Polycystic Ovarian Syndrome (PCOS), a common endocrine disorder, has emerged as a significant health concern among women of reproductive age worldwide. It is characterized by a range of hormonal imbalances, metabolic disturbances, and reproductive challenges. PCOS affects approximately 5% to 15% of women, making it one of the most prevalent endocrine disorders globally. Its multifaceted nature and potential long-term health consequences necessitate heightened awareness, especially among women in the reproductive age group [1-3].

PCOS is typified by a spectrum of symptoms and clinical manifestations, including irregular menstrual cycles, ovarian cysts, hyperandrogenism, and insulin resistance. These features can lead to complications such as infertility, obesity, type 2 diabetes, cardiovascular disease, and psychological distress. The complexity of PCOS, with its interplay of genetic, environmental, and lifestyle factors, underscores the importance of early diagnosis and management [4-7].

In recent years, there has been a growing recognition of PCOS as a major reproductive health concern. However, awareness and understanding of this syndrome remain variable among women, influenced by factors such as education, socio-economic status, and geographic location. Given the unique demographic and sociocultural context of District Shimla, Himachal Pradesh, India, there is a need to comprehensively assess the level of PCOS awareness among women in this region.

District Shimla, nestled in the picturesque state of Himachal Pradesh, boasts a diverse population with distinct healthcare needs and challenges. The impact of geographical and cultural factors on PCOS awareness in this region warrants in-depth   exploration.   An    informed and aware population is better equipped to seek timely medical intervention and make lifestyle modifications to mitigate the effects of PCOS.

This study seeks to bridge the knowledge gap by conducting a comprehensive analysis of PCOS awareness among women of reproductive age in District Shimla, Himachal Pradesh. By evaluating their knowledge and perceptions of PCOS, this research aims to identify areas of misconceptions, knowledge deficits, and educational needs. Ultimately, the goal is to enlighten women about PCOS, empowering them to take control of their reproductive health and well-being.

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 Shimla, Himachal Pradesh

• Research Approach: Descriptive

• Research Design:  Cross-sectional survey design

• Study area:  District Shimla, 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 Pradesh for 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 Shimla, 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 primary aim of this study was to assess the knowledge level regarding PCOS among women of reproductive age residing in District Shimla, Himachal Pradesh. A total of 400 respondents participated in the study, with 216 (54%) hailing from urban areas and 184 (46%) from rural regions. 

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

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

In the present study 35.75% (143) participants had very good knowledge (16-20 marks) towards Polycystic Ovarian Syndrome (PCOS), 38% (152) had good knowledge (12-15 marks), 18.5% (74) had fair knowledge  (8-11 marks) and 7.75 (31) having poor knowledge (<8 marks).

Polycystic Ovarian Syndrome (PCOS) is a prevalent endocrine disorder affecting women of reproductive age. This study aimed to assess the level of PCOS awareness among women in District Shimla, Himachal Pradesh, and to identify areas of misconception, knowledge gaps, and educational needs.

The study included 400 women of reproductive age, with a majority from urban areas (54%). The findings reveal varying levels of awareness among participants regarding PCOS. Approximately 63.5% correctly understood that PCOD (Polycystic Ovarian Disease) refers to PCOS, highlighting a reasonable understanding of the syndrome's nomenclature. This is a positive starting point for recognizing and discussing PCOS. Approximately 61.75% recognized common signs and symptoms associated with PCOS. This awareness is crucial, as it aids in early recognition and potential intervention. Approximately 61.5% of participants understood the impact of PCOS on the menstrual cycle. This knowledge is essential for women seeking regularity in their menstrual cycles and fertility management.

Concerningly, only 46.25% recognized possible factors or risks linked to the development of PCOS. This highlights a significant knowledge gap regarding the syndrome's etiology, which is complex and multifactorial. Around 43.5% acknowledged that PCOS can impact a woman's fertility and ability to conceive. This understanding is vital for women planning pregnancies and seeking appropriate medical guidance. Approximately 41% were aware of the existence of specific medical tests or criteria for diagnosing PCOS. Early and accurate diagnosis is crucial for effective management.

Approximately 51% recognized that PCOS is a lifelong condition, and only 46.5% were aware of the available treatment options. This suggests that while women may know about the condition, there is less awareness regarding its long-term implications and management strategies. Approximately 43% understood the potential long-term health consequences of having PCOS, including risks like diabetes and heart disease. This awareness is essential for comprehensive healthcare planning. Around 45.5% recognized that lifestyle modifications, such as exercise and diet changes, can help manage PCOS symptoms. Lifestyle interventions play a crucial role in PCOS management. Approximately 45.75% acknowledged the use of medications to regulate hormone levels and menstrual cycles in women with PCOS, indicating an awareness of the medical management options.

About 38.25% were aware of natural or alternative approaches that can be effective in managing PCOS, which is promising, considering the importance of holistic well-being.Around 42.75% recognized that PCOS can increase the risk of developing other conditions like diabetes or heart disease, underlining the need for comprehensive healthcare. Approximately 37.75% were aware of the possibility of preventing PCOS, emphasizing the importance of preventive measures and lifestyle modifications. Around 42.75% recognized that stress or emotional factors can contribute to the development or worsening of PCOS. This highlights the need for addressing mental health aspects in PCOS management.Approximately 29% were aware of specific dietary guidelines for women with PCOS, indicating room for improvement in nutritional education.

Only 26% recognized surgical procedures like ovarian drilling or cyst removal as potential treatments, indicating a lower awareness of surgical options. Approximately 24.75% were aware of support groups or resources available for women dealing with PCOS, suggesting the potential for improved patient support and education. Around 44.25% understood that weight management can have a positive impact on improving PCOS symptoms, emphasizing the role of lifestyle modifications. Approximately 36% recognized potential complications associated with untreated or poorly managed PCOS, emphasizing the importance of timely diagnosis and intervention.

Overall, the study revealed that while there is some awareness of PCOS among women in District Shimla, significant knowledge gaps exist. These gaps include understanding the risk factors for PCOS, the potential for long-term health consequences, surgical treatments, and support resources. 

When comparing these findings with studies conducted in similar settings and populations, District Shimla's women exhibited a relatively favorable level of awareness regarding PCOS.8-13 However, there are still areas where education and awareness can be improved, particularly in terms of understanding risk factors, dietary guidelines, and the availability of support resources.

In conclusion, this study provides valuable insights into PCOS awareness among women in District Shimla, Himachal Pradesh. While a significant proportion of participants displayed good to very good knowledge of PCOS, there are specific areas that warrant focused educational efforts. Empowering women with accurate information about PCOS can facilitate early diagnosis, effective management, and improved overall reproductive health and well-being.

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