Premarin vaginal cream vs Estradiol vaginal cream

I’m on Estradiol and have never been on the other. I’m 71 and learned the hard way that I must continue using the cream.
When I don’t, the tissues become so dry and thin that I feel as if I have a UTI all the time.

If you can't tolerate either of these estrogen creams (which I've tried and can't because of Allergic Contact Dermatitis, ACD) I have had amazing, fantastic success with a silicone ring, Estring, which is infused with time release estrogen, This ring is insterted into the vagina and stays for 3 months. Occasionally it requires inserting ones finger and pushing the ring higher up into the vagina, which I can check occasionally when I'm in the shower. It's never fallen out and is not noticeable during intercourse for either person. It only took about 2 months for my decades of burning and redness in the vagina to dissapate. Intercourse is no longer painful. Also the pervious dryness caused a fishy odor which is no longer present. My gynocologist explained that without vaginal secretions present because the body lacks estrogen the vagina doesn't cleanse itself. Now at 75 years of age and almost 2 years later I have no memory of the discomfort in that area.
Only down side is the expense, my Medicare pharmacutical plan includes this prescription which helps. Initally for the year I pay close to $500 and after that it's close to $300. However living pain free makes the expense worth it.

@gardeningjunkie thank you for the reply. I have been using estradiol cream but along the way was also using other over the counter stuff. I developed contact irritant dermatitis. Biopsy showed that diagnosis. North American Patch testing was negative and the dermatologist said I did not need the estrogen cream and just use vaseline after showering. My gyn, a vulvar specialist, agreed and said I could cut back to 1x a week. Well... after trying to cut back on the cream my urethra/vaginal irritation was back. So I am going back to using the cream 3x a week( my decision). No idea if the estradiol is even what caused my contact dermatitis. Not sure if I should do more as I am still irritated although the urethra irritation has gotten better. This has been going on for almost 1 year now and I cannot get answers. The current gyn is my 4th doctor. All the others just kept giving me steroid creams to use. Very frustrated. Needless to say I was curious if Premarin would be different. Tired and scared to try different things at this point.

Patch testing for Allergic Contact Dermatitis, is helpful, but sometimes allergies or irriatants take more than the standard 5 days to develop so your patch test site may not show a reaction. I have that issues with make up that don't have my postive allergens in them. I figured out I react to coconut and phenoxethanol but they didn't test positive.
Look at the inactive ingredients in the cream, it may be one of those causing the irritation.
I used Vasiline as it helped give some relief and one derm told me not to use it because it trapped bacteria, although I never tested postive to bacteria, but I couldn't stop using it because it helped some. I don't need it anymore.
As mentioned following The Yeast Connection Handbook by William Crooke, Md (buy it used online for $5.00 it helped a great deal with the burning and inflamation, (I had no visible yeast symtoms) but Estring has been a miracle because the estrogen has returned my healthy vaginal secretions and my tissues have thickened so intercourse is a pleasure again. Zero burning, zero pain, zero odor.
I hope you can afford it. They may have a low income discount, ask your gynocologist.
Like you I saw a slew of gynocologists, only one ever suggested dietary changes and the new one I saw 2 years ago suggested the Estring. I will be grateful to her for the rest of my life. I don't know how long the product been on the market and don't know why it's not recommended when less expensive options fail.
Steroids are only a treatment. It's like a doctor prescribing a steroid on a burn. It is not a cure! It's just a treament. You've got to figure out the cause.

My gyn also said to use coconut oil on the days when I don’t use estrogen cream. This seems to help. I was also told not to use regular soap on the vaginal area. I got this cleanser from a company called Good Clean Love. Does a good job of cleaning the area with no irritation.

I tried the estring but results were not good. I now am using Estradiol Vaginal cream 0.01% - 0.1 mg 2x per week and it has worked wonders. Along with that, the dr gave me a Rx for Lidocaine ointment. I put a very small amount on the opening of my vagina to alleviate any initial sexual activity discomfort.
Last but not least, my dr also recommended 2 other products:
"Coconu Hemp Infused body oil" https://www.amazon.com/gp/product/B092KWKMJY/ref=ppx_yo_dt_b_search_asin_title?ie=UTF8&psc=1
"Femallay Coconut Vaginal mosturizing suppository "
https://www.amazon.com/gp/product/B07S42FBFC/ref=ppx_yo_dt_b_search_asin_title?ie=UTF8&psc=1
both, purchased on Amazon. I no longer experience any pain and discomfort from vaginal dryness. I don't know if it would work for everyone but, for me, it has been a real game changer.

I just started Estradiol last week per my GYN. How long did it take for you to start getting relief from the UTI-type pain? I am so uncomfortable right now with the stinging and burning! I am negative for UTI. I had a urologist visit yesterday. He told me that my bladder is healthy, so the discomfort must be from the lack of estrogen. He told me that it will take about a month to get relief!

Marlene,
It took a week or so to get relief. But, it did take care of the problem. As I’ve said here, sometimes I slack off with the estrogen cream and the problem comes right back. I’m also doing pelvic floor exercises which help. If I stop doing those, I have trouble. So, I’ve learned the hard way to comply with estrogen cream and PT.