Progesterone vs Progestins

Progesterone vs Progestins
Tim Van Mol, RPh

Progesterone is a term that is often used incorrectly to describe both natural bio-identical progesterone and synthetic progestins (also called progestogens).  Bio-identical progesterone, as the name implies, is chemically identical to the progesterone produced by the human body.  Progestins on the other hand are derivatives which were developed prior to the availability of micronized bio-identical progesterone to provide an oral preparation that could be patented, and therefore, profitable to manufacture. For example, the “Pro” ingredient in the brand, PremPro, is a progestin.


Progesterone (bio-identical) and progestins (synthetic) both exert an antiproliferative effect (in other words a braking mechanism on cell multiplication) on the uterine endometrium in women who are receiving estrogen replacement. This is necessary to protect the uterus. They are equally protective in this instance.  However, if you are told that you don’t need progesterone because you no longer have a uterus, that statement is only partially true.


Bio-identical progesterone therapy is also valuable for women who have had a hysterectomy since there are progesterone receptors throughout the body.  The breast and brain in particular are replete with progesterone receptor sites.  If these receptor sites are not receiving progesterone, then the body responds with negative symptoms.  That’s why hysterectomized women not on progesterone often suffer foggy thinking and tender breasts in addition to other unpleasant side effects such as trouble sleeping.


Mayo Clinic researchers surveyed 176 women taking bio-identical micronized progesterone who had previously taken synthetic progestins.  After one to six months, the women reported an overall 34% increase in satisfaction on progesterone compared to the previous synthetic HRT (hormone replacement therapy).  Women reported improvement of 50% in hot flashes; 47% in anxiety; and 42% in depression.  Additionally, micronized bio-identical progesterone more effectively controlled breakthrough bleeding.


Our experience has been that compounding progesterone capsules for women with progesterone deficiencies has helped them with sleeping. A side effect of oral progesterone is quite often drowsiness, and we have put this knowledge to good use by compounding capsules for these women. For women who do not have sleeping difficulties and are deficient in progesterone, we normally compound a transdermal cream. As opposed to commercially available progestins, one size does not fit all in compounding bio-identical hormones.


Educate yourself and see if bio-identical hormone replacement therapy is for you. We are happy to provide you with information on bio-identical hormones. Call us and ask for our printout of the 50 most frequently asked questions and answers on bio-identical hormone replacement. You can pick one up at Vanmol Family Pharmacy.  Come visit us in Woodworth, or feel free to call us at (318) 443-7073 for a free hormone consultation about how we can improve your quality of life!