Progesterone vs Progestins

You say either and I say either

You say neither and I say neither

Either, either, Neither, neither

Let's call the whole thing off.

You like potato and I like potahto

You like tomato and I like tomahto

Potato, potahto, Tomato, tomahto

Let's call the whole thing off.

- Let's Call The Whole Thing Off
by Louis Armstrong

The above comes off better when you get a chance to listen to him sing the lyrics but I think you get the idea.  Sometimes it doesn't matter, but other times it does.

For instance, bio-identical hormones.  Progesterone is what our bodies produce (out of the class of steroid hormones known as progestogens).  In a very small study published in this month's Journal of Clinical Endocrinology & Metabolism, the authors demonstrated that oral progesterone given nightly can help restore normal sleep pattern (whereas currently marketed sedative-hypnotics tend to inhibit deep sleep).  In fact, they noted that progesterone actually improved growth hormone release.

On the other hand, in a case-cohort study just published in the British Medical Journal, the authors noted a doubling of the risk for non-fatal venous thromboembolism in those women who took oral contraceptives containing drosperinone compared to those who received contraception containing levonorgestrel.  Granted both drospirenone & levonorgestrel are non-bio-identical progestins, but it would appear that the latter is significantly safer than the former.

Given that women have a large number of (oral) contraceptives from which to choose, we might want to consider safety & side effect profile in addition to efficacy.  However, before abruptly stopping one's oral contraceptive (since pregnancy & delivery are fraught w/health risks), one needs to review one's options w/one's prescribing physician, be it your family physician or obstetrician.

So while potato & potahto and tomato & tomahto may refer to the same things, remember that progesterone and progestins don't.

One last item:  in another study also published in this month's JCEM, the authors found no increase risk of  heart disease regardless of the type of progestin used in contraception and regardless of the route of administration of said progestin.  I'll take good news any way I can.