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Topical estrogen gel used once daily to treat moderate to severe hot flashes of menopause.
Reviewed by:
Dr. Steve Malen, PharmD
Dr. Steven Blikstein, PharmD
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Divigel (estradiol gel) is a topical estrogen used to treat moderate to severe hot flashes associated with menopause. It comes in single-use packets ranging from 0.25 mg to 1.25 mg of estradiol. Apply once daily to one thigh, alternating sides each day, covering an area about the size of two hand-widths, and allow the gel to dry before dressing; avoid washing the area for at least an hour afterward. Women who still have a uterus and use estrogen without a progestogen have an increased risk of endometrial cancer, so a progestogen is typically added and any abnormal vaginal bleeding should be reported promptly. Common side effects include breast tenderness, irregular vaginal bleeding, and vaginal yeast infections. Estrogen therapy also carries an increased risk of blood clots, stroke, heart attack, and certain cancers, and should not be used by women with a history of these conditions or unexplained vaginal bleeding.
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Boxed warning: Women with a uterus who use estrogen alone (without a progestogen) have an increased risk of endometrial cancer. Report any abnormal vaginal bleeding to your provider promptly.
Common side effects include breast tenderness, irregular vaginal bleeding, vaginal yeast infections, and headache.
Important warnings:
Use the lowest effective dose for the shortest time needed to control symptoms, and discuss the risks and benefits with your provider.
Norethindrone (Aygestin) is a prescription progestin hormone used to treat menstrual disorders, endometriosis, and abnormal uterine bleeding, or to delay menstruation.
