PROGESTERONE VS. PROGESTIN: WHY YOUR DOCTOR MIGHT BE LYING (Unintentionally)
Progesterone vs. Progestin: Why Your Doctor Might Be Lying (Unintentionally)
"Your doctor says they’re prescribing progesterone… but are they really?"
Let’s talk straight: most women are being misled, and not necessarily with bad intent. When your doctor says they’re prescribing progesterone, they’re often actually prescribing progestin, a synthetic version that is not the same thing. Not chemically. Not functionally. Not biologically.
And the difference? It’s not subtle—it’s crucial.
What Is Progesterone?
Progesterone is a natural hormone your body produces after ovulation. It plays a critical role in maintaining a healthy menstrual cycle, preparing the uterine lining for pregnancy, and balancing the effects of estrogen. It also promotes restful sleep, calms the nervous system, supports bone health, and may even protect against breast cancer.
When we talk about using progesterone in therapy, we’re referring to bioidentical progesterone, a form that is chemically identical to what your body naturally produces. This version is available under names like Prometrium® or Utrogestan®, and is also found in custom-compounded creams and capsules.
What Is Progestin?
Progestins, on the other hand, are synthetic hormone-like drugs designed to mimic some actions of progesterone, but they are not the same molecule.
These synthetics are found in most hormonal contraceptives (like the pill, mini-pill, and hormonal IUDs), hormone replacement therapies (HRT), and contraceptive injections like Depo-Provera®.
While progestins can suppress ovulation and control bleeding, they don’t behave like progesterone in the body. They can’t offer the same brain-calming, bone-building, or breast-protective benefits that real progesterone does. And in many cases, they cause the opposite effects.
The Side Effects of Synthetic Progestins
Here’s where things get real. Progestins are associated with a wide range of side effects, especially when used long-term or without proper guidance.
Mood changes are among the most common, and most disruptive. Many women on synthetic progestins report increased anxiety, depression, mood swings, and even panic attacks. Unlike progesterone, which interacts with GABA receptors in the brain to promote calm, progestins lack this calming effect. For some, they actually worsen mental health.
Weight gain and fluid retention are also common complaints. Synthetic progestins can disrupt appetite regulation, increase water retention, and contribute to bloating.
Breast tenderness, headaches, and migraine exacerbation are other frequently reported side effects. Progestins can also cause acne and oily skin, particularly those with androgenic (testosterone-like) properties.
Even more concerning, synthetic progestins have been linked to an increased risk of breast cancer when used in hormone replacement therapy. In contrast, natural progesterone has been shown to be safer, and may even offer protective effects.
Additionally, progestins can negatively impact your metabolism, increasing insulin resistance, raising LDL ("bad") cholesterol, and lowering HDL ("good") cholesterol. Natural progesterone doesn’t have these same harmful metabolic effects, in fact, it supports metabolic and thyroid function.
But My Doctor Said It’s Progesterone…
Unfortunately, many doctors use the term “progesterone” interchangeably with “progestin,” which leads to widespread confusion. The problem isn’t just semantics, it’s that women are being told they're receiving a natural hormone when, in fact, they’re being given a synthetic drug that doesn’t work the same way.
This confusion can leave women frustrated and gaslit, especially when they experience mood issues, worsening symptoms, or side effects and are told “it’s all in your head.” It’s not. It’s the wrong hormone.
Here’s What You Can Do
Ask for clarity. When your provider suggests progesterone, clarify: “Is this bioidentical progesterone, or a synthetic progestin?”
Get curious. Look up the brand or compound you’ve been prescribed. Don’t just assume it’s what your body needs.
Consider natural options. Bioidentical progesterone is available and has decades of research supporting its use in fertility, perimenopause, PMS, and more.
Work with practitioners who understand the difference and take the time to educate and individualize treatment, especially when hormones are involved.
Final Thought
If you’ve felt “off” while on birth control or hormone therapy, there’s a good chance it wasn’t all in your head, it was in your prescription. Synthetic progestins and real progesterone are not the same. And knowing that difference could be the key to reclaiming your mood, your energy, and your hormonal balance.
You deserve the truth, and you deserve better hormones.
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