Progesterone vs. Progestin for menopause

There is still a lot of confusion regarding Progestin, which is Provera or a synthetic progesterone, versus progesterone – the identical form of the hormone found in the body. Just one small change in the shape of the molecule makes a big difference in how it acts in the body.

Most women that come into my office are concerned about taking hormones for menopause since the Women’s Health Initiative (WHI) was abruptly stopped in 2002 due to an increased risk of breast cancer, heart disease, blood clots and pulmonary blood clots. Most women want to avoid using estrogen in their menopausal treatment.

Julie, age 58, came into my office with joint aches and pains that prevented her from keeping up her jogging practice and she also had vaginal dryness.

After obtaining a five panel saliva result for a baseline I tried her on a low dose transdermanl estradiol/estriol biest combined with a low dosage progesterone. I explained to Julie that bio-identical progesterone blocks the recycling of estrogen, replenishes estrogen receptors and improves the ability of the cell to get rid of estrogen.

Which in layman’s terms protects against some of the negative effects of estrogen. I also use bio-identical estradiol and estriol in a 20/80 per cent ratio mimicking the body’s natural balance and I never prescribe an estrogen without a progesterone.

I also cycle the use of hormones to three weeks on, and one week off, to give the body a rest.

Bio-identical estrogens can really help with joint health and body aches and pains and for Julie, this was most important as she was able to get back to her jogging routine.

“Why doesn’t my MD know this?” asked Julie.

Well, in gynecological circles, there is no such thing as an estrogen/progesterone imbalance. Progesterone, in their minds, is only used to prevent estrogen from creating uterine cancer but when they say progesterone, what they really mean is “progestin” or Provera!

The other confusion is that oral estrogen increases the liver’s production of clotting proteins whereas the transdermal form does not.

Oral micronized progesterone and transdermal forms have a much more favourable effect on cholesterol and fibrinogen and clotting than Provera.

Bio-identical progesterone is made from diosgensin, a compound derived from the wild yam or soy bean, however “wild yam” cream contains no progesterone as the diosgensin needs to be chemically manipulated to make bio-identical progesterone.

In other words estrogen and progesterone is NOT naturally available in plants and the reason that soy does NOT contain the hormone estrogen.

Progesterone has a calming effect on the body and women sleep a lot better with it as well as controlling hot flashes and night sweats. It also reverses the effects of estrogen stimulation of the lining of the uterus. Julie found that it helped with her anxiety and lumpy breasts also. Some women have found applying their hormone creams sparingly to their face several times per cycle helps improve the tone of the skin.

Julie is very happy to add this biest-progesterone combination cream to her regime and in one year we will reassess her five panel saliva hormone levels to make sure a balance is maintained. The common question always is “how long do I stay on these hormones” and the answer is as long as you want to feel this well!

Dr. Ingrid Pincott, N.D. Naturopathic Physician has been practicing since 1985 and the last 18 years in Campbell River.  She can be reached at 250-286-3655 or


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