The Crucial Difference Between Progesterone and Progestins

Progestins versus progesterone.The progestins in hormonal birth control are not progesterone.

Yet, so many journalists and even doctors use the word progesterone when they really mean a progestin drug such as drospirenone, levonorgestrel, or medroxyprogesterone. They are not the same thing.

Progesterone is not a generic term like estrogen. Instead, progesterone refers only to the hormone made by the corpus luteum or taken as oral micronized progesterone.

The progestins of hormonal birth control and old styles of hormone replacement are not progesterone.

As an example, consider the structural difference between progesterone and the progestin drug levonorgestrel, which is used in many oral contraceptives, implants, Mirena IUD, and the morning-after pill.

Progestin or levonorgestrel versus progesterone

Can you spot the difference?

Levonorgestrel is actually more similar to testosterone than it is to progesterone, which is why it can cause hair loss and weight gain.

Levonorgestrel has a high androgen index and is similar to testosterone.

Progesterone versus progestins

ProgesteroneProgestins
beneficial for cardiovascular healthcan cause high blood pressure
stimulates hair growth can cause hair loss
has anti-androgen properties can be androgenic, or “testosterone-like”
generally good for mood and sleep can cause anxiety and depression
may help to prevent breast cancerincreases the risk of breast cancer

Still confused about progesterone versus progestin? Think of this way: Progestin and progesterone have the same beneficial thinning effect on the uterine lining but almost opposite effects in every other part of the body including the breasts and brain. That’s why progesterone is safer than a progestin and also has fewer side effects for mood and hair.

How to get more progesterone

Progesterone is beneficial for mood and sleep and hair.

You might, therefore, be thinking you’d like to take progesterone but please remember:

There’s no progesterone in hormonal birth control. There’s no progesterone in conventional hormone replacement (HRT). They’re progestins.

The only way to get real, natural progesterone is to:

  • Make it yourself. Read Roadmap to progesterone and Period Repair Manual.
  • Take natural or micronized progesterone. Body-identical progesterone is actual progesterone (like the molecule above)—not levonorgestrel or another progestin. Micronized progesterone is available as natural progesterone cream, compounded progesterone, Prometrium, Utrogestan, or Teva generic progesterone capsules.

178 thoughts on “The Crucial Difference Between Progesterone and Progestins”

  1. I’m so confused and being told different things by regular OB and functional med Dr. I took desogen for 12 years continously- no breaks for grade/ stage 4 endo and recurring ovarian cysts. I stopped almost 2 years ago and they put me on progesterone 200mg every day and said to use the cream also. My periods have gotten worse over the two years but the biggest problem is my hair is severely thinning.

    Is it wise to take 200mg of progesterone daily for so long? Is it damaging my hair? I also take spironolactone 200mg a day and biotin but it hasn’t helped the hair problem. I can’t seem to get a definitive answer anywhere.

    Reply
  2. Hi Lara,
    Thank you for clarifying these details, the information on the web is so confusing!
    I am 48 and pre menopausal. My gyno put me on 200mg per day continuous natural micronized progesterone for suspected congested uterus after I suggested that Pelvic Congestion Syndrome seemed to match my symptoms, specifically that I was much improved when laying down and sitting and standing were causing such discomfort that I wasn’t going anywhere and was mostly staying in bed for months. I started the Pro in early August and have had several cycles and the symptoms of congestion have improved to make me functional but not always comfortable. I am seeing an interventional radiologist next week for evaluation of PCS after CT showed ‘prominent’ veins. How exactly does the progesterone help PCS? On continuous 200mg progesterone I will still ovulate right? But I will stop getting my period? How does that work? Just wondering what should be expected from a long term 200mg/day progesterone and if it safe long term, should I continue until meno?

    Reply
  3. Hi Lisa,

    I am currently readying your book ‘The period repair manual’ for starters thank you so much for writing such a helpful resource for women !!!

    I have a question for you, what do you think about the contraception ‘Kyleena’? It’s like the Mirena but with less hormones.

    I can see you have written about most contraception but not this particular one and I wanted to hear your thoughts on it.

    I was told by the doctor all it does is thins your uterus lining so an egg can service in there. But that you still ovulate and have a period. Which to be sounds really harmless but I am still skeptical. I want to ovulate and I want to still have my period as soon as I get off it. I don’t don’t to lose hair or have any negative side affects.

    I’m worried about it potentially affecting my mood, my fertility in the future, my gut, my recurring yeast infections / thrush.

    Thank you for your time.

    Reply
  4. Hi Dr.Briden!

    I just wanted to say thank you so much for your book. I learned so much from it, and it gave me the confidence I needed to quit BC for good, earlier this year in quarantine. My crippling anxiety and depression has mostly subsided, my scary bout of optic neuritis has mostly gone away, and I feel more like myself again. I’ve ovulated 3 times so far, assuming the timing and mittelschmerz were correct.

    I do have one question though. I’m having issues with De Quervain’s tenosynovitis. I’ve started doing some PT exercises that are helping a little bit. But in my research, I found that DQ is also known as “Mommy Thumb” because it’s often associated with the loss of hormones from pregnancy or something. I was wondering if there’s any validity to this statement – and if you have any recommendations for supplements that might help the condition.

    Anyhoo. Thanks so much for all the work you’ve done – you’ve truly changed my life for the better. 🙂

    Reply
  5. I am about to start taking progesterone via Utrogestan, recommended by a doctor from US, close to family (I live in Europe) because of a menopause, I am 46 years old. My concern is in regards of my fear of future breast cancer…or any cancer. No family history by the way, just my thoughts. Please, can you give me your advice! I am in Europe, Bulgaria and taking hormones is not very common thing specially for menopause.
    Thanks in advance!!!

    Reply
  6. Hello Dr. Lara,

    I got off birth control 7-8 weeks ago after being on it for 6 1/2 years. I have been tracking my temperatures using a LadyComp. At first it seemed like things clicked back into gear pretty quickly. I ovulated on day 19 or 20 of my pill bleed cycle and then had a short luteal phase (8 or 9 days) and then had a period for about 5 days with 3 days of spotting at the end. However, this month I am on day 25 of my cycle and still haven’t ovulated. Would it be okay to take a tablespoon of flax seeds each day, grind them up and eat them with my food? I’ve read that in a study they lengthened the luteal phase of some women:

    https://pubmed.ncbi.nlm.nih.gov/8077314/

    I eat a pretty clean diet. I avoid gluten and dairy for the most part and cook the majority of our food at home, largely from scratch. I eat very little processed sugar and avoid industrialized oils. I also take magnesium, B6 and other supplements. I have your book and have read part of it but not finished it yet. I know that it can take time for cycles to regulate coming off the pill but I want to help mine regulate as quickly as I can as long as I’m not hurting anything in the long run.

    Reply
  7. Hi Lara,

    I am in early menopause and trying to conceive as l also did before while being on early menopause and with the help of Vitex . I would like to have another child and I am on estradiol patches 50mcg and progesterone for 12 days x 200 mgs. After finding out that progesterone could inhibit ovulation, l now want to either stop the body identical hormone therapy and be back to Vitex only or find a solution where l can get less progesterone whilst on oestrogen patch. Is 100mgs x 12 days okay or will it also suppress ovulation? Another question is how can l have 20mg of natural progesterone as they all come in 100 or 200mg capsules? Thank you so much.

    Reply
  8. But unfortunately there is no small dose when it comes to micronised progesterone, only the progestins come in small doses. Can this be achieved with vitex perhaps?

    Reply
  9. Hi Lara, can vaginal micronised progesterone be used half dose as it gets absorbed better and internally? Thank you.

    Reply
  10. Hi Lara, I’ve been in a long hormonal trip (in less than 2 years I jumped from Lyza, to Nexplanon and now I’m with Tulana)
    I read your book and I really want to quit the pill but i don’t know how, I talked to my doctor and she practically said I was crazy and suggested that I should keep the pill. I know the pill is bad for my body, and also I know Tulana is only progestin but I don’t know a lot about their components and the effects in my body besides the irregular periods (I’ve been with irregular periods since I started the only progestin treatment. I’m very frustrated…also I’ve been in treatment for HPV and I really need to improve my immunological system, but I don’t want to overcharge my body with pills.
    Thanks for your help Lara. Any help will be really appreciated.

    Caro.

    Reply
      • Interesting! I was going to ask the same, well not the cream. My sister is on a progesterone only pill due to her Diabetes type 1 for contraception. Can she take natural micronised progesterone instead? As I assume it is the thinning of the lining that is being the contraceptive??

        Thanks!

        Reply
        • Sorry I know the pill she is on (Ceravette) actually inhibits ovulation and increases viscosity of the cervical mucus. But thoughts on if there is a safer progesterone to use for contraception would be great! Thanks.

          Reply
  11. My doctor just prescribed both Prometrium (take at night) and Provera to take in the day. I am a bit nervous about the Provera. Do you have any thoughts on this prescription?

    Reply
    • Well, it’s good that at least some of your prescription is Prometrium. If she has prescribed Provera as well as Prometrium, it could be for an issue (like hyperplasia?) for which Prometrium alone is not strong enough.

      Reply
  12. I have been taking compounded natural progesterone for a long time but now apparently have to move to Prometrium. Is there anything I should be aware of/concerned about (apart from the fact I think its even more expensive than the compounded was!)? Thanks

    Reply
  13. Hi Lara,
    I have pcos and I’m in an anovulatory cycle right now. I’m unfortunately starting letrazole to try and conceive but I still haven’t got my period. My Dr. wanted me to take norithendrone acetate for 5 days to start it but it contains lactose. I have natural progesterone cream from wild yam root. Is taking 20mg twice a day for 5 days a high enough dose to get a bleed? I can’t even ask my Dr. because he has no clue about anything natural! Thanks.

    Reply
    • I had lap excision for endometriosis Jan 2019. I was prescribed dienogest – Visanne to be taken daily until menopause (I am currently 47). Is it possible for natural progesterone to be effective for preventing return of endometriomas? I am terrified to be in endo pain again (surgery changed my life amazingly), but I am equally terrified to be in this pill for years. Ridiculous breast pain, zero libido, new mood and anxiety issues that come and go, etc.

      Reply
  14. Hello! Very good to know about the differences. I was on the combined pill but then put on the mini pill due to migraines with aura. I don’t like the mini pill much and am only on it for contraceptive purposes. However I’ve just bought a bioidentical micronised progesterone cream which I want to try instead as I have so many symptoms of low progesterone which I’ve noticed flare up since being switched from the combined pill to the mini pill. I was taking Cilest which had 250mcg of progestin and 3mcg of estradiol and it was the perfect ratio for me as it kept so much under control. But since switching to the mini pill which is only 75mcg of a different progestin, I’ve developed mild acne on my upper back as well as jawline spots, I’ve gained 2kg around my waist and bottom, my skin is dry and aged, my moods are so irritable and anxious and my sleep patterns have worsened! My progesterone cream is due to arrive this week and I stopped taking the mini pill last night, but I don’t quite know how I should take the progesterone cream as I haven’t had a period since the beginning of January. I also wondered if I could take the mini pill and progesterone cream together so I can have the benefits of both (ie contraception and the benefits of bioidentical progesterone)? If you could illuminate the answers I seek, I’d be so grateful! 🙏🏻

    Oh, I also have hirsutism (hence why I first went on the combined pill) but don’t have PCOS and in a hormone panel test a few years ago it was revealed that I had severely low progesterone and high cortisol.

    Reply
      • Sorry, I forgot to mention that I have Hashimotos thyroid disease too and have been on medication for that since 2011. I think the thyroid thing has been driven by the high stress and low progesterone though!

        Reply
  15. Lara, I have adenomyosis and I’ve been taking 200 mg progesterone on days 12-26/27 for about a year now and it’s helping, but there is still a lot of room for improvement. Is it possible to take more than that dose? I also take 320 mg magnesium glycinate, 30 mg zinc, and just added turmeric. I also have low thyroid and take 90 mcg armour thyroid, plus some B6 and Vit D3/K2.

    Reply
  16. Hello,
    I have been taking cyclic compounded progesterone for a couple of months now. My husband is waiting on his vasectomy so we are using non hormonal birth control such as condoms until he gets it done and is cleared. We have a vacation coming up next month and he asks if it would hurt for me to take the mini pill for one month and then return to my 14on 14 off compounded progesterone the following month.
    Would that cause me any serious health concerns? I have several months supply of the minipill left over after my last baby.
    Any advice would be great as I am not finding any information online.

    Thank you.

    Reply
  17. Read your book and thought it was life changing. When I brought it up with my gyno they called it “fake news” ugh. Question: Why can pharmaceutical companies not put real progesterone in the pill if it exists instead of making a similar but different version?

    Reply
    • Natural or micronized progesterone is now being prescribed more frequently by conventional doctors. It’s recognized to be better and safer than progestins and is officially called “body identical” hormone treatment. Your doctor’s comment that it’s “fake news” is absurd and really just a sign that he’s not keeping up with modern developments.

      Micronized progesterone is prescribed for menopause, heavy bleeding, endometriosis, adenomyosis, and PMS or PMDD. It’s not prescribed as a contraceptive method because you’d need a pretty huge dose of it to suppress ovulation.

      Reply
  18. Hi Dr. Briden, my OB/GYN recommended I take bioidentical progesterone during my luteal phase to treat progesterone deficiency diagnosed via blood work. He prescribed me Prometrium, but after doing some research it appears the pharmacy gave me a generic form made by the company Teva. From my research, it appears this compound is a progestin, even though it says progesterone on the label. I am having trouble figuring out what manufacturer of Prometrium is safe for me to take, and why I was given a progestin if I’m supposed to be taking bioidentical progesterone. I cannot tolerate synthetic progestins (learned the hard way after a horrible reaction to HBC) and am really nervous about moving forward with Prometrium after reading about the Teva form being so falsely marketed. I would appreciate any insight you may have on which manufacturers in the US are offering the pure form of progesterone without synthetics or dangerous fillers. I am only in my 20s and am trying to be very conscious of my long-term health as I decide how to address my hormone imbalance. Feel free to contact via email if it is easier for you. Thank you.

    Reply
  19. This is all so confusing. I am 45, been on continuous bc (desogen) for 10+ years because of grade 4 endo with obliterated cul de sac and multiple ovarian cysts. No troubles with that since on the continuous bc but hair loss is a problem- take Spiro 100mg for that- not sure it helps. Recently diagnosed with carotid artery blockage 50% and osteopenia (t score -2.3 in hips). Dr says change to Aygestin which they say is progesterone. Is that a good idea? Im not sure whether to take it or not. Everything i read is conflicting.

    Reply
    • Hopefully, this helps. Aygestin is the drug norethindrone, not progesterone.

      Real progesterone also called micronized progesterone or the brand names Prometrium or Utrogestan can also be helpful for endometriosis symptoms and does not cause hair loss.

      Reply
        • No, Norethindrone is a progestin. Progestins are synthetic forms of progesterone.

          I was just surgically diagnosed with endo/adeno a few months ago. Taking micronized progesterone actually exacerbated my endo symptoms (but did help control my heavy bleeding). A endo excision specialist out of Dallas Texas (Dr Dulemba) actually says he tends to see that with younger women who have more aggressive forms of endo…where progesterone (though me probably actually means progestin) actually exacerbates symptoms.

          Reply
        • There’s only one progesterone and that’s micronized progesterone (brand names Prometrium or Utrogestan).
          Progestins are different molecules.

          Reply
    • They’re both low. It’s not really about the ratio.
      Are you still cycling or are you postmenopausal?
      If you’re cycling, then the numbers can only be interpreted according to which day you were relative to ovulation.

      Reply
  20. My girlfriend (29) has had long term un/semi-diagnosed exhaustion problems. Her current doctors have labelled it as Idiopathic Hypersomnia which seems to be a catch all term when they don’t really know whats happening. We’ve been to all the sleep specialists in the UK but no help. I’ve always had a suspicion it was hormonal.

    Anyway she recently had the Mirena IUD put in and had her first days of feeling normal in about 15 years. No exhaustion. Words can’t explain how this made her feel after years of being exhausted.

    This occurred 3/4 days after insertions and 3/4 days before the start of her period.

    My question now is what was happening on these days?

    Does levonorgestrel inhibit natural progesterone production or is it in addition?

    Does levonorgestrel have any effect on other hormones? Oestrogen etc?

    Thanks in advance! If it’s easier to setup a private skype please let me know!

    Reply
    • Levonorgestrel does potentially inhibit or compete with progesterone. Which, in this case, could be a beneficial effect… If your girlfriend was very sensitive to the neurological effects of progesterone.

      Progesterone çonverts to the neurosteroid allopregnanolone which is sedating, and could potentially have contributed to her feeling of exhaustion. Was it all the time or only premenstrually?

      Reply
      • Thanks for getting back to me. I know it’s not exactly on topic. The exhaustion has been constant since approximately her early teens. She could easily sleep 12 hours a day and still be completely exhausted.

        That’s really interesting that Progesterone converts to Allopregnanolone which modulates the GABAa receptor. I didn’t know that. This is one of the primary research areas for Idiopathic Hypersomnia and Narcolepsy.

        This study seems to agree with your first point. There’s a lot of medial terms I don’t fully follow!
        https://www.ncbi.nlm.nih.gov/pubmed/22634062

        It appears there are two possible routes –

        1 – Find a way to lower Allopregnanolone – Will any generation Progestogen work for this or are some better than others in lowering ALLO?

        2 – Find a way to get hold of a GABAa antagonist which will leave her hormones alone – Flumazenil, Pentylenetetrazole. Unlikely! Sepranolone/Isopregnanolone in medical trials.

        Perhaps its the Progesterone/Allopregnanolone that has been causing her issues all along?

        Or at least may provide a temporary treatment?

        Does this sound about right?

        Reply
        • A hypersensitivity to ALLO could have been in her problem, but in that case, the symptoms would have been restricted to the luteal (post-ovulation) phase which is the last two weeks of the cycle. Because we only make ALLO after ovulation.

          Pretty much any progestin will shut down ALLO. The problem is that many progestins have their own negative effects on the mood and nervous system. The good thing about Mirena is that it’s a low dose of levonorgestrel. Maybe just enough to suppress ovulation but not so much as to cause side effects.

          The other people to ask are PMDD researchers or support groups.

          Reply
  21. Hi, just discovered your blog which is amazing. I have had several uterine polyps removed in the past and my periods are regular but very heavy. Does it mean a new polyp formed? I did a scan and my Dr could not see any polyp but he also said that they can be hard to see…. The heavy periods are ruining my quality of life and relationship, and the only solution my OBGYN has is to put me on birth control pill which I can’t stand. Is there any solution to my pain?

    Reply
    • Dydrogesterone is not bioidentical progesterone.

      Micronised bioidentical progesterone can be obtained as the brands Prometrium, Utrogestan, or compounded capsules.

      Reply
  22. Amazing, here I am worrying that having come off the Merina that my body will miss all the progesterone!!! I think its a disgrace that we are not more informed about what we put in our bodies… thank you for this information

    Reply
  23. I am 49 and estrogen dominant but I don’t tolerate bio identical progesterone in oral pill form or cream form very well . Makes me dizzy and feel a little anxious and depressed. Is this common and any other suggestions .

    Reply
  24. Since I was 24 years old and dived into a deep depression, and finally FINALLY after months of saying it felt like a PHYSICAL issue not psychological, I was told I was deficient in progesterone. I took a natural compound for 6 months and felt amazing. We always assumed it was due to long-term use of birth control, which I stopped.

    4 years later, I began to get bad bouts of anxiety in April. There were some life stressors, but I swore it was another imbalance, and yet, all came back normal. Again and again. 6 months into every medication and therapy you can think of (SSRIs made me flat), I get a call from my doctor that my estrogen is “scary high.” I had a high estrogen result in July as well, but not as high. One was the 13th day of my cycle, and one was the 18th after ovulation. I tried taking progesterone (told this is what can be done for high estrogen) months ago and I didn’t like how I felt – the bottle says Progesterone but I got it from a regular pharmacy and my insurance paid, so I dont know if it was really progesterone.

    Any suggestions?

    Reply
  25. Hi Lara! Thanks to you and your book I started to understand better my specifics and after 3 months BBT charting and testing progesterone 7 days after ovulation it seems I do have a progesterone deficiency. I am 41 years old and I have endometriosis, so it’s quite normal probably to face a progesterone deficiency and short luteal phase. I’ve been through 1 missed abortion and 2 misscariages. So I need to start supplementing progesterone, but in Europe is hard to find natural progesterone. Its interesting that for both progestins and progesterone are described the same side effects such as blood clots, depression and liver disfunction. What do you thinkabou that?

    Reply
  26. PLEASE CAN YOU TELL ME IS THE BRAND PROGESTERIL BY PHARMAXA LABS A NATURAL PROGESTERONE AS OPPOSED TO SYNTHETIC PROGESTIN ? IF NOT CAN YOU POSSIBLY GIVE ME THE NAME OF A BRAND I COULD BUY NO SYNTHETICS PLEASE THANK YOU

    Reply
    • From what I can see on their website, Progesteril contains only wild yam and soy and no hormones, bioidentical or otherwise. Unless the hormones are there but not on the ingredient list.

      Reply
  27. Dear lara I need your help, progesterone from my doctor i found the ingredients: it is ” progesteronum micronisatum 100 mg” – is it progestins please? thank you

    Reply
        • Thank you, just one thing more – is it still pharmaceutical, isnt it? It is not make from wild yam as the progesterone creame is made. Thank you.

          Reply
          • Yes, all steroid hormones (including progestins and ‘unnatural’ hormones) are made from plant sterols. What they’re made ‘from’ doesn’t matter. What matters is what they’re made ‘to.’

  28. Hello Lara, just to clarify, would levonorgestrel block progesterone (lower it), making cortisol high or would it increase progesterone levels overall?
    Very much interested in your reply, thank you!

    Reply
    • When levonorgestrel is given in a dose sufficient to block ovulation (most pills and implants), then it switches off progesterone entirely. Because ovulation is the only way to make progesterone. The levonorgestrel in the Mirena IUD is a lower dose and so does not always switch off ovulation (but it sometimes does), so does not lower progesterone as much.

      Reply
  29. I have been recommended the mirena to stop heavy periods as my ferritin is and has been well below acceptable for a long time. But the research has scared me as I’m also close to perimenopause (44). I don’t need birth control just less bleeding as it wipes me out. But I also have subclinical thyroid issues (T3 and T4 ok but TSH super low) and have for a long time. Had radioactive nuclear scan and thyroid ok. Should I just change my diet or be looking at progesterone therapy? Or is my only option surgical eg ablation? Or will I find the movie re natural answers in your book as I do t want to mess up the balance and communication pathways even more before I hit menopause.

    Reply
  30. Follow up question about 17-P shots: Any way they could be testosterone-like and cause hair loss/miniaturization like some progestins? Just trying to figure out why my hair started to miniaturize after being on those shots during weeks 16-36 of my pregnancy. I know going on and then off Ortho-Tri-Cyclen Lo after that pregnancy to “regulate” my hormones certainly didn’t help, but I also know it’s a low androgen index pill and shouldn’t cause miniaturization. All of my androgens (with the exception of DHT, which hasn’t been measured) are actually on the low normal side. So unless I’m extremely sensitive to androgens or unless my DHT numbers are actually elevated, then I’m not sure why I’ve been experiencing miniaturization?

    Reply
    • Hi Leah, I can understand your frustration. And I’m also now dismayed to discover that the synthetic progestin hydroxyprogesterone caproate is being given to pregnant women. When natural progesterone could be given instead. I really hope it changes soon!

      As for your symptoms, it would make sense to me that exposure to that progesterone-like drug could set you up for a progesterone allergy. But, I do not know that to be true. I’m not aware of any research. And no, I don’t think hydroxyprogesterone caproate has a high androgen index. As far as I can tell.

      Reply
    • Whoops, saw that you already answered this below in the comments (to one of my earlier questions, no less). Any idea what the standard dose is for these shots (am just trying to figure out how much I was given and I no longer have my script handy)?

      Reply
        • Thank you, Lara. I’m not going to lie, I am so frustrated right now! All of my issues (hot flashes, allergic reactions, hair loss, etc) started after this shot years ago during my 3rd pregnancy, and I’ve always felt like the shots I was given were a big part of my story (especially since I had two other previous pregnancies, where I was not given the shots, and my experiences were drastically different).

          My biggest frustration is that I specifically asked my high-risk OB in a major metropolitan area what the ingredients and side effects were. I was told that the shots were identical to natural progesterone and that there are no risks of side effects. I should have known better, and maybe if I had been given ALL of the CORRECT information, I would have made the same decision, but at least I would have gone into it with my eyes wide open. This frustration is second only to my frustration with doctors that keep telling me I need to go back on birth control to “regulate” my periods (to undo the damage that was caused by synthetic hormones, no less). Grrrr!

          Reply
  31. My doctor put me on medroxyprogesterone and told me it is not effective as birth control. He is clearly confused. I told him it is birth control because that is what it says. I am so frustrated.

    Reply
    • I need to add that he told me to use it because I am currently going through fertility treatments. I see that you said bioidentical progesterone is used in fertility treatments. Will this cause harm to me or my child since I was given a progestin and not bioidentical progesterone?

      Reply
  32. I’ve been considering progestin based birth control to alleviate menstrual symptoms. I hate to go a normal route but my cramps are extreme and I’ve damaged my stomach trying to weaken the pain. I exercise regularly and have a well balanced, nutritious diet. I need help! I don’t like to lean on the doctors because they promote heavy medical routes and I like to keep my body as natural as possible. I didn’t know there was a difference between progestin and progesterone, so thank you for this article! I am wondering though – would getting more progesterone help with menstrual pain? Looking for a serious answer!

    Reply
  33. Do you think progesterone cream would help with ovulation pains that come every month? Even if you have regular cycles?

    Reply
    • For my patients, I sometimes recommend a dairy-free diet and low-dose iodine to resolve ovulation pain. It depends on whether there is another condition present like endometriosis.

      Reply
  34. Have you heard of “Lutenyl” (made in France)? Is that a progestin as well? And is there a natural progesterone strong enough to suppress menstruation completely?

    Reply
    • Lutenyl is the progestin nomegestrol acetate. It’s not progesterone.
      At a dose of >200 mg per day, natural progesterone can potentially suppress ovulation, but that is not currently recommended as birth control

      Reply
  35. Hello! I really need to supplement natural progesterone, but it is cost prohibitive for me on a retired income to do this through a doctor. Are there any over the counter natural progesterone products available that are trustworthy? Thank you so much

    Reply
  36. Had the Mirena IUD inserted to treat heavy bleeding caused by a submucosal fibroid. It worked. The bleeding stopped. I stopped having periods. Been on Wellbutrin 20+ years for depression. Read reports the Mirena was contraindicated for depression + told my GYN. Within a few weeks, my mood dipped + weight gain. (I’m 5′ tall, 105 lbs, athletic and health conscious — the weight gain was abnormal) My GYN told me to “give things time to even out.” I wanted the Mirena out. GYN was insistent about leaving it in. After a miserable year, I found a new GYN, had the Mirena removed, and immediately started bleeding like never before. Had 2 hysterscopic myomectomies 6 mos. apart to shave back the fibroid. Didn’t work. 3 mos ago, started taking generic Prometrium 100mg with hopes it would treat the bleeding like the Mirena without impacting my mood. My mood is fine, but the bleeding continues. Upped the dose to 200 mg. Still bleeding.
    These are my questions: 1) Are there differences between generic bio-identical micronized progesterone capsules and brand-name Prometrium? 2) Is the transdermal Prometrium vaginal ring or a progesterone cream more effective than oral meds? 3) Could Mirena/Prometrium combo treat bleeding without depression? Thanks!

    Reply
    • Generic bioidentical micronized progesterone is the same as Prometrium. You could try talking to your doctor about a higher dose 200 mg dose of the Prometrium. It might work used in conjunction with the heavy period treatments dairy-free and turmeric. Please see my heavy period post. I don’t have experience with the progesterone vaginal ring but it doesn’t look like a high enough dose to prevent heavy bleeding.
      One of the reasons that Mirena disrupts mood is that it alters the stress (adrenal) response, so you could try it combined with treatments for the stress response including magnesium, zinc, and yes, maybe Prometrium.

      Reply
  37. Hello,
    Is there a difference ibetween prometrium and the generic teva progesterone, beyond the fillers in them? Are they both bioidenticals?

    Reply
  38. Hi Lara, I was prescribed Duphaston (a progestin) 12 days a month to help regulate my periods (always been irregular probably due to PCOS). It doesn’t block ovulation. Have you heard of it, and do you think it’s ok to take? Or should I insist on Prometrium or bioidentical progesterone cream?
    (By the way, I sent you a more detailed private message asking for general advice on Facebook, but maybe you couldn’t see it since we’re not connected? What’s the best way to contact you?)

    Reply
  39. Will progesterone supplements cause IUDs to be ineffective? I currently have Mirena and I am dealing with the side effects of having too much estrogen and no progesterone such as acne, low libido, and mood swings.

    Reply
  40. My daughter has PMDD. I am fairly certain the gynecologist will recommend birth control. I am trying to research bio identical hormone options BEFORE we go to the gynecologist so we can ask good questions. Are ther options out there? She is not sexually active and Would prefer not to be on animal-based synthetic hormones.

    Reply
  41. Hi, dr. Briden
    My gyn prescribed progendo vaginal cápsules to get my period, it was for two capsules of 200mg for ten days. after 5 days finish the last pill i get my period, but reading comments see that is too much and it can affect me. Wich could be a safe dosis to support a lutheal phase or to get a period ?
    Thank you

    Reply
    • A high-dose progesterone-induced bleed is not a real period.
      A real period is one that follows ovulation and a luteal phase. A luteal phase is defined as the time following ovulation.

      So the strategy to have a real period is to figure out why ovulation is not occurring and then correct THAT. For more information, please see my Ovulation post, and also my book Period Repair Manual.

      Reply
      • Thank you for your response, she order it to me (my doctor) because i quit the pill three months ago, she wanted me to start a “period” with progesterone and start the pill again, I finished reading your book while during the time I had to take the pill and I did not want to take it any more. My fear was that i tooked so much of it (progesterone).
        Thank you

        Reply
  42. Hi Lara!

    Thank you for this awesome website and help! I have had PCOS for 15 years (I am 27 years old) and have used birth control to help regulate periods for all of these years. About 5 months ago I started a gluten, dairy, and soy free diet as well as cut out sugar and caffeine. I am extremely wowed by the results I have had thus far. I have been able to get off of my anti-depressant and birth control. Feeling great! My doctor wants me to take Progesterone if I do not get my period, for I am trying to conceive. I am all about being “all-natural” these days because I can tell it is helping my body. I told my doctor I wanted to take Prometrium instead of Provera because of the “bio-identical” aspect of the Prometrium. My pharmacist prescribed me the generic version of Prometrium…and it was filled as Progesterone Capsules. Are these Progesterone Capsules really the same thing as Prometrium?

    Thanks so much!

    Reply
  43. Hi Lara
    i have pcos.initially i donn’t have acne,hairloss and sleep problems.but after using of high androgen index pills i have got all these .after using peony for month i stoped that and used spironoloctone for 10 days and all symptoms are resolved.but after stopping spiro i got all symptoms back.and after that i started spiro back but symptoms are not resolved.then i tried so many things nothing worked.i tried natural progestrone cream with this periods came but not symptoms.then i stopped natural progestrone cream and started peony for 40 days i didn’t notice any changes how long it will take .and my question is even natural progestorne cream works as
    high androgen pill.because i noticed problems .can u explain please.

    Reply
  44. Hi Dr. Briden!

    Oh my god, I’m so thankful I found your work. Do you ever do consults? I would love to pay for some of your time. Ordering your book right now, regardless…

    I’m 28 and I had a really rough transition off of birth control last year- 7 months without a period, hair loss, weight gain, water retention, depression, lethargy, inflammation.

    Lots of things happened between then and now including vitex berry (did not help), diagnosis of PCOS with massive allergic reaction to medications (birth control, metformin), diagnosis of adrenal fatigue (none of the adrenal treatments worked).

    I found my own way to bioidentical progesterone cream last month and it has taken care of many of my symptoms!!! I still have awful acne that comes and goes with the wind and my periods are off, but I feel amazing and my other symptoms seem to be going away slowly.

    I started with 10mg BID days 8-16, 20mg BID days 17-24 of my cycle like the packaging of Pro-Gest says, but my period (spotting?) came day 18 so I stopped taking it for a week per directions.

    I started again on day 8, but my period started after a week. I don’t know if I should stop taking it or continue?? I’ve continued applying it until I can do enough research to figure out my next move in the mean time.

    I’m not sure what I’m doing wrong here… I think I’m either taking the wrong dose or my timing is wrong, but I don’t know how to judge timing now that my period is all over the map.

    It seems all the info on the internet is conflicting and I really need a professional opinion. I do not trust my naturopaths / doctors now after the allergic reactions and unhelpful diagnoses.

    Please let me know if we could have a Skype call! And enjoy your holiday weekend.
    Best regards,
    Marlee

    Reply
    • I generally do not like to give progesterone in the follicular phase (before ovulation) because it can disrupt ovulation. As for a possible Skype consult, please send me a private message.

      Reply
    • Have seen some practitioners say that progesterone used as a cream is 8-10x stronger than oral, injected forms. And that if someone did get too much of it bia cream that some of it can start converting into more estrogen and/or cortisol! ZRT Labs has some interesting videos on the potential of P overdosing w/creams you might find interesting.

      Reply
  45. Let me just begin here by stating that I love your posts!

    I am taking Prometrium by Merck, and have been told that this is NOT a natural biodentical hormone, yet I see it repeatedly referred to as being one. You have even mentioned it on your blog post. Is there a different Prometrium product that I am not aware of or is this the product you are recommending in your post?

    Reply
        • My concern about Prometrium is that it’s a pretty big dose: 100 or 200 mg. Which is high compared to the dose of 20 mg that I discuss in my book. 200 mg is too much for many women, especially if it’s dosed every day, as Prometrium often is.

          So for any hormone replacement there are two issues: First: is it bioidentical. And second: How MUCH is being used.

          Reply
          • I have just increased my dose of promethium to 200mg and taking two pumps of Estrogel and feel great. Until today. I got my period. I have been in menopause for 3 years. Is this caused by too much estrogen? Too much progesterone? I should mention that I have adrenal fatigue and low cortisol.

          • Please speak to your doctor about the fact that you got a period. At the right dose, post-menopausal HRT should not cause bleeding.

  46. I’ve read the articles and comments but am unclear what the best bio identical progesterone cream is in Australia that is not too high a dose. I have endo and low progesterone, peri menopausal, mid-40s, not on contraceptive pill (since 21), healthy diet. Am also going to supplement with your rec herbs and minerals. Can I buy over-counter at chemist?

    Reply
    • Bio-identical progesterone is not available over-the-counter in Australia. Most people obtain either from a compounding chemist (with a script), or order online from the US. Most of the creams available online are a 2% formulation, which is low dose.

      Reply
      • I’ve looked at some online brands and they are full of chemical excipients – do you recommend any brand that is really natural? Otherwise I’ll speak with my GP about a script. Great website too thanks Lara.

        Reply
  47. Dear Lara,

    i would like to ask you about my problem.
    Actually, i was diagnosed at ovarian cysts and uterine polyp by ultrasonic.
    A have problems with my period – I have Two periods per month – first normally in 28 days and meanwhile second after 15 days, but only “spotting”. I have painful menstruation.
    My doctor said me, that at first its important to reduce cyst and he prescribed mi hormonal birth control (YAZ) for three months. He said me, that it makes the cyst smaller or let it disappear. I have to come to control in next month. Than, he will remove me uterine polyp.
    My question is, if its needs to take hormonal birth control (HBM) to make the cyst smaller (or let it disappear). Why is the HBM prescribing? I do not take HBM already 6 year and I don’t won’t to take it.

    Thank You very much

    Reply
  48. Mu daughter is on the BC pill to regulate her periods since she was having them every 1 1/2 weeks. What would you do to help her more naturally?

    Reply
  49. Hi Lara, I just finished your wonderful book and am sleeping well again thanks to magnesium. So thank you! My question though is about natural progesterone cream dosage and application. I’m 40, trying to conceive and my progesterone seems to fluctuate from good some months to low normal others. Last month it was at 12 on day ten of my luteal phase and my doctor says 10 is the minimum amount he likes to see. Interestingly, I notice a sharp dropping feeling in my abdomen around day ten and my breasts decrease in size. I think it’s the drop in progesterone and I’m not sure if it’s a normal drop because I didn’t conceive- or if it’s a premature drop that can be prevented with supplementstion. I decided to start taking natural progesterone and see. I’m finding varied recommendations for dosage. I’m taking 40mg per day now and not sure it’s doing much. I read on various websites that 100mg is a minimum- yet the bottle suggests starting with 40. I’m inclined to bump the dose to 100 if that’s fairly standard. Also- I’m reading various suggestions for where to apply. The bottles suggest the thighs, abdomen and hands while some NDs suggest neck and back of arms where there’s less fat. Can you throw your two cents in about any and all of this? Thank you so much for your wonderful work. I’m loving learning about my hormones and systems for the first time in 40 years!
    Sarah

    Reply
    • Thanks for your feedback about my book.
      For fertility support in older women, I would generally work with a dose of 40-100 mg. ? (exactly what you’re trying). Generally, I would give the lower dose 3 months before going up, but of course you must speak to your own clinician about what’s best for you. I’m like other NDs in that I prefer to apply to it areas with thinner skin and a good blood supply (behind knees, and inside elbows). Vaginal application can also be helpful for fertility. Not fatty areas because I don’t want it to accumulate in the fat and then potentially release during the follicular phase or disrupt other hormones.

      Reply
      • Hello! Can you please give your opinion about when in your cycle should someone start a progesterone supplement (in order to lengthen the luteal phase)? In theory, progesterone should only “happen” after ovulation (which, for me, typically happens at cycle day 18) so, in theory too, the supplement should only be taken after confirmed ovulation, is that correct?
        I have had a gyn-obs opinion, however, that I should start taking it at cycle day 16 (so, before my ovulation) for 10 days.
        My luteal phase is only 9 days..
        What is your opinion on this?
        Thank you and congratulations on this fantastic blog!

        Reply
        • Hi Carolina,
          Progesterone supplements can enhance progesterone levels, but they cannot lengthen the luteal phase. That depends on the lifespan of the corpus luteum. I discuss ovulation and corpus luteum in some detail in my book.

          Reply
  50. Hello again, Dr. Briden!

    I’ve noticed that zinc makes me nauseous right after taking it. Why is that? Am I taking it incorrectly? What should I do differently?

    Aurora

    Reply
    • On an empty stomach, zinc can cause nausea in almost anyone (because it stimulates the stomach lining). You need to take directly after food. Or take a lower dose.

      Reply
  51. Hello Lara, I have just gone off the pill after 24 years. I am booked in to get the mirena but ultimately want my husband to get “the snip” but he is hesitant. I have high cortisol, high copper, high mercury, and am in the first stage of adrenal fatigue. I am currently detoxing under the guidance of a nutritionist taking magnesium, vitamin D, CoQ10, EnteroCare and EstroSense, amongst other supplements. I feel as though I am on an emotional rollercoaster. There is so much info out there it’s difficult to know what to do about imbalanced hormones etc. Am I heading in the right direction to feeling “normal” again?

    Reply
  52. Hello Lara, is there any other way besides probiotics to try to influence the good bacteria to outweigh the bad? Would CoQ10 do this? Anything besides probiotics?

    Reply
    • The most powerful way to influence our microbiome (good bacteria) is with diet (lots of vegetables), and to avoid antibiotics as much as possible.

      Reply
  53. Hi Lara, a read a post of yours on Daysy Planet where you recommend Licorice & Peony for non insulin resistant PCOS…I have adrenal PCOS, is this a good treatment for me? How would I use it & in what dose? Thank you so much, you are an only resource for so many of us suffering through female conditions.

    Reply
    • Hi Hannah, did you see my androgen post? It discusses the differences between adrenal PCOS and ovarian PCOS.
      I use peony and licorice primarily for ovarian PCOS, but it can also be helpful for adrenal PCOS.

      Reply
  54. Lara, thanks for this information. I feel somewhat stuck between a rock and a hard spot. I have PCOS (unsure of which type) and I’ve gotten off of hormonal birth control pills in order to attempt to ovulate- I am now taking Paragard (Copper IUD). In the process, however, my irregular periods have become significantly heavier (bleeding for over 9-11 days). I have purchased progesterone cream and was also prescribed Prometrium from my M.D. In previous comments, you have mentioned that 100+ mg can be counter productive by increasing testosterone. However, I have also read that at least 200+mg is needed to stop heavy bleeding. In my particular case, would you still advise staying at a dosage of 20mg per 1/4 tsp?

    Reply
    • It’s a priority to get control of your heavy bleeding, so you may have to take the big dose the doctor recommends. 20 mg won’t be enough.
      In the big picture, you might want to think about additional treatments for heavy periods. Please see my Heavy Period post and also Chapter 9 in my book.

      Reply
  55. I suffer from breast tenderness 95% of the month. Im 48 years old and still have somewhat regular periods. I have seen numerous naturopaths but nothing really helped. They did mention though i have excess oestrogen. I would love your input, its so uncomfortable

    Reply
  56. Hi Lara, that is such an interesting comment from Leah. I have developed a rash/eczema on my shins and tops of my arms since I started bio identicals for menopause. I have just about eliminated everything I can think of to try and lower any inflammation (all the usuals, soy, corn, dairy, wheat/gluten, yeast, omega 6, grains) but nothing has changed. Can hormones or lack of hormones cause eczema/rashes?? I’m taking 100mg progesterone at night.

    Reply
    • Certainly, hormones affect immune function, and can influence eczema/rashes. Leah brought up the more specific issue of a progesterone allergy. It’s rare, but I have seen it. You might want to have a little break from the progesterone just to see.

      Reply
  57. Hi Lara,

    What do you think of the Dr. McDougall diet claiming it is the answer to all your health problems? I am having a battle on what to do. My body feels yucky & I suffer consequences such as acne when I eat meat or dairy. My body feels great when I eat a high starch diet, but I get more cavities than normal and my teeth feel yucky. What to do? Please let us know what you think of the McDougall diet.

    Reply
  58. Hi Lara,

    Since I went into preterm labor with my 2nd, my perinatologist recommended compounded “progesterone” shots with my 3rd from week 16-36. I’m guessing I was given the bioidentical progesterone? The Dr assured me I wouldn’t have any side effects b/c it was natural, but after the birth of my third, I developed all sorts of new allergies to foods and products, including a sensitivity to my own progesterone, which manifests itself in a rash on my legs that peaks at 7-10 days before my period and stops when I start my period. My dermatologist and allergist think it’s all related to the hormone shots from my 3rd pregnancy. Have you seen something like that before?

    Reply
    • Hi Leah, Thanks for sharing your story. If it was the 17-P or 17-hydroxyprogesterone shot, it was a progestin–not bioidentical progesterone.

      But I have heard of what seems like a progesterone allergy occurring after high-dose bioidentical progesterone. It’s rare, but I had one patient who developed it after using high dose progesterone pessaries. And yes, you could now be reacting to your own progesterone. My strategy would be to try to stablize the hormone receptors and the immune system but reducing inflammation (with some of the dietary strategies that I discuss in Chapter 6 of my book).

      Reply
  59. My doctor has recommened mirena for me when i undergo laparoscopy and removal of left ovary end of october (they think i may have 2 chocolate cysts). I have been having period like cramps before and after period with nausea and extreme tiredness. My doctor thinks I may have endometriosis. But I am not sure about mirena. I have read just as many negative comments as positive and think at this stage I would just prefer to try the surgery followed by diet and supplements? What are your thoughts? Thanks from Robyn

    Reply
    • Hi Robyn, Diet and herbal medicine can be effect treatment to prevent the recurrence of endometriosis, but it’s not a guarantee. But then, neither is Mirena or any form of hormonal birth control a guarantee against recurrence. With many of my patients, I find that diet and herbal medicine actually work as well or better. Please see my Endometriosis post. For many endometriosis-sufferers, the single most important thing is to avoid dairy products.

      Reply
  60. I didn’t know Prometrium was bioidentical progesterone. I was prescribed it, but was afraid it would cause many of the effects of BC and progestins. Do you think Prometrium is safe for PCOS? Thank you!

    Reply
    • Actually, I think Prometrium is too high dose for any kind of practical use. It’s available as 100 or 200 mg capsules, which is a huge amount compared to the 20 mg per day made by the corpus luteum. They need to give higher dose because most of an oral dose be lost in the liver, and will not actually reach the blood. So, the 100 mg might be okay. Low dose progesterone has an anti-androgenic effect (testosterone-blocking effect), but too much progesterone can convert to testosterone.

      Also externally supplementing progesterone doesn’t solve the underlying issues of PCOS, which are usually insulin and inflammation (see my 4 Types of PCOS post). The goal with PCOS treatment is to start to ovulate again, and to therefore make progesterone. High daily dose of progesterone will almost certainly suppress ovulation. On the other hand, a small dose (less than 20 mg) taken cyclically can help to promote ovulation because it suppresses LH.

      Reply
      • Dr Briden
        So if I was given a compounded bioidentical 50ml cream will this be too high? PCOS and worried about already high testosterone. Thanks!!

        Reply
          • Thank you for replying! It says it is progesterone 50ml/mg cream and then it says one pump delivers 0.25ml. Also, I have read that applying the cream vaginally may avoid dermal fatigue issue and/or the cream ‘building’ up in areas over time. Does this have any validity to it? Thanks!

          • That’s the quantity of cream but it still doesn’t tell me the strength or dose if the hormone. Does it give a % ?

          • Hi Dr. Briden,
            Thank you for helping me better clarify what to look for to know what % my cream actually is. I called the pharmacy and they said it is 25mg strength per 2 pumps. (Wasn’t labeled on the script) So, it looks like it’s 5mg more than the 20mg usually rec. I am hoping this will be safe dose and I will apply it the last part of the luteal phase ( 7-10days?) I hope this posts under your last reply to my thread. Thanks again!!

I welcome your comment!

Send this to a friend