oMeds
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Comparison · hormone optimization

Micronized Progesterone vs Medroxyprogesterone

Micronized progesterone is bioidentical; MPA is a synthetic progestin used in legacy HRT regimens. Modern BHRT favors micronized progesterone for endometrial protection due to a more favorable safety and quality-of-life signal.

Reviewed by Dr. Laura PurdyMay 29, 2026
Attribute
Micronized progesterone
Medroxyprogesterone acetate (MPA)
Molecule
Bioidentical progesterone
Synthetic 17α-hydroxyprogesterone derivative
Endometrial protection
Effective
Effective
Cardiovascular signal
Neutral
Less favorable in WHI-era CEE+MPA arm
Sleep effect
Supportive (allopregnanolone)
Neutral to disruptive
Modern use
Standard in BHRT
Legacy
Pathway
BHRT
Not offered by oMeds
Choose Micronized progesterone

Micronized progesterone is the modern default in BHRT for endometrial protection and sleep support.

Explore pathway
Choose Medroxyprogesterone acetate (MPA)

MPA is reserved for legacy regimens and is outside the oMeds BHRT pathway.

Educational. Final pathway selection is provider-reviewed via synchronous video consultation against your biomarkers, history, and goals.

Frequently asked

Why did the WHI signal involve MPA?

The combined-arm signal involved CEE + MPA specifically; bioidentical regimens have a different safety profile.

Can patients switch from MPA to micronized progesterone?

Switching is provider-reviewed against current regimen, uterus status, and symptom profile.

Next step

Take the optimization assessment.

The adaptive assessment maps your symptoms, history, and goals to candidate pathways — and routes you into provider review.

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