All four medications contain estradiol as the active ingredient, which is used to alleviate symptoms associated with menopause. Generic estradiol vaginal cream, Vagifem, and Yuvafem are prescribed for treating vaginal dryness, thinning, and irritation caused by menopause. On the other hand, Imvexxy is indicated for the management of moderate-to-severe painful sex, a symptom resulting from vaginal dryness and tissue thinning due to menopause.Z