Vivelle-Dot vs. Provera
See how Vivelle-Dot and Provera compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Vivelle-Dot is an estrogen patch for hot flashes and vaginal dryness, while Provera is an oral progestin used for abnormal bleeding or to protect the uterus during estrogen therapy.
Women with a uterus who use Vivelle-Dot typically need a progestin such as Provera added to lower the risk of endometrial cancer from unopposed estrogen.
Vivelle-Dot is changed on the skin twice a week, while Provera is taken by mouth only for short, defined courses of 5 to 10 days.
Vivelle-Dot vs. Provera Drug Summary
Vivelle-Dot
Vivelle-Dot is an estrogen (estradiol) patch used to treat moderate to severe hot flashes and vaginal dryness caused by menopause, and to help prevent bone loss after menopause. The patch is worn on the skin and replaced twice weekly, delivering a steady dose of hormone without a daily pill.
Provera
Provera is a progestin (synthetic progesterone) tablet used to bring on a period in women with secondary amenorrhea and to treat abnormal uterine bleeding from hormone imbalance. It is taken by mouth in short courses of 5 to 10 days, or added to daily estrogen to protect the uterine lining.
Vivelle-Dot vs. Provera Side Effects
Vivelle-Dot
Provera
Vivelle-Dot vs. Provera Dosage
Vivelle-Dot
Provera
| STAGE | DOSE | WHEN |
| Starting dose | 0.0375 mg/day patch | At the start |
| Maximum dose | 0.025-0.1 mg/day patch | If needed |
| Dose changes | 2 increases | As tolerated |
| STAGE | DOSE | WHEN |
| Starting dose | 5 mg or 10 mg daily | At the start |
| Maximum dose | 10 mg daily | If needed |
| Dose changes | 1 increase | As tolerated |
Vivelle-Dot
| STAGE | DOSE | WHEN |
| Starting dose | 0.0375 mg/day patch | At the start |
| Maximum dose | 0.025-0.1 mg/day patch | If needed |
| Dose changes | 2 increases | As tolerated |
Provera
| STAGE | DOSE | WHEN |
| Starting dose | 5 mg or 10 mg daily | At the start |
| Maximum dose | 10 mg daily | If needed |
| Dose changes | 1 increase | As tolerated |
Vivelle-Dot vs. Provera Indications
Vivelle-Dot
Vivelle-Dot delivers estradiol through a patch worn on the skin to relieve moderate to severe hot flashes, night sweats, and vaginal dryness that come with menopause. It is also approved to help prevent bone loss in postmenopausal women at risk for osteoporosis.
Moderate to severe hot flashes from menopause
Vaginal dryness and vulvar/vaginal atrophy
Low estrogen from ovarian failure or removal
Provera
Provera delivers medroxyprogesterone acetate by mouth to bring on a period in women with secondary amenorrhea and to treat abnormal uterine bleeding caused by hormone imbalance. It is also prescribed alongside daily conjugated estrogen to protect the uterine lining in women who still have a uterus.
Secondary amenorrhea (absent periods)
Abnormal uterine bleeding from hormone imbalance
Endometrial protection with conjugated estrogen
Vivelle-Dot vs. Provera Pros and Cons
Vivelle-Dot
Vivelle-Dot delivers estrogen through the skin, avoiding the liver's first pass and potentially lowering clotting risk compared with oral estrogen pills. Coverage varies by plan, and many insurers favor the lower-cost generic estradiol patch over the brand name.
Pros
Twice-weekly patch avoids daily pills
Five dose strengths allow fine-tuned titration
Transdermal route may carry lower clot risk than oral estrogen
Stays on through showering, swimming, and exercise
Cons
Must add a progestin if the uterus is still present
Contraindicated with history of clots, stroke, or heart attack
Brand-name cost runs roughly $150 to $450 a month without insurance
Possible skin irritation at the patch site
Provera
Provera is an inexpensive, well-established progestin used in short, defined courses rather than continuous daily therapy. It carries the same class-wide boxed warning as other progestins when combined with estrogen, and it does not treat hot flashes or vaginal dryness on its own.
Pros
Roughly $15 to $75 a month, far less than brand-name Vivelle-Dot
Short 5- to 10-day courses instead of continuous daily use
Protects the uterine lining when added to estrogen therapy
Long track record since FDA approval in 1959
Cons
Shares the same boxed warning risks when combined with estrogen
Requires daily oral dosing during each treatment course
Does not relieve hot flashes or vaginal dryness on its own
Contraindicated in liver disease or hormone-sensitive cancers
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