Cyclic Progesterone and Spironolactone Treatment for Polycystic Ovarian Syndrome (PCOS)

Individuals living with androgenic-PCOS have had few choices and effective therapy options for many years. This 6-month open-label trial is exploring cyclic oral micronized progesterone and spironolactone as an option for individuals who are not tolerating or are dissatisfied with CHC. There is a strong rationale for use of each of these therapies. It may be that these results lead to improved PCOS quality of life, more regular cycles, less psychologically devastating skin/hair changes and improved fertility. Should this pilot study show what we expect—better PCOS-Q quality of life including emotional, weight, hirsutism, cycles and fertility domains, it will have provided the first evidence supporting a potentially important new therapy for PCOS. This new therapy might be life-changing for some individuals in BC who are now struggling to deal with the changes associated with living with androgenic-PCOS. This project is supported by CANTRAIN-CTTP & Michael Smith Health Research BC Masters’ Studentship 2023 Award Program. Dr. Jerilynn C. Prior, the principal investigator is an endocrinology professor at the University of British Columbia, is the scientific director of the Centre for Menstrual Cycle and Ovulation Research and my supervisor. 

End of Award Update – December 2024

Results

Women living with Polycystic Ovary Syndrome (PCOS), over the course of six months, taking cyclic progesterone (14 days a month) and a male hormone-blocking medicine, saw exciting and meaningful improvements in their quality of life. Using a specialized questionnaire for women with PCOS, we observed significant gains in areas of emotional well-being, body hair, weight concerns, menstrual health, and infertility-related distress. Participants also reported improved sleep and reduced acne severity, which are fundamental to health and well-being. This research suggests that our innovative “luteal phase replacement” treatment approach could offer an alternative path to enhance the quality of life for individuals with PCOS. 

Impact

Although our study was a feasibility study, and we are in the early stages of sharing results publicly, participants have already experienced meaningful improvements in their quality of life, particularly in areas like emotional well-being, sleep, and acne severity. These positive changes have shown the potential of this treatment to address some of the daily challenges faced by people with PCOS, providing valuable insights for future approaches to improving women’s health care in British Columbia. 

Potential Influence

Our study paves the way for a future, multi-centre randomized controlled trial comparing our new treatment approach to the current standard of care, combined hormonal contraceptives. By directly evaluating these two approaches, we aim to provide clearer guidance for healthcare providers and offer individuals with PCOS more informed treatment options. This next phase could help enhance women’s health care in British Columbia and potentially set the stage for broader applications across Canada and beyond. 

Next Steps

Our next steps involve creating a manuscript for submission to an academic journal to share our findings with the broader scientific community. We will also communicate individualized final results to study participants. Once these data have been published, we will make our exciting research results accessible through the internationally popular Centre for Menstrual Cycle and Ovulation Research website (www.cemcor.ubc.ca) for those who may benefit from these innovative insights into PCOS management.