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

Most common
headache (≥10%)
breast pain (≥10%)
abdominal pain (≥10%)
generalized pain (≥10%)

Provera

Most common
headache (reported, rate not specified in label)
abnormal uterine bleeding (reported, rate not specified in label)
nausea (reported, rate not specified in label)
mental depression/insomnia (reported, rate not specified in label)

Climara vs. Provera Dosage

Climara

Dosage
Dosage Table
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

Dosage
Dosage Table
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

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