Progesterone vs Progestin: Natural vs Synthetic: Antiandrogen and Androgenic

You hear the word progesterone used a lot. This general class of hormone, and it's synthetic varieties is about ubiquitous as any medication in current use. If a compound acts like a progesterone its classified as a "progestin" and this class of medicines is very broad and some form or other is in the birth control pill, its made by the ovary, it's made by the placenta, it's used to prevent miscarriages, its been a treatment for PMS, it's been used to bring on missing periods, to prevent preterm birth, and it's used to protect the uterus from estrogen use in menopausal hormone therapy. So when we say there is a tug of war out there of information on which is better to be taking, natural or synthetic, we want you to understand there is a lot of scientific evidence and some of it conflicting. In general you can think of two big classes of medicines if we are just talking about menopausal hormones: we are talking about Natural Progesterone vs Synthetic Progestin, such as the provera or Depo-Provera type progesterone. The natural is a compound that has only 21 carbons in the structure, it causes blood vessels to dilate, and it is anti-male hormone in most females. The 'synthetic' variety has 24 carbon molecules and constricts blood vessels and has been found to be slightly androgenic (producing male hormone effects). In truth all are synthetically manufactured, the natural, usually from yam sources, but the 'natural' progesterones are more similar to what is in our body. And some of the progesterones stimulate the A progesterone receptors and some the B! So many varied effects of progesterone on tissues possible. And what we hope to accomplish is a healthy understanding that all these progesterone treatments are very different, and confer very different risks to women depending upon the reason they are on the hormone, the dosage, the administration with other hormones and the duration of use. For birth control pills there is a great diversity in the types of progesterones in the pill, and many will have effects that act sometimes like the natural progesterone and sometimes like the synthetic. You cannot just make assumptions on this compound, there is still a lot for us to learn about. It is important to speak to your gyno, particularly if you are considering being on a progesterone of any type.


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