If you’re considering hormone replacement therapy to ease menopause symptoms, you may feel confused about progesterone and progestin. These terms are often used interchangeably, but they are, in fact, two different compounds that don’t offer the exact same benefits. Dr. Anna Garrett, Board Certified Pharmacotherapy Specialist and author of Perimenopause: The Savvy Sisters Guide to Hormone Therapy, explains how progesterone and progestins are different and which one might be better for your purposes and your health.*

Progesterone v. progestin

The most basic difference between the two substances is that progesterone is a natural hormone your body makes during ovulation each month, while progestins are synthetic compounds that are similar to progesterone, and provide some though not all of the same benefits. 

Since naturally-occurring substances can’t be patented, Dr. Garrett explains, pharmaceutical companies created progestins in order to patent and sell their medications. Progestins are used in most birth control pills, in the Mirena IUD, and in hormone replacement therapy for menopausal women. 

Not an even trade

Progesterone has a calming, anti-anxiety effect on your body, and is also good for bone health, nerve health, quality sleep, and other health benefits. Starting sometime in early midlife, estrogen and progesterone levels begin to fluctuate. This is what causes common menopause symptoms, including problems sleeping, mood swings, and fatigue. 

While progestin may help relieve menopause symptoms when combined with estrogen, it may not be as good as the progesterone that occurs naturally in your body.

“It’s not like you’re substituting one for the other,” Dr. Garrett explains. “[Progestin] does not give you all of the same wonderful benefits of progesterone, like calming and anti-anxiety, [and] it doesn’t help with nerve or bone health.” 

Progestins have also been associated with certain cancers. Since some states lump progesterone and progestins together in the same category, cancer warnings often appear on the labels of both products. 

How to increase progesterone

Dr. Garrett recommends getting your progesterone levels tested before starting hormone therapy, since having too much progesterone in your body can lead to negative side effects, such as worsening depression or making you feel sleepy at inconvenient times. 

If you’re looking to increase your progesterone levels, Dr. Garrett says, there are some remedies you can try, including:

• Supplements that contain vitex or chasteberry,
• Progesterone cream, or
• Oral progesterone.

Different methods are recommended for different symptoms. If you’re experiencing symptoms other than problems sleeping, a supplement or cream may be the easiest option. If you are having trouble falling asleep, getting a prescription for oral progesterone may help, since one of the compounds in the medication can make you sleepy. 

If you’re looking for some relief from menopause symptoms and are considering hormone replacement therapy, speak with your doctor. Together you can come up with a treatment plan that is right for you and your specific needs.

*Garrett, A. [Hormone Harmony with Dr.  Anna Garrett]. (2017, September 28). The Difference Between Progesterone and Progestins [Video]. YouTube. https://www.youtube.com/watch?v=Erv-4OK_qZY