By Carol Petersen, RPh, CNP

Progesterone is a hormone that is often prescribed or recommended to women during perimenopause to help ease common symptoms of hormone imbalance, sleep disruptions, and anxiousness. But when your practitioner hands over your “progesterone” prescription, do you really know what you’re getting? The terms progesterone, progestin, or progestagen are loosely interchanged in the medical community, and “progestin” and “progestagen” are designated molecules meant to mimic some of progesterone’s many activities. What is not readily shared is that these molecules are not technically progesterone, as they are not molecularly identical to the progesterone our body makes.

Progestin and progestagen are in fact altered progesterone-like chemicals that are used to supplement progesterone hormone deficiencies. Unfortunately, many medical practitioners prescribe these altered hormones and use the word “progesterone”, leading unsuspecting patients to believe they are getting the real thing.

Altered Molecules Get Rewarded

Prescribing practitioners can often get caught in Big Pharma’s web.  Drug manufacturers are rewarded with patent protection when they create altered molecules/products like progestins – a profitable endeavor, unlike the unpatentable naturally occurring hormone. Market exclusivity is offered for creating new molecules and FDA approval has been sought and given for these altered progesterone molecules. If you are wondering if any of these altered progesterone products are in your medicine cabinet – this website provides several names of commonly prescribed products.

Drug manufacturers market these products as a better alternative than the natural source. These companies then reward healthcare professionals for promoting and selling these products to their patients.

Altered Molecules Have A Down Stream Effect

Alterations in the structure of a molecule can become a big problem in the body. These altered molecules will occupy receptor sites (for example, attach to a progesterone receptor) with the purpose of providing similar activity as the real hormone.  When the receptor site is blocked by an imposter, the real hormone is essentially locked out, which only exasperates the original problem.

Unfortunately, these altered molecules can also accumulate in the body.  The liver, our largest and most over-worked detoxification organ, is not equipped with enzymes for these foreign substances. But because these molecules are prescribed daily for months and even years, many people are left with a steadily increasing toxic burden.

Bioidentical Progesterone

In perimenopause, progesterone is often the first sex hormone to decline. Common perimenopausal symptoms that are related to this decline can include anxiety, heart palpitations, excess endometrial build up, water retention, tender sore breasts, short-term memory loss, and sleep problems.

Thankfully, there are several bioidentical progesterone solutions available. Bioidentical hormone replacement or replenishment therapy (BHRT) means using a hormone with the exact chemical structure as those naturally produced in the body.   The first progesterone available was extracted from the placenta.  Now, cholesterol-like molecules from plants like yams are converted to hormones. Both the human identical and altered molecules are made this way.

You can request FDA-approved bioidentical compounded hormones like progesterone from your licensed healthcare provider. This requires a prescription and a compounding pharmacy. Bioidentical progesterone can be delivered to the body in a variety of ways including pills, patches, creams, troches (lozenges), injections, and pellets that are inserted under the skin’s surface.

Looking for a more convenient way to get bioidentical progesterone? There are many over-the-counter (OTC) topical serums and creams available online or at your local drug or health food store. Because it can be time-consuming and cumbersome to go through a practitioner, these OTC versions are a great solution. Just make sure you choose a product from a qualified manufacturer and that they are indeed bioidentical.

Remember, real progesterone does everything that naturally produced progesterone does and it can be a game-changer throughout perimenopause and menopause. Don’t settle for a substitute.