If you learn one thing from this blog, let it be this: The progestins in hormonal birth control are not progesterone.
It seems simple, and it should be simple. Yet most journalists, doctors, and even the British Medical Journal get it wrong. They use the word progesterone when they really mean a progestin such as drospirenone, levonorgestrel, or medroxyprogesterone. They’re not the same thing. At all.
It’s an understandable mistake. After all, estrogen is a generic term. It can be used to refer to anything estrogenic such as estradiol, ethinylestradiol in the Pill, and xenoestrogens from the environment.
Progesterone is not a generic term. It’s one thing. It’s progesterone, and there is no other.
The many progestins used in hormonal birth control and hormone replacement are something different. Just how different? Take a look below at the molecular structures of progesterone and drospirenone (the progestin used in Yaz and Yasmin pills).
Can you spot the difference? Progesterone is actually more different from drospirenone than it is from testosterone below.
No wonder progesterone and progestins have such vastly different physiologic effects!
How to get more progesterone
You’ve probably heard good things about progesterone. It’s beneficial for mood and hair. It boosts thyroid hormone, promotes sleep, and clears skin.
You might be thinking you’d like to take some progesterone, but please remember: There’s no progesterone in hormonal birth control. There’s no progesterone in conventional hormone replacement (HRT). Those are progestins.
There are only two ways to get real, natural progesterone:
- Make it yourself. For details, please see Road Map to Progesterone and my book Period Repair Manual.
- Take bioidentical progesterone. Bioidentical means human-identical. It’s made in the lab from yam sterols (like all hormone replacement), but it’s made to be actual progesterone—not drospirenone or another progestin. Bioidentical progesterone’s molecular structure looks like progesterone in the diagram above. You can detect it on a blood test for progesterone (try detecting drospirenone on a blood test!). Bioidentical progesterone is the progesterone used in fertility treatment (at very high dose). It’s also available as Prometrium, natural progesterone cream, and compounded HRT (see Natural Progesterone is a Safer Kind of HRT). Bioidentical progesterone is not effective as birth control.
I hope this clears up some confusion about progesterone and progestins. Please ask me more in the comments below!
Yours in health,