The Crucial Difference Between Progesterone and Progestins

Progestins such as drospirenone, levonorgestrel, or medroxyprogesterone are not progesterone.

That’s because 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.

Consider the structural difference between progesterone and the progestin drug levonorgestrel, which is used in many oral contraceptives, implants, hormonal IUDs, and the morning-after pill.

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.

Progesterone versus progestins

There are several important differences between real (body-identical) progesterone and progestins.

Still confused? Think of it this way: Progestins and progesterone have the same beneficial thinning effect on the uterine lining but opposite effects in almost every other part of the body, including the breasts and brain.

In general, real progesterone has the advantage of being safer for breasts and usually better for mood.

How to get progesterone

There’s no progesterone in hormonal birth control.

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

• Make it yourself by ovulating.
• Take oral micronized progesterone capsules (natural progesterone). Bioidentical or body-identical progesterone is actual progesterone (like the molecule above)—not levonorgestrel or another progestin. Progesterone is available as natural progesterone cream, compounded progesterone capsules, or products such as Prometrium, Utrogestan, Famenita, or Teva.

Further reading:

• How science got it wrong about progesterone
• Guide to using progesterone for women’s health
• A safer type of hormone therapy
• My books