#185: What’s the Difference Between Progesterone and Progestin?

Hey beautiful, it's Dr. Tabatha.

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I can't wait to see you in there. Hi, I'm Dr. Tabatha, the Gutsy Gynecologist. I'm a triple board-certified OB-GYN and functional medicine physician. I've embraced the world of functional medicine and wellness through my own personal health journey, and I'm super excited to share my wisdom and unique perspective as it pertains to women's health. After caring for thousands of women, I've come to realize that your gut health determines your gyn health and your overall health. And it's a super gutsy thing for me to go against conventional gynecology practice to bring you the truth. No more Band-Aid medicine, ladies.

We're talking root cause resolution on this show.

So if you're struggling with hormone imbalance, weight gain, period issues, anxiety, insomnia, you name it, then you've come to the right place. And I want to be your gutsy gynecologist. So welcome. Welcome back to the Gutsy Gynecologist Show. I keep getting questions about progesterone, so I wanted to talk all about it today.

Okay.

I got a patient who said, the doctor told me I didn't need progesterone because I don't have a uterus. So do you need progesterone? Okay, ladies, we need to start from the beginning. So if you haven't listened to, you know, my episodes way back in the day, I would encourage you to get on whatever, you know, podcast host you are going through— Apple, Spotify, Google, you name it— or if you're on YouTube, scroll all the way back to episode 1 and listen from the beginning. Okay, I talk about the menstrual cycle because it's really important for you to understand what your hormones are supposed to be doing so that when they're misbehaving and they're not in a normal healthy cycle and rhythm, then you can understand why and try to troubleshoot it. So at first, we need some basic understanding of the fact that our brain makes hormones called follicle stimulating hormone. stimulating hormone and luteinizing hormone. Those hormones talk to our ovaries. Our ovaries make estrogen, progesterone, and testosterone. Our adrenal glands also make sex hormones as well from DHEA. So I want you to understand that when our brain makes hormones, talks to our ovaries, our ovaries make estrogen. And we have a nice rise in the beginning half of our cycle, and then that stimulates luteinizing hormone, which stimulates ovulation. So our ovary releases an egg in the hopes of getting fertilized and you becoming pregnant. That's, you know, what's supposed to happen. And after you ovulate and release that egg for the fallopian tube to grab onto and take into the tube, The remaining area of the ovary called the corpus luteum makes progesterone, and it should make progesterone that whole second half of the cycle after you've ovulated until a few days before your estrogen and progesterone drop together. Those levels decline, and that triggers your uterus to shed the lining or to bleed it off, bleed The tissue off. If you become pregnant, that lining is where the egg implants, and so you don't want to shed that lining. You don't want to bleed it off, and therefore your hormones would stay elevated, and your progesterone would continue to be made. And we need progesterone to stabilize that pregnancy, and oftentimes. first trimester miscarriages are because our progesterone production didn't stay up high as we needed it to. But either way, you need estrogen, you need progesterone, you got testosterone coming in in the middle of the month, especially gives you a little bump right when you're ovulating so that you have a higher sex drive and want to procreate. So here's the key, ladies. We all are going to stop ovulating at some point. Our ovary reserve starts to decline. And for some of us, this declines quicker, often because our adrenals are dysfunctional. We have chronic gut issues. We have heavy metal burdens, mold exposures. We have some root cause issues that can drive our ovaries not to function appropriately and ovulate and to kill off our egg supply earlier. Autoimmune conditions, all kinds of stuff. So that's a fertility episode. That's for another episode. But understand that it's a normal process for us to decline and no longer ovulate every month and start skipping months. And this should be happening kind of late 40s, early 50s. That is the perimenopausal transition. Or if you do ovulate, your ovary may not produce enough progesterone to get you through the month. That often looks like spotting before your period or your period coming at 3 weeks instead of 4 because you didn't have progesterone to maintain that endometrial lining that the estrogen had grown. Estrogen's a growth hormone. Progesterone is a maintenance balancing hormone and you need them together. So what happens when your progesterone starts to decline? You shift into almost an estrogen dominance picture, and you don't even necessarily have to be producing too much estrogen or not metabolizing your estrogen properly or have major estrogen problems. But if you don't have enough progesterone to keep estrogen in check, That turns into an estrogen dominance picture, and that can start to look like heavier periods, more severe PMS symptoms, more severe mood swings, anxiety, depression, all of those things because your progesterone is lacking. And so it's really important to decide at that point, do you want to get on progesterone replacement? To give your body what it's missing, and these questions should be discussed with a practitioner who understands hormones and functional medicine, integrative medicine, anti-aging medicine. Somebody who has extra training outside of their gynecology training. And if you're asking why, you need to go back into my podcast episodes and listen to my older episodes. about why conventional gynecology is failing you. Why don't we understand? Because essentially gynecologists are surgeons. I didn't learn all of this stuff in my gynecology residency. I learned this after the fact, investing tons and tons of money learning and continuing to understand this. So you want to find a provider that you can have this conversation with. But in general, Sometimes just supporting your ovaries to do their processes while you're working on removing or healing those root cause issues can be enough. Something like chaste tree or Vitex is a hormone— I'm sorry, is an herbal supplement that can help stimulate your ovaries to continue making their progesterone and doing their job longer. And sometimes that can extend the life of your ovary. Maca is also a lovely herbal supplement that you can take that can help support your ovaries. So there's a lot of things you can do to support your ovaries functioning for a while, but eventually you're going to go into menopause. That is the natural transition. Our ovaries stop producing to the same reproductive levels that they once were, and this is a time That it's like a fork in the road. You have to make a decision which way you're going with your health and your future. Essentially, you can either decide that you are going to welcome the menopause transition naturally, allow your body to start functioning in this new state of lower, lower sex hormones. It feels different. Your body will function differently without those sex hormones that they used to have that protected you your whole life. And I have a whole podcast episode on whether bioidentical hormones are right for you, so please listen to that episode if you want to know more about this. But you can just focus on optimizing your other systems and making sure they are in balance so that you can handle living in this low hormonal state called menopause. And I'll give you a hint: Your adrenal function is key on this one. So the other fork in the road is you want to get on bioidentical hormone replacement to keep the body that you had at 45 or 40, keep those systems supported because our entire body has sex hormone receptors throughout it. And once we no longer have those hormones, We're no longer protected the way we were. And so if you would like to go the bioidentical route, then the question becomes, what does that look like? My BHRT episode goes into all this in detail, but I wanted to focus on progesterone today because conventional gynecology continues to spew out this complete lie, this total myth. This is what I was trained as well. Unfortunately, they're practicing antiquated I'm just going to be super honest right now. What we say as gynecologists is that you only need progesterone if you have a uterus and you're on estrogen replacement therapy. This comes from the idea that unopposed estrogen, meaning estrogen in your body without progesterone to keep it balanced, can cause the uterine lining to overgrow and lead to uterine cancer. And what we understand is that progesterone prevents that uterine lining from overgrowing and getting too much stimulation from estrogen and hopefully protects you from developing uterine cancer. We actually use progesterone to stop the growth of abnormal cells in the uterus like hyperplasia, which can be a precursor to uterine cancer. And so progesterone does a great job of keeping estrogen in check and preventing it from overgrowing your endometrial lining. But okay, here's the problem. Progesterone has so many other benefits that gynecologists are not aware of. And the problem is that gynecologists only are familiar with progestins. These are the synthetic forms or the man-made forms of progesterone. So they're a little different chemically when you look at the chemical structure of them. And if you had high school chemistry, you'll understand the different carbons and hydrogens and molecules where they are laid out on this chemical structure are different than the natural progesterone our body makes. So synthetic progestins, they send kind of the same signal to the uterus, which is Great to prevent too much overgrowth, but they don't send the same signal to the rest of our body. So unfortunately, progestins often come with side effects: anxiety, depression, weight gain, mood swings, irritability, all the things that we don't want, decrease in libido. And so that is what gynecologists have experience with. They have experience with giving women progestins and women telling them, I gained weight, I don't feel good, or I don't get any benefit from them. If it doesn't make them feel bad, it doesn't necessarily make them feel any better. Whereas actual bioidentical progesterone, which you can get as a prescription, it comes the same chemical your body makes. We can get that as a prescription, you guys. It actually makes you feel better. Progesterone is our natural anti-anxiety hormone. It keeps us calm. And when you go in the menopausal perimenopausal transition and your progesterone starts to drop, one of the most common things I hear is I feel anxious. I feel overwhelmed. I can no longer deal with the stuff that I could deal with. I'm having heart palpitations and anxiety. I'm waking up at night with my mind racing. Or my heart racing, and that is all lack of progesterone. So it also converts into a metabolite called pregnenolone, and this form works on the GABA receptors in our brain to help us sleep, and that's what keeps us calm. And so progesterone can be super beneficial, especially when you're going through a perimenopausal transition and your ovaries are still producing. producing estrogen, but they're no longer maintaining that progesterone production. So you're getting into this estrogen-dominant picture. Super common perimenopause in the 40s, and now for some of you in your 30s because of the toxic burdens on our environment and the stressors and the gut issues you have. You're feeling these effects at a younger and younger age. So if something like Progest Lift, which you can get at my supplement store, that has the chasteberry in it. If that isn't enough to help your ovaries produce their progesterone, you might want to consider going on progesterone replacement therapy. Not a progestin, not Provera, not Prempro, not norethindrone acetate, not A Norplant rod or a Depo shot, all of those are synthetic progestins. The mini pill, another synthetic progestin. Those will not help you feel better. But progesterone, that could very well help you feel better. So it's not all about protecting your uterus. Yes, we need to make sure that you don't have unopposed estrogen, but during this perimenopausal time, You are getting unopposed estrogen, and the gynecologists aren't realizing that. So you would feel so much better if you got on some progesterone during this transition to help you through. And then when you no longer are making your own estrogen, you can make a decision at that point. Do I want to add in estrogen and have my hormones replaced, or do I now want to transition off of the progesterone because I'm no longer needing it because of this crazy estrogen issue, and now I'm just going to go into menopause and focus on my adrenal glands and my other systems. So I hope that makes sense to you guys. Please, like, go back and consume all my episodes. It all starts to make sense the more that you put the pieces of the puzzle together because all of our systems are connected and they're all affecting one another. And so the more that you can understand how your body's supposed to function, what a normal menstrual cycle is supposed to look like, then you can better understand what the heck is going on with your body and why these changes and shifts are happening. Because I promise you, you have way more control over your body and your health than any white coat is giving you credit for. I used to believe that lie as well, that disease was inevitable and all these problems are inevitable and hormone Imbalances are just a part of life, and it's just not true. God did not create our bodies to live in dysfunction and to betray us and to fall apart. It's what we're doing or not doing that are causing these problems. So keep learning, keep getting educated, be a lifelong learner, be open, question why, why, why. And then don't be afraid to, you know, reach out and work with a provider and figure out what is going on with you. Turn over all the pieces of the puzzle so you can actually see what's going on and not just like one snapshot in time of one little thing that we don't know because all the systems are connected. So scroll back through, listen to my old episodes. And the cool thing about podcasts, you guys, is You can actually go into the playback settings and speed up how quickly you listen. So if I've heard an episode before that I want to just gain a couple nuggets again and be reminded of it, I'll play it on like 1.5 or even 2 if I'm really searching for something specific. So there's so many ways to like go back and keep gaining the knowledge because the more you put the pieces of the puzzle together, The more things start to click. And so I've gone back and listened to, you know, podcast episodes more than once on things that I needed help understanding, especially in my business world. Like, it's a whole new world to me. I'm trying to learn so many things being a health entrepreneur and trying to serve women and understanding the psychology of women and eating disorders and all of these things. So I'm constantly consuming information. Like, I'm a professional learner. I really am. So take it from me, it's good to just go back, look at the episodes that are speaking to you, listen to them, take notes, do what you need to do until you can figure out what your body needs because you really are the CEO of your body. You know your body best, way better than any doctor does. You know— What challenges it's faced and what has worked and what hasn't and what is still lingering and what issues that you need to address. So keep putting the pieces of the puzzle together, you guys. If you feel like you want to work with my team, we are here for you. Like, this is what we do and we're licensed in over half the country so we can see women everywhere. We will help you turn over all the pieces of the puzzle. I promise you, you can test hormones. I have a whole podcast episode on that. So if your doctor is dismissing you, telling you they can't really help you out, or this is just normal, or this is just aging, or here's an antidepressant— that's even worse— please don't accept that as the answer because it's not. Really the right answer, so we can help you. You can go to DrTabitha.com, fill out the form, have a call with my team, and we'll tell you how we can help you. We are here for you, ladies. I promise I do all of this for you. And I just want to address one thing real quick because it kind of made my heart sad. I got an email about my fast to face. program, and they said, I can't believe you're charging this much in the name of Jesus. That really hurt me because I spend so much money investing in my education and getting the experience I need, getting the team behind me that I need to create programs for you. And to serve you, and I'm not getting rich off of this, you guys. I am doing what I need to do to bring you the truth, to help you reclaim your health. And so when I price something, it's to cover the bills. It's to get things taken care of. And even if we're doing stuff. With our faith and trying to reconnect with God and grow our relationship, things still cost money, you know, and I'm sure most of you listening here completely understand that. I just want to remind you guys that I would never ask you to invest in yourself with your time, which is the most important, your talents, your money or your trust if I didn't do that myself. You know, I spend probably $100 grand a year being in masterminds, being in groups with mentors that train me and better me so that I can show up better for you. So I promise you, I'm walking the walk that I'm asking you to walk 100 times over. And I'm not trying to brag. Like, I am just telling you that I am completely invested in me because I'm invested in you. I want the best for you. And so I need to know how to show up and be a good example. I need to eat the way that I tell you how to eat. I need to move my body the way I tell you how to move my body. I need to handle my finances and my relationships and my business the way that I am expecting you to— like, I am here walking the walk and I want you to walk with me because that is what I believe life is about. Life is about a journey of growth and expansion. I believe that we're supposed to leave this world a better place than we found it, including ourselves. So please understand that Everything that I do, I'm doing to give back to you. Okay, I hope you have an amazing week. Let me know what else you want to hear about. I am here for you, and you know I'm the real deal. I I can't fake it. I can't. You know, I'm just I'm transparent. I wear my heart on my sleeve. I wear my everything that. I do, you're going to know about. So if you're cool with that, join me on this journey. Stay with me. We're going to keep improving together. All right. Go have an amazing week, ladies. Love you.