Polycystic ovarian syndrome is a complex endocrine disorder affecting women across all the stages of their life. Adolescent girls often present with menstrual irregularities, acne, hirsutism, and obesity which can further lead to body image disorders, low self-esteem, anxiety, and depression in them. Women with PCOS may have difficulty in spontaneous conception and often need fertility treatment. These women can also experience repeated pregnancy losses. Later in life, they are at increased risk of diabetes, hypertension, and cardiovascular disorders. Due to the unopposed estrogen, they are at risk of development of endometrial hyperplasia and endometrial cancer. Management often includes measures targeted to reduce the symptoms or to prevent the complications associated with the disorder. There is no permanent cure but the lifestyle modifications in PCOS women like weight reduction, exercise, meditation, and a healthy diet is seen to help them to fight their symptoms. Hence it is very important to spread knowledge and awareness in the community regarding the risk factors, symptoms, complications when to seek help and whom to seek help from. Along with this importance adopting a healthy lifestyle in today's world where stress, sedentary lifestyle, and preserved food have become the new norm should also be stressed upon.
In the present study, researchers found that a significant proportion of women (43.4%) have heard about the term PCOS. The above findings are similar to the findings published by Alessa et al.17 where researchers found that 56.7% of the women had heard about PCOS. These findings show that a significant percentage of women had heard about the disorder but still it is not 100% and there is a lot that needs to be done to disseminate this knowledge among the community. The most common source of information in our study was health care provider/doctor (26.6%) followed by internet (6.28%), teacher (5.6%), and friends (4.7%) however the most common source of information in the study conducted by Alessa et al. was internet (21.3%) followed by patients (10.4%), doctors (10.8%) and books (3%). Another study by Rao et al. found that 83.7% of women got the information from doctors, 29.4% family, 25% friends. Government websites and PCOS support groups were the other mentioned sources in the study. The difference could be because in our study the study participants were those attending the Gynaecological OPD for various reasons however the study done by Alessa et al. and Rao et al. included college students. Around 9.3% of the study population was already diagnosed to have PCOS in contrast to 15.3% of the women in the Study by Alessa et al. and 28.5% in a study by Rao et al.18 The difference can be explained by the regional variation in the distribution and variation in the sample size of the studies. In the present study, researchers found that the women who were not diagnosed with PCOS also had certain symptoms which need evaluation to rule out PCOS as 35.6% had change in their cycles, 6.3% reported weight gain, 2.4% had excessive hair growth, 9% had excessive hair fall, 8.7% had acne,6.6% had a problem in conception. Rao et al. in their study also found that around 40.5% of women not formally diagnosed with PCOS had PCOS-like symptoms. While assessing knowledge regarding risk factors associated with PCOS 33.3% were aware that excess weight is associated with PCOS and 35% knew unhealthy eating habits can be related to PCOS. Around 32 % said it is familial. When asked regarding complications related to PCOS it is seen that similar to the study by Alessa et al. in the present study participants are aware regarding its association with subfertility (40% Vs 39%), diabetes (28.7% vs 14.5%), endometrial cancer (35.9% vs 30.2%) and psychological disturbances (37.1%vs 34.1% ). Assessment about management knowledge showed that in both the studies (37.1% vs 39.9%) the participants are aware that exercise and losing weight can help reduce the symptoms and related complications. Around 41% of the women are aware that eating a healthy and balanced diet is helpful and the findings are similar to the finding in the study by Alessa et al where 34.2% were aware of the benefits of eating healthy food. In the present study around 34%, of women said that medications and surgery are the other options to manage PCOS while in a study by Alessa et al around 29.4% of women were aware of the medical management. In the Study done by Alessa et al. author has not mentioned the awareness about the surgical procedures for PCOS. In both the studies it is seen that more the level of education more was the knowledge score.
With increasing education level the percentage of women who know about the risk factors, symptoms, complications, and management is also rising across the globe but is this knowledge getting translated into actual practice? In this study only 23.95% of the study participants were exercising daily, only 11.7% were meditating and 14.7% said they rarely take junk food. The finding suggests that only disseminated knowledge and awareness are not enough it requires a tremendous effort to bring about the behavioral changes at the community level.
To bring about these behavioral changes authors suggest that the knowledge and awareness about a healthy lifestyle need to be incorporated right from the beginning so that they become an integral part of our lives. Behavioral modification can start from home for which the parents need to be educated, schools where teachers need to be educated to disseminate the knowledge, and then social media, the internet, government websites, and television advertisements can play an important role. At community levels, teams of volunteers can arrange nuked Natak and stage shows. Hospitals and support groups should provide educational material regarding the benefits of lifestyle modifications.
Limitation of the Study: This study is done in the hospital setting so the study population is not the true representative of the general population. The knowledge regarding PCOS is assessed only in female participants. Since PCOS management starts way before the appearance of the symptoms it requires a behavioral change at the community level to incorporate healthy lifestyle changes at an early age. Hence educating both males as well as the female is necessary. The sample size is also small so the findings cannot be generalized to the whole population.