relieve painful sex due to menopause.
  • 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
  • Vaginal estrogens can weaken latex (rubber) condoms, cervical caps, and diaphragms. Do not rely on these methods to protect against sexually transmitted infections for up to 72 hours after using Premarin vaginal cream (conjugated estrogens).
  • Premarin vaginal cream (conjugated estrogens) increases risk of uterine cancer so women with intact uterus should not use it by itself.
  • Available as a branded product only, so it may be expensive.
  • 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.
ADVERTISEMENT
Used for
  • Vaginal dryness and inflammation due to menopause
  • Painful sex due to menopause
  • Hot flashes and night sweats
Dosage forms
  • Cream
  • Spray
Price
Want to save even more money?
Sign up now for a 30-day trial and save up to 95% at CVS, Kroger, Albertsons, and other pharmacies.
Learn more
Reviews
Not enough review data.Leave a review
Not enough review data.Leave a review
Side effects
6possible side effects
  • Pelvic pain
    3%
  • Vaginal discharge
    3%
  • Headache
    2%
  • Breast pain
    2%
  • Vaginal inflammation
    2%
  • Other problems with the vagina or vulva
    2%
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 one year
    • Higher dose of estrogen
  • Breast cancer
    • Personal or family history of breast cancer
    • Using estrogen and progestin 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
  • 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