It Matters How You Say It…

Pro-je-stens or Pro-je-ste-ron

Does it matter?

Tomatoes, no matter how they’re pronounced or what side of the pond you’re from, are essentially the same. But Progestins and Progesterone are most definitely different, even though they’re often talked about as if they were the same. Progestins are synthetic. Progesterone is not.

All through a woman’s life, estrogen usually gets most of the attention and top billing when we’re talking about balancing hormones, perimenopause and menopause. But progesterone is just as important as estrogen. Progesterone is the yin of estrogen. It’s our calming hormone. It is an anti-inflammatory and anti-growth hormone. 

Unfortunately, progesterones, as a group, were given a bad rap with the Woman’s Health Initiative (WHI) study. This is the study that set Hormone Replacement Therapy aka HRT back on its heels in 2002.They used Progestins, not Progesterone AND I’ll show you why this matters!

So let’s unpack this a bit. 

First off, progestins can only be made in a laboratory. They do not naturally occur in the human body and the chemical structure actually looks more like testosterone than progesterone. They began to be widely used in the early 1950’s and were the only form of progesterone available until the 1980’s when something called body-identical/micronized progesterone was introduced.

Progestins are the form of hormone used in the BC pill, implants, and hormonal IUDs and they come with a warning. They can cause blood clots, heart attacks and strokes. Taken orally, they can also cause a change in the microbiome, cause nutrient depletion of vitamins and minerals, reduce libido, cause weight gain, and depression. 

Below is a table that clearly shows the difference between progestins and progesterone.

As you can see, they pretty much work in opposite ways. 

Since there are obvious and crucial differences between Progestins and Progesterone, it’s super important to know what form was used when reading published results on hormone replacement therapy studies, listening to the media, or even to professional groups.

This is also important when discussing hormones with your doctor. There are still many doctors who are of the mindset that progesterone causes cancer and heart disease. They haven’t been taught the distinction between the two forms. And maybe it’s not their fault. Teaching about hormone replacement in medical school pretty much came to a halt in 2002 with the, not-so-well reviewed, results of the WHI. So that means the majority of doctors 50 years and younger have not received much training in this arena.

I began this piece by saying that progesterone is the yin of estrogen. It works as a counterbalance to estrogen in all parts of the body including:

  • The UTERUS, where progesterone thins the lining while estrogen thickens it
  • The BRAIN, where progesterone is calming while estrogen is stimulation
  • The BREASTS, where progesterone helps to slow cell division, while estrogen increases cell division.

It’s a wonderful modulator and equalizer.

Many doctors do not feel it’s necessary to include micronized progesterone if a woman has had a hysterectomy but as I’ve just pointed out, it does more than just thin the uterine lining, so in my opinion, it’s beneficial to add.

Over a woman’s lifetime, until menopause, she receives protective effects from both estrogen and progesterone. Canadian endocrinology professor Jerilynn Prior stated in her recent paper on women’s reproductive system, “ovulatory cycles across a woman’s long reproductive lifespan are needed to prevent osteoporosis and fractures, heart attacks and breast and endometrial cancers during a woman’s older years. Each and every ovulatory cycle is like a deposit into the bank account of long-term health”.

The use of oral birth control pills (progestins) stops this whole beautiful dance between estrogen and progesterone and actually takes away this protective process. While I’m all for stopping unwanted pregnancy, I’m not so much in favor of the way BC pills are prescribed to young women, to help with acne, ‘regulating periods’, and reducing PMS. The pill, used in this way, is  just masking the underlying problem(s). And it’s all too often given without a clear disclosure of risks or a full informed consent.

I know, I’ve digressed a bit here but there’s so much I want to say and all at once!!! The important thing to remember is, it does matter how you say it because these two different types of progesterones behave differently and often with different outcomes and consequences.

I welcome any comments or questions here! Be well!


Cindy D

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