Compare Premarin vaginal cream vs. Vivelle-Dot

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

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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 menopausal symptoms.

Vivelle-Dot (Estradiol patch) is an estrogen patch that may be easier and more convenient to use than the pill or gel form.

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.
  • Good choice if you want to avoid daily dosing of the pill or gel form.
  • Available in wider variety of strengths compared to other estrogen patches.
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.
  • Other estrogen patches are dosed once weekly and may be more convenient than Vivelle-Dot (Estradiol patch).
  • Patches can fall off.
  • Estrogen therapy is associated with serious risks for uterine cancer, breast cancer, and blood clots. Don't start treatment until you have had a thorough discussion of the risks and benefits with your doctor.
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Used for
  • Vaginal dryness and inflammation due to menopause
  • Painful sex due to menopause
  • Hot flashes
  • Vaginal dryness and inflammation
  • Low estrogen
  • Prevention of osteoporosis in menopausal women
Dosage forms
  • Cream
  • Patch
Price
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Reviews
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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
20possible side effects
  • Headache
    26%
  • Breast pain
    13%
  • Back pain
    11%
  • Menstrual bleeding
    11%
  • Influenza
    8%
  • Common cold
    8%
  • Nausea
    5%
  • Pain
    5%
  • Sinus infection
    5%
  • Lung infection
    5%
  • Neck pain
    5%
  • Limb pain
    5%
  • Nasal congestion
    5%
  • Joint pain
    4%
  • Depression
    3%
  • Constipation
    2%
  • Flu-like symptoms
    2%
  • Sinus headache
    2%
  • Anxiety
    2%
  • Trouble sleeping
    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
  • Uterine 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
  • Inflammation of pancreas
    • High levels of triglycerides
See more detailed risks and warnings