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Progestins are not progesterone

The Crucial Difference Between Progesterone and Progestins

The progestins in hormonal birth control and HRT are NOT progesterone.

It seems simple, and it should be simple. Yet most journalists, doctors, and even the British Medical Journal get it wrong. They use the word progesterone when they really mean a progestin such as drospirenone, levonorgestrel, or medroxyprogesterone. They’re not the same thing at all.

It’s an understandable mistake. After all, estrogen is a generic term. It can be used to refer to anything estrogenic such as estradiol, ethinylestradiol in the Pill, and xenoestrogens from the environment.

Progesterone is not a generic term. It’s one thing. It’s progesterone, and there is no other.

The motley crew of progestins used in hormonal birth control and hormone replacement are entirely different molecules than progesterone. How different? Take a look below at the structures of progesterone versus levonorgestrel (the progestin used many oral contraceptives, implants, Mirena IUD, and the morning-after pill).

Articles. Progestin Progesterone

Progestin versus progesterone

Can you spot the difference?

Levonorgestrel is actually more similar to testosterone than it is to progesterone (which is why levonorgestrel can cause hair loss).

Articles. Progestin Testosterone

Progestin versus testosterone

No wonder progesterone and progestins have such vastly different physiologic effects!


• beneficial for cardiovascular health
• stimulates hair growth
• calms mood and promotes sleep
• prevents breast cancer


• increases the risk of fatal blood clots
• can cause hair loss
• may cause anxiety and depression
• increases the risk of breast cancer

How to get more progesterone

Progesterone is beneficial for mood and hair. It boosts thyroid hormone and promotes sleep.

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

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

There is only one way to get real, natural progesterone:

Take bioidentical progesterone. Bioidentical means human-identical. It’s made in the lab from yam sterols (like all hormonal medication), but it’s made to be actual progesterone—not drospirenone or another progestin. Bioidentical progesterone is also called micronized progesterone and its molecular structure looks like progesterone in the diagram above. You can detect micronized progesterone on a serum test, which you cannot do with any kind of progestin. Bioidentical progesterone is the progesterone used in fertility treatment. It’s also available as Prometrium or Utrogestan capsules, natural progesterone cream, or compounded progesterone. Bioidentical progesterone cannot be used as birth control.

I hope this clears up some confusion about progesterone and progestins.

Extract from an article by Lara Briden


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