Progesterone vs. Progestin: What’s the Difference?

“My doctor has me on the progesterone only birth control pill.”

“I’m using the patch that has progesterone and estrogen in it.”

“I don’t need progesterone. I have the IUD that has it.”

These are comments I hear from women and see in groups I belong to. The truth is that NONE of these products contain progesterone.

So, let’s have a chat about this to clear things up. They are two very similar words, but from a hormone balance standpoint, they couldn’t be more different.

Both provide a counterbalance to estrogen that helps protect the uterus from a constant estrogen barrage. This helps reduce the likelihood of uterine cancer.

But, this is where the therapeutic similarities end. 

What is Progesterone?

Progesterone is the hormone primarily produced in the second half of your menstrual cycle. In the first 14 days of the cycle, estrogen is in charge. Estrogen’s job is to grow the cells of the uterus to prepare it for implementation of a fertilized egg. 

Around day 14, when ovulation occurs, progesterone production ramps up in case you become pregnant. If a fertilized egg implants itself, progesterone levels will continue to rise. If not, progesterone drops, signaling the end of the cycle, and the whole process starts over again.

But that’s not progesterone’s only job. 

Progesterone receptors are located in the blood vessels, the liver, breast tissue, the bone, and the brain. This hormone has an essential influence on the functioning of all these body parts. 

Most of your progesterone production occurs by ripened eggs. That means when your ovaries start winding down their function, and you stop ovulating regularly, progesterone production slows down dramatically. Your adrenal glands pick up a bit of the slack, but not in quantities that are enough to oppose estrogen.

Estrogen is produced by other cells in the body besides the ovaries, namely fat cells and, to a small extent, the adrenal glands, so it’s easy to see how things can get out of balance.

What are Progestins?

Progestins are synthetic forms of progesterone found in birth control pills, IUDs, and products like Prempro, Provera, and Depo-Provera. They have a somewhat similar chemical structure to progesterone, but they do not have the same side effects or therapeutic benefits.

While they are useful for opposing estrogen and providing protection against uterine cancer, they do not offer the same positive health effects as progesterone (easing anxiety, bone health, helping with insomnia, etc.). Also, some women just don’t tolerate progestins well. Side effects include abdominal pain or cramping, bloating or swelling of ankles or feet, blood pressure increase, dizziness, headache, mood changes, nervousness, and unusual or rapid weight gain.

Why is There So Much Confusion??

The medical community and drug manufacturers have lumped progesterone into the progestin category, and these words are often used interchangeably despite their differences. This causes huge amounts of confusion for women when it comes to managing hormone imbalances and making choices regarding therapy.

What About Cancer Risk?

Progesterone has NEVER been implicated in causing breast cancer and, in fact, has a protective effect. You can read more about it here, and it is safe to use. Progesterone is helpful for many women, but it’s not a magic bullet. You and your provider need to look at the whole picture of hormones and health to determine if it’s a good idea to use it or not. Synthetic progestins can increase the risk of breast cancer (Women’s Health Initiative Study 2002), and I generally recommend avoiding them if possible. This increase also extends to birth control pills and hormone-containing IUDs. 

If you’re on the fence or afraid to try progesterone, I can help you with that. Don’t suffer; get the correct information from a healthcare professional and menopause expert. Find out more about that here: https://www.drannagarrett.com/lets-talk/

Dr. Anna Garrett is a menopause expert and Doctor of Pharmacy. She helps women who are struggling with symptoms of perimenopause and menopause find natural hormone balancing solutions so they can rock their mojo through midlife and beyond. Dr. Anna is the author of Perimenopause: The Savvy Sister’s Guide to Hormone Harmony. Order your copy at www.perimenopausebook.com.

Dr. Anna is available for 1-1 consultations. Find out more at www.drannagarrett.com/lets-talk or by clicking the button below to schedule a call with Dr. Anna today!

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