Cyclic Progesterone and Spironolactone Therapy for Ovulatory Fertility in PCOS (Anovulatory Androgen Excess)

Jerilynn Prior BA, MD, FRCPC, ABIM, ABEM
Lecture Type: 
Breakout Session
Lecture Day: 
Day 3
Fletcher Challenge Theatre


This lecture will present a clinically focussed background on the current diagnosis and treatment of so-called “polycystic ovary syndrome” (PCOS) and why the Centre for Menstrual Cycle and Ovulation Research ( believes that its important elements are disturbances of ovulation and cycling and the presence of androgen excess so call it “Anovulatory Androgen Excess” (AAE). We will then review ideas for the origin of PCOS/AAE including hereditary, androgen exposure in utero, insulin resistance and abnormally rapid neuroendocrine GnRH/LH pulsatility. Finally, we’ll discuss the preliminary evidence that cyclic progesterone therapy with spironolactone is appropriate/effective PCOS/AAE therapy.   


Learning Objectives

Practitioners attending this class will learn:

  • What is Polycystic Ovary Syndrome and why does CeMCOR call it Anovulatory Androgen Excess?
  • What do we know about the root cause(s) for PCOS/AAE?
  • Why does treatment with cyclic progesterone and spironolactone make scientific and clinical sense for PCOS/AAE?
Jerilynn Prior BA, MD, FRCPC, ABIM, ABEM

Jerilynn C. Prior BA, MD, FRCPC is a Professor of Endocrinology at the University of British Columbia in Vancouver, BC. She studies menstrual cycles and the effects of the cycle’s changing estrogen and progesterone (ovulation) levels on women’s health. She is the founder (2002) and Scientific Director of the Centre for Menstrual Cycle and Ovulation Research ( page-views/d. She is also Director of the BC Centre of the Canadian Multicentre Osteoporosis Study ( that studies bone health and incident fracture over almost 20 years in population-based women and men. Dr. Prior is known for innovative research showing:  1) perimenopause is a time of higher and erratic estrogen/lower progesterone levels and paradoxical bone loss (Prior Estrogen’s Storm Season—stories of perimenopause); 2) normally ovulatory cycles are necessary to prevent bone loss—progesterone increases bone formation; and 3) that combined hormonal birth control use is associated with decreased adolescent women’s peak bone mass accrual. 

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Symposium Location

Simon Fraser University at Harbour Centre
515 West Hastings Street
Vancouver, BC