THE DL ON PROGESTIN-BASED BIRTH CONTROL
Before we get into the nitty gritty, let’s first start with an explanation of Progesterone, the hormone your body makes naturally that Progestin, the synthetic version, is mimicking.
Progesterone is a natural hormone that regulates various functions in the body.
You can thank progesterone for all things related to reproduction:
Progesterone also supports:
Menstrual cramp control
Healthy sex drive
We looooove Progesterone!
HOW IT WORKS
Progesterone, like any hormone in the body, exerts its effect by binding to a receptor. Think about the progesterone molecule as a key and the receptor as a lock that has been specially designed to fit progesterone's key. Once bound together, progesterone can work its magic. It is possible to experience times when there’s an excessive amount of progesterone binding to receptors. This can result in symptoms of hormone imbalance and means that the level of bound progesterone in relation to the level of bound estrogen is a bit out of whack. If progesterone levels are high, we may experience symptoms such as PMS or skin breakouts. When our progesterone levels are low, we may notice a decrease in sex drive, heavier, crampier periods, irregular cycles, or difficulty getting pregnant.
Progestin, is a synthetic version of progesterone—meaning it was made in a lab to mimic the real stuff. Many of us have met Progestin before in the form of birth control (pills, the patch, the ring, the implant, the IUD, and the depo shot.) Others may have met Progestin as part of a treatment plan for hormonal imbalances (sometimes it is used in combination with synthetic estrogen and other times it is used on its own). Progestin is also used medically to treat various gynecological conditions and as an aid in fertility treatments. Later in life we encounter progestin for the management of menopausal symptoms.
HOW IT WORKS
Progestin is designed to have similar effects to Progesterone, except that unlike progesterone, which fits perfectly into that receptor, Progestin, well, almooosst does the trick. Ya know when the key fits in the lock enough that you can turn it slightly, but not enough that it actually opens the door? Well it’s kinda like that except that the “desired effect” in this case is a lot more complicated.
The effects of progestin binding to progesterone receptors differs from person to person. But one thing to note is that there are no “double occupancies.” If Progestin floods all the Progesterone receptors, it can block our natural progesterone from binding.
For some, this is therapeutic. For example, your friend that started birth control for contraception purposes and as a result found her menstrual cramps completely stopped. She may be lovin’ on progestin.
For others, the effects of this are undesirable—like your friend who started birth control for contraception purposes and started having mood swings that made her feel, well, not like lovin’ all that much.
So when we use Progestin for a particular purpose (contraception, menstrual cramping, etc.), it is important to pay attention to all the other parts of your experience that Progesterone typically influences.
As a reminder, these are:
Changes in skin and hair
Because unfortunately, you cannot use Progestin selectively. In other words, you can’t choose to use Progestin-based birth control to prevent pregnancy without the understanding that it may impact the other aspects of your experience that progesterone can influence (see above list).
And sometimes these side effects can be sneaky and hard to detect since relationships, stress, diet, sleep etc. also play such a role. Plus, because Progestin has a different effect on every body, so there’s no playbook to follow—everyone’s experience can be different. Awareness is key!
THE TAKE AWAY
There are a lot of different progestin-based contraceptive methods out there. It is important to note that not all of these methods/pills have the same type of progestin in them and not all progestin molecules are created equal for every body. One of the things that differentiates one birth control from another is the type of progestin in that particular preparation. Some may have a more favorable lock and key experience with one type of progestin than another. Unfortunately the only way to know this is to try!
So if you start a birth control pill and you don’t like the way you feel on it, ask your health care provider to switch you to a pill with a different type of progestin. This just may do the trick!
Always remember that using hormonal birth control is a big decision as it alters your natural hormonal system and can mask signs of imbalance and illness. Always pay attention to the signs your body is giving you while you are on it and be sure to talk to your provider to ensure you have a full understanding of all your contraceptive options so you can choose what works best for your unique body and situation.
Written by: Dr. Erica Matluck, Naturopathic Doctor, Nurse Practitioner and Founder of Seven Senses.
If you would like to work with Dr. Matluck, click here.