Polycystic Ovarian Syndrome (PCOS) stands as one of the most prevalent endocrine disorders affecting women of reproductive age, with a global prevalence ranging from 6% to 20%, varying across different populations and diagnostic criteria. This complex syndrome is characterized by a multitude of symptoms, including irregular menstrual cycles, hyperandrogenism, and polycystic ovaries on ultrasound imaging. Moreover, PCOS is often associated with metabolic comorbidities, such as insulin resistance, obesity, and an increased risk of type 2 diabetes and cardiovascular disease. As such, PCOS poses a significant public health concern, demanding comprehensive understanding and effective management strategies [1-3].

While PCOS has garnered substantial attention in medical literature, the awareness and knowledge about this syndrome among women of reproductive age remain variable and often inadequate. The accurate knowledge about PCOS is crucial for timely diagnosis, appropriate management, and prevention of associated complications. Thus, evaluating the level of knowledge regarding PCOS among women becomes imperative to design targeted interventions and educational programs that can bridge the awareness gap and enhance women's overall reproductive healt [4,5].       

In the context of India, a country with a diverse population and varying socio-economic landscapes, the awareness and understanding of PCOS might exhibit distinctive patterns. Himachal Pradesh, a northern state known for its unique demographic characteristics and geographical features, presents an intriguing setting to investigate the knowledge about PCOS among women of reproductive age. The District Sirmaur, nestled in the lap of the Himalayas, exemplifies this diversity and provides an opportunity to assess the grasp of PCOS-related information within a specific regional context.

This research aims to address the gap in existing literature by conducting a comprehensive assessment of knowledge about PCOS among women of reproductive age in District Sirmaur, Himachal Pradesh. The findings of this study hold the potential to inform policymakers, healthcare providers, and educators about the specific areas of misinformation or lack of awareness, thereby guiding the development of targeted interventions that can empower women to take charge of their reproductive health.

Objectives of the Study

The objective of this study is to assess the level of knowledge about Polycystic Ovarian Syndrome (PCOS) among women of reproductive age in District Sirmaur, Himachal Pradesh.

• Research Approach: Descriptive

• Research Design:  Cross-sectional survey design

• Study Area:  District Sirmaur, Himachal Pradesh

• Study Duration: Between April 2023 to June 2023

• Study Population: All reproductive age group females who were staying in the District Sirmaur, Himachal Pradeshfor 12 months or more

• Sample Size: 400 reproductive age group females, assuming 50% have adequate knowledge regarding Polycystic Ovarian Syndrome (PCOS), 5% absolute error, 95% confidence level, and 5% non response rate

• Study Tool: A google form questionnaire consisting of questions regarding socio-demography and knowledge regarding Polycystic Ovarian Syndrome

(PCOS) was created. The questionnaire was initially pre-tested on a small number of females to identify any difficulty in understanding by the respondents.

Description of Tool

• Demographic Data Survey Instrument: The demographic form elicited information on participants’ background: age, marital status, religion, employment, education and many more

• Questionnaire: The questionnaire contains 20 structured knowledge related questions regarding Polycystic Ovarian Syndrome (PCOS). One mark was given for each correct answer and zero for incorrect answer. The maximum score was 20 and minimum score was zero. Scoring was done on the basis of marks as >80%(16-20)=very good,60-79%(12-15) =Good,41-59% ( 8-11)=Fair,<40% (< 8)=poor

• Validity of Tool: By the experts in this field

• Data Collection: Data was collected under the guidance of supervisors. The google form questionnaire was circulated among reproductive age group female residents of District Sirmaur, Himachal Pradesh for responses using online modes like e-mail and social media platforms like Whatsapp groups, Facebook, Instagram and Linkedin till the 400 responses were collected

• Data Analysis: Data was collected and entered in Microsoft excel spread sheet, cleaned for errors and analyzed with Epi Info V7 Software with appropriate statistical test in terms of frequencies and percentage.

• Ethical Considerations: Participants confidentiality and anonymity was maintained

The goal of the current study was to evaluate the level of knowledge about PCOS among women of reproductive age in District Sirmaur, Himachal Pradesh. A total of 400 respondents including 116 (29%) were from urban area and 284(71%) were from rural area were participated in the study (Table 1).

Table 1: Knowledge Regarding Polycystic Ovarian Syndrome (PCOS) Among Study Participants

In the present study 32.75% (131) participants had very good knowledge (16-20 marks) towards Polycystic Ovarian Syndrome (PCOS), 33.75% (135) had good knowledge (12-15 marks), 22.75% (91) had fair knowledge  (8-11 marks) and 10.75 (43)  having poor knowledge (<8 marks) (Table 2).

Table 2: Knowledge Score Regarding Polycystic Ovarian Syndrome (PCOS) Among Study Participants

The findings of this study provide a comprehensive insight into the knowledge about Polycystic Ovarian Syndrome (PCOS) among women of reproductive age in District Sirmaur, Himachal Pradesh. The assessment of PCOS awareness is crucial, as accurate knowledge plays a pivotal role in early diagnosis, effective management, and prevention of complications related to this complex endocrine disorder.

The study revealed that 32.75% of participants demonstrated very good knowledge (16-20 marks), 33.75% had good knowledge (12-15 marks), 22.75% had fair knowledge (8-11 marks), and 10.75% exhibited poor knowledge (<8 marks) regarding PCOS. This distribution signifies a moderate level of awareness in the study population, with room for improvement. It is encouraging to note that a significant portion of participants displayed satisfactory knowledge, which could potentially be attributed to increased accessibility to health-related information through digital platforms and educational initiatives.

Comparing these findings with existing literature, the level of PCOS knowledge observed in this study aligns with certain similar investigations. For instance, a study conducted by Pandey et al⁴ in a semi-urban area of Uttar Pradesh reported similar knowledge distribution, with 27.5% participants exhibiting very good knowledge, 34.5% good knowledge, 25.4% fair knowledge, and 12.6% poor knowledge. A study by Pal et al. [5] reported similar findings, with a diverse range of knowledge levels among participants. However, it's important to acknowledge that variations in socio-economic factors, educational opportunities, and regional disparities can influence the knowledge levels across different geographical locations.

On the other hand, research by Smith et al. [6] in a developed country context showed a higher overall level of awareness about PCOS among women. This difference could be attributed to differences in healthcare infrastructure, education systems, and media exposure. The findings emphasize that region-specific interventions are crucial to addressing awareness gaps effectively.

The study's outcomes also indicate areas where misconceptions or gaps in understanding persist. Notably, a considerable number of participants   were  unaware  of the potential long-term health consequences associated with PCOS, such as its link to diabetes and heart disease. This knowledge gap highlights the need for targeted health education programs that emphasize the holistic implications of PCOS beyond its reproductive aspects.

Furthermore, the study identified a lack of awareness regarding alternative or natural approaches for managing PCOS symptoms. This finding resonates with a study by Moridi et al. [7], which suggested that many women with PCOS tend to rely on pharmaceutical treatments rather than exploring holistic options. Bridging this gap requires disseminating information about lifestyle modifications, stress management, and the potential benefits of complementary therapies.

It's worth noting that while the study provides valuable insights into the knowledge status among women in District Sirmaur, the cross-sectional nature of the research might limit the assessment of temporal trends. Additionally, the reliance on online platforms for data collection could introduce bias toward participants with better digital access and literacy.

In conclusion, this research contributes to the understanding of PCOS knowledge among women in District Sirmaur, Himachal Pradesh. The moderate level of awareness observed highlights the need for targeted educational interventions that address specific gaps in understanding. By comparing these findings with similar studies and acknowledging regional nuances, policymakers and healthcare providers can design contextually relevant interventions to empower women in managing their reproductive health effectively.

1. Teede, H.J. et al. International Evidence-Based Guideline for the Assessment and Management of Polycystic Ovary Syndrome (PCOS). Monash University, 2018.

2. Azziz, R. et al. “Polycystic Ovary Syndrome.” Nature Reviews Disease Primers, vol. 2, 2016, p. 16057.

3. Bazarganipour, F. et al. “Worldwide Prevalence and Risk Factors of Polycystic Ovary Syndrome: A Review.” International Journal of Women’s Health, vol. 13, 2021, pp. 695–706.

4. Pandey, P. et al. “Knowledge About Polycystic Ovarian Syndrome Among Young Women in Urban and Rural Population.” Journal of Family Medicine and Primary Care, vol. 8, no. 1, 2019, pp. 215–220.

5. Pal, A. et al. “Assessment of Awareness About Polycystic Ovarian Syndrome Among Adolescent Girls in a City of West Bengal: A Cross-Sectional Study.” Journal of Human Reproductive Sciences, vol. 13, no. 2, 2020, pp. 121–125.

6. Smith, B.Y. et al. “Polycystic Ovary Syndrome (PCOS) Knowledge, Awareness, and Education in Adolescent Girls.” Journal of Pediatric and Adolescent Gynecology, vol. 32, no. 1, 2019, pp. 55–61.

7. Moridi, M. et al. “Knowledge, Attitude, and Behavior of Reproductive-Age Women About Polycystic Ovary Syndrome.” Journal of Medical Education and Development, vol. 11, no. 2, 2018, pp. 105–115.