Climara vs. Provera
See how Climara and Provera compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Climara is an estrogen patch that treats hot flashes, vaginal atrophy, and low estrogen levels, while Provera is a progestin pill that treats abnormal bleeding or protects the uterine lining.
Both drugs carry boxed warnings for stroke, heart attack, blood clots, breast cancer, and dementia risk, especially when estrogen and progestin are combined long-term.
Climara is applied once a week through the skin, while Provera is swallowed daily for 10 to 13 days each cycle.
Climara vs. Provera Drug Summary
Climara
Climara is a steroidal estrogen delivered through a once-weekly skin patch. It treats moderate to severe hot flashes and vaginal atrophy from menopause, low estrogen from ovarian failure, and helps prevent bone loss after menopause.
Provera
Provera is a synthetic progestin taken as a daily oral tablet for a set number of days each cycle. It treats abnormal uterine bleeding and missed periods, and it is added to estrogen therapy to prevent endometrial hyperplasia in women who still have a uterus.
Climara vs. Provera Side Effects
Climara
Provera
Climara vs. Provera Dosage
Climara
Provera
| STAGE | DOSE | WHEN |
| Starting dose | 0.025 mg/day patch | At the start |
| Maximum dose | 0.1 mg/day patch | If needed |
| Dose changes | 5 increases | As tolerated |
| STAGE | DOSE | WHEN |
| Starting dose | 5 to 10 mg daily | At the start |
| Maximum dose | 10 mg daily | If needed |
| Dose changes | 1 increase | As tolerated |
Climara
| STAGE | DOSE | WHEN |
| Starting dose | 0.025 mg/day patch | At the start |
| Maximum dose | 0.1 mg/day patch | If needed |
| Dose changes | 5 increases | As tolerated |
Provera
| STAGE | DOSE | WHEN |
| Starting dose | 5 to 10 mg daily | At the start |
| Maximum dose | 10 mg daily | If needed |
| Dose changes | 1 increase | As tolerated |
Climara vs. Provera Indications
Climara
Climara replaces estrogen the body stops making after menopause, ovary removal, or ovarian failure. It is FDA-approved for hot flashes, vaginal atrophy, and preventing osteoporosis, and is sometimes used off-label for feminizing hormone therapy in transgender women.
Hot flashes and night sweats from menopause
Vaginal dryness and vulvar atrophy
Low estrogen from ovarian failure or removal
Provera
Provera is prescribed on its own for missed periods or abnormal uterine bleeding caused by hormone imbalances. When a woman with a uterus takes estrogen for menopause symptoms, Provera is added on a cycle to keep the uterine lining from overgrowing.
Secondary amenorrhea (missed periods)
Abnormal uterine bleeding from hormone imbalance
Prevention of endometrial hyperplasia with estrogen
Climara vs. Provera Pros and Cons
Climara
Climara's patch form skips the liver's first pass, which may lower clotting risk compared with oral estrogens, and its six dose strengths allow gradual adjustment. It still carries the same class-wide boxed warnings for cancer, stroke, and dementia risk as other estrogens.
Pros
Once-weekly patch, no daily pill to remember
Skin delivery avoids first-pass liver metabolism
Six dose strengths allow gradual titration
Cons
Needs an added progestin if the uterus is intact
Patch can cause skin irritation at application site
Boxed warning for endometrial cancer with estrogen alone
Provera
Provera is an oral progestin that works well alone for abnormal bleeding or missed periods, not just as an add-on to estrogen. It requires precise daily dosing for a set number of days each cycle rather than a single weekly application.
Pros
Works alone for abnormal bleeding, no estrogen needed
Cyclic dosing schedule, not a daily long-term commitment
Available in three tablet strengths for flexible dosing
Cons
Oral tablet undergoes first-pass liver metabolism
Not approved for hot flashes or bone loss prevention
Requires remembering daily doses for 10-13 days
Common Symptoms and Related Diseases You Can Explore
Explore a range of common symptoms the Doctronic Symptom Checker can help you understand.