Endocrine Abstracts

Objective: Polycystic Ovary Syndrome (PCOS) is one of the most common endocrine conditions affecting women of reproductive age. Current estimates place the condition as more common than Type 2 Diabetes Mellitus (T2DM). Recent studies have shown several long term comorbidities associated with PCOS, thus making it essential that all physicians, regardless of training and speciality, understand and empower women with PCOS to adopt evidence-based behavioural changes. This study set out to establish an understanding of evidence-based lifestyle management of PCOS and the current practices of implementing it in clinical practice amongst final year medical students and newly graduated healthcare professionals.

Design: A survey was constructed using evidence-based recommendations in the international guidelines for PCOS.

Method: We invited final year medical students and non-specialist junior doctors in the UK to complete an online survey between September 2020 and January 2021. The findings were reported as frequency and proportion.

Results: A total 67 participants took part in the survey (41 female and 25 male; medical students (21%), foundation doctors (64%) and senior house officers (15%); 34% from London deanery and 27% from the West Midlands deanery). 54% (n=36) knew the correct prevalence of PCOS. Although 70% (n=47) knew biochemical androgen excess is a sign of PCOS, only 43% (n=28) and 1% (n=1) knew free testosterone and free androgen index respectively, were the tests of choice to diagnose this. Instead, androstenedione (52% (n=35) and DHEAS (43% (n=29) were the most common biochemical tests of choice by this cohort. Interestingly, 55% (n37) said they would use AMH as a test to diagnose PCOS. Although most of the participants knew that BMI 94% (n=63) and waist circumference 95% (n=64) required routine monitoring between 6-12 months for PCOS, only 6% (n=4) were aware of the national recommendations for exercise. 36% (n=26) identified obesity and T2DM as the most common long term effects of PCOS.

Conclusion: Effective evidence-based lifestyle advice and patient empowerment are crucial for enhanced clinical outcomes in people with PCOS. Our study highlights that physicians and medical students have a limited understanding of the international evidence-based recommendations for PCOS. Our future work will focus on understanding the current educational opportunities for medical students and junior doctors about lifestyle advice and patient empowerment. With this information, we will work with all involved stakeholders to improve access to these programmes for medical students and early career clinicians.