Prevalence and knowledge of polycystic ovary syndrome (PCOS) and health-related practices among women of Syria: a cross-sectional study

Figures & data

Table 1. Sociodemographic characteristics and history of PE.

Variable	Frequency (n)	Percentage (%)
Age (years), mean (±SD)	25.93 (±7.01)
Age groups, years
18–20	272	14.8
21–29	1181	64.2
30–39	227	12.3
≥40	160	8.7
Marital status
Single	1281	69.6
Married	532	28.9
Divorced	27	1.5
Work sector
Non-health sector	910	49.5
Health sector	930	50.5
Employment status
Unemployed	231	12.6
Student	883	48
Housewife	247	13.4
Freelancing	168	9.1
Employed	307	16.7
Retired	4	0.2
Educational level
Primary	76	4.1
Secondary	362	19.7
Diploma	58	3.2
Bachelor	1281	69.6
Master/PhD	63	3.4
Monthly household income
Bad	228	12.4
Moderate	1042	56.6
Good	522	28.4
Excellent	48	2.6
Chronic disease
No	1714	93.2
Yes	126	6.8
Medically diagnosed with PCOS
No	1335	72.6
Yes	505	27.4
BMI category
<18.5 kg/m^2	142	7.7
18.5–24.9 kg/m^2	1236	67.2
25.0–29.9 kg/m^2	391	21.3
≥30 kg/m^2	71	3.9

Table 2. Differences in knowledge and health-related practice scores among different sociodemographic characteristics.

Variable	Mean score (SD)		Mean score (SD)
	Knowledge	p-Value	Practice	p-Value
Age groups, years		<0.001^b		0.263^b
18–20	10.66 (3.961)		27.32 (7.061)
21–29	13.14 (4.457)		27.76 (7.376)
30–39	10.67 (4.576)		26.84 (8.077)
40–59	9.93 (4.717)		27.84 (7.703)
Marital status		<0.001^b		0.239^b
Single	12.78 (4.5)		27.66 (7.434)
Married	10.86 (4.494)		27.55 (7.45)
Divorced	10.81 (6)		25 (8.062)
Work sector		<0.001^a		0.015^a
Non-health sector	10.58 (4.212)		27.22 (7.56)
Health sector	13.77 (4.426)		27.96 (7.328)
Employment status		<0.001^b		0.013^b
Unemployed	11.88 (4.741)		26.97 (7.341)
Student	13.19 (4.36)		27.53 (7.263)
Housewife	10.08 (4.553)		26.47 (7.373)
Freelancing	11.88 (4.175)		29.13 (7.901)
Employed	11.44 (4.712)		28.23 (7.696)
Retired	12.25 (5.439)		31.75 (8.995)
Educational level		<0.001^b		<0.001^b
Primary	8.67 (5.28)		25.66 (6.989)
Secondary	10.7 (4.605)		26.48 (7.073)
Diploma	10.91 (4.165)		27.62 (8.728)
Bachelor	12.86 (4.371)		27.88 (7.444)
Master/PhD	12.65 (4.773)		30.43 (7.77)
Monthly household income		<0.001^b		<0.001^b
Bad	10.98 (5.054)		25.12 (7.41)
Moderate	12.22 (4.58)		27.5 (7.295)
Good	12.52 (4.419)		28.57 (7.44)
Excellent	13.71 (3.908)		30.52 (8.095)
Chronic disease		0.288^a		0.582^a
No	12.22 (4.606)		27.61 (7.425)
Yes	11.76 (4.614)		27.26 (7.815)
Medically diagnosed with PCOS		<0.001^a		0.145^a
No	11.61 (4.804)		27.45 (7.455)
Yes	13.74 (3.609)		27.95 (7.434)
BMI category		0.976^b		0.229^b
<18.5 kg/m^2	12.37 (4.387)		26.63 (7.395)
18.5–24.9 kg/m^2	12.18 (4.676)		27.58 (7.531)
25.0–29.9 kg/m^2	12.18 (4.452)		27.99 (7.172)
≥30 kg/m^2	12.11 (4.728)		27.49 (7.625)

^aMann–Whitney U Test.

^bKruskal–Wallis H Test.

Table 3. Responses of respondents to knowledge questions.

Questions for knowledge of PCOS	Response	Frequency (n)	Percentage (%)
1. Have you heard about the term called “polycystic ovary syndrome (PCOS)”?	Correct	1728	93.9
	Incorrect	112	6.1
2. Have you heard about the androgen (male) hormone? E.g. testosterone	Correct	1584	86.1
	Incorrect	256	13.9
3. In PCOS, there is an increased level of androgen level	Correct	1079	58.6
	Incorrect	761	41.4
4. Patients suffering from PCOS have small multiple cysts in their ovaries	Correct	1462	79.5
	Incorrect	378	20.5
5. Obesity may cause PCOS	Correct	1228	66.7
	Incorrect	612	33.3
6. Prediabetes condition (due to decreased insulin action in the body) may cause PCOS	Correct	666	36.2
	Incorrect	1174	63.8
7. Irregular or absence of menstrual (periods) cycle is a symptom of PCOS	Correct	1653	89.8
	Incorrect	187	10.2
8. An unusual amount of hair growth on different body parts (upper lip, chin, abdomen, breast, thighs etc.) is a symptom of PCOS	Correct	1573	85.5
	Incorrect	267	14.5
9. Severe acne problem during the menstrual (periods) cycle is a symptom of PCOS	Correct	1247	67.8
	Incorrect	593	32.2
10. Hair loss from the scalp more than normal is a symptom of PCOS	Correct	904	49.1
	Incorrect	936	50.9
11. PCOS diagnosis can be confirmed by vaginal ultrasound	Correct	1130	61.4
	Incorrect	710	38.6
12. A specific blood test can be used for the diagnosis of PCOS	Correct	521	28.3
	Incorrect	1319	71.7
13. PCOS may lead to diabetes (long-term high blood sugar level)	Correct	539	29.3
	Incorrect	1301	70.7
14. PCOS may lead to heart diseases	Correct	313	17
	Incorrect	1527	83
15. PCOS may lead to infertility (inability to have children) or reduced fertility (reduced chance to get pregnant)	Correct	1412	76.7
	Incorrect	428	23.3
16. PCOS may lead to anxiety and depression	Correct	1393	75.7
	Incorrect	447	24.3
17. Hormonal therapy (oral contraceptives, hormone intrauterine device, etc.) may be used to treat PCOS	Correct	1149	62.4
	Incorrect	691	37.6
18. Anti-diabetic medications (metformin) may be used to treat PCOS	Correct	901	49
	Incorrect	939	51
19. Symptomatic treatment (clomiphene, letrozole, acne topical cream, spironolactone, etc.) may be given to relieve the symptoms of PCOS	Correct	672	36.5
	Incorrect	1168	63.5
20. Surgery may be used to remove ovarian cysts	Correct	1279	69.5
	Incorrect	561	30.5

Table 4. Responses of respondents to health-related practice statements.

Questions for practices	Response	Frequency (n)	Percentage (%)
1. How often do you read nutrition labels?	Never	231	12.6
	Rarely	397	21.6
	Sometimes	822	44.7
	Usually	296	16.1
	Always	94	5.1
2. I incorporate low-fat foods into my diet	Never	186	10.1
	Rarely	342	18.6
	Sometimes	773	42
	Usually	461	25.1
	Always	78	4.2
3. I incorporate low salt foods into my diet	Never	367	19.9
	Rarely	413	22.4
	Sometimes	537	29.2
	Usually	405	22
	Always	118	6.4
4. I eat 5 servings of fruits and vegetables per day	Never	431	23.4
	Rarely	582	31.6
	Sometimes	486	26.4
	Usually	277	15.1
	Always	64	3.5
5. I decrease the amount of refined sugar in my diet	Never	397	21.6
	Rarely	377	20.5
	Sometimes	508	27.6
	Usually	409	22.2
	Always	149	8.1
6. I eat more high-fiber foods	Never	256	13.9
	Rarely	339	18.4
	Sometimes	615	33.4
	Usually	492	26.7
	Always	138	7.5
7. I eat smaller portions at dinner	Never	261	14.2
	Rarely	253	13.8
	Sometimes	439	23.9
	Usually	606	32.9
	Always	281	15.3
8. I exercise 30 min 5 days a week	Never	533	29
	Rarely	548	29.8
	Sometimes	390	21.2
	Usually	260	14.1
	Always	109	5.9
9. I control my eating on weekends	Never	519	28.2
	Rarely	440	23.9
	Sometimes	431	23.4
	Usually	349	19
	Always	101	5.5
10. It is easy for me to eat a healthy diet	Never	351	19.1
	Rarely	334	18.2
	Sometimes	477	25.9
	Usually	521	28.3
	Always	157	8.5

Table 5. Clinical evaluation of PCOS.

Questions for practices	Response	Frequency (n)	Percentage (%)
1. History of PCOS in your mother or sister	No	1168	63.5
	Yes	566	30.8
	I don’t know	106	5.8
2. Very heavy periods (more than 2 pads per day	No	1099	59.7
	Yes	706	38.4
	I don’t know	35	1.9
3. Prolonged periods (more than 7 days)	No	1378	74.9
	Yes	429	23.3
	I don’t know	33	1.8
4. Complete absence of periods (not at all)	No	1732	94.1
	Yes	65	3.5
	I don’t know	43	2.3
5. Partial absence of periods (not after 28 days)	No	1324	72
	Yes	472	25.7
	I don’t know	44	2.4
6. Acne problem during menstrual cycle	No	989	53.8
	Yes	812	44.1
	I don’t know	39	2.1
7. Unusual amount of hair loss from scalp	No	1123	61
	Yes	658	35.8
	I don’t know	59	3.2
8. Unusual amount of hair growth at different parts of your body (upper lip, chin, abdomen, breast, thighs, etc.)	No	1112	60.4
	Yes	688	37.4
	I don’t know	40	2.2
9. Discoloration or dark color patches on skin	No	1537	83.5
	Yes	262	14.2
	I don’t know	41	2.2
10. Continuous abnormal weight gain	No	1455	79.1
	Yes	346	18.8
	I don’t know	39	2.1
11. Diabetes	No	1760	95.7
	Yes	27	1.5
	I don’t know	53	2.9
12. Family history of diabetes	No	1034	56.2
	Yes	736	40
	I don’t know	70	3.8

Table 6. Association between knowledge and health-related practices.

Comparison		Knowledge of PCOS		p-Value
		Good	Poor
Health-related practice	Good	448 (70.80)	185 (29.20)	<0.001**
	Poor	754 (62.50)	453 (37.5)

**p value < 0.001.

Table 7. Diagnosis of PCOS.

Description	Frequency (n)	Percentage (%)
Not diagnosed	1101	59.8
Suspected	716	38.9
Diagnosed	23	1.3
Already diagnosed	505	27.4

Table 8. Regression K.

Variable		95% Confidence interval
	Odds ratio	Lower	Upper	P
Age groups, years
21–29—18–20	2.5527	1.8519	3.519	<0.001
30–39—18–20	3.3	2.0225	5.385	<0.001
40–59—18–20	2.4554	1.4324	4.209	0.001
Marital status
Divorced—Single	0.9693	0.3983	2.359	0.945
Married—Single	1.1007	0.7849	1.543	0.578
Educational level
Bachelor—Primary	3.954	2.1967	7.117	<0.001
Diploma—Primary	2.4726	1.1196	5.46	0.025
Master/PhD—Primary	4.2184	1.845	9.645	<0.001
Secondary—Primary	2.3114	1.2842	4.16	0.005
Work sector
Health sector—Non-health sector	3.3681	2.6442	4.29	<0.001
Employment status
Employed—Unemployed	0.9085	0.614	1.344	0.631
Freelancing—Unemployed	1.0151	0.6428	1.603	0.949
Housewife—Unemployed	0.8726	0.5511	1.382	0.561
Retired—Unemployed	1.3251	0.1744	10.07	0.786
Student—Unemployed	1.6393	1.1446	2.348	0.007
Monthly household income
Excellent—Bad	1.9168	0.8562	4.291	0.114
Good—Bad	1.1835	0.8259	1.696	0.359
Moderate—Bad	1.3102	0.9445	1.818	0.106
Chronic disease
Yes—No	0.9107	0.5888	1.409	0.674
Medically diagnosed with PCOS
Yes—No	3.4111	2.5891	4.494	<0.001
BMI category
25.0–29.9—18.5–24.9 kg/m^2	1.2951	0.9747	1.721	0.075
<18.5—18.5–24.9 kg/m^2	0.9943	0.6585	1.501	0.978
≥30–18.5–24.9 kg/m^2	1.502	0.8452	2.669	0.166

Table 9. Regression P.

Variable		95% Confidence interval
	Odds ratio	Lower	Upper	P
Age groups, years
21–29—18–20	0.971	0.7164	1.317	0.851
30–39—18–20	0.914	0.5718	1.461	0.707
40–59—18–20	1.042	0.6213	1.748	0.876
Marital status
Divorced—Single	0.683	0.2712	1.718	0.417
Married—Single	1.188	0.8679	1.627	0.282
Educational level
Bachelor—Primary	1.275	0.7149	2.273	0.411
Diploma—Primary	1.063	0.4872	2.319	0.878
Master/PhD—Primary	1.696	0.7855	3.663	0.179
Secondary—Primary	0.88	0.4912	1.578	0.669
Work sector
Health sector—Non-health sector	1.262	1.0113	1.574	0.039
Employment status
Employed—Unemployed	1.424	0.9734	2.082	0.069
Freelancing—Unemployed	1.683	1.0971	2.582	0.017
Housewife—Unemployed	1.045	0.6644	1.642	0.85
Retired—Unemployed	2.007	0.2579	15.62	0.506
Student—Unemployed	1.017	0.7256	1.426	0.92
Monthly household income
Excellent—Bad	2.668	1.3798	5.16	0.004
Good—Bad	2.135	1.4868	3.065	<0.001
Moderate—Bad	1.546	1.102	2.169	0.012
Chronic disease
Yes—No	1.111	0.7405	1.668	0.61
Medically diagnosed with PCOS
Yes—No	1.07	0.855	1.338	0.556
BMI category
25.0–29.9—18.5–24.9 kg/m^2	1.027	0.7963	1.325	0.836
<18.5—18.5–24.9 kg/m^2	0.755	0.5118	1.114	0.157
≥30—18.5–24.9 kg/m^2	0.866	0.5057	1.482	0.599

Data availability statement

The authors have access to and have saved all the data necessary to support this paper’s conclusion. All data are accessible upon reasonable request from the corresponding author.