Endocrine Abstracts

Introduction: Polycystic ovary syndrome (PCOS) affects 10-15% of women worldwide, depending on the population and the diagnostic criteria used. The diagnostic criteria include clinical and/or biochemical hyperandrogenism, oligo/anovulation, and polycystic morphologic appearance of the ovaries. PCOS is associated with high risk of obesity, diabetes, cardiovascular diseases, and a wide spectrum of mental health disorders. Despite international recommendations, there is still lack of awareness regarding the diagnostic and management approaches with studies being reported mostly from high-income countries. Herein, we aimed to investigate healthcare professionals’ knowledge and practices regarding PCOS in a middle-income country.

Methods: A survey-based study was conducted among Georgian physicians, namely endocrinologist, gynaecologists, and family doctors, in March 2022. The survey consisted of questions regarding participants’ general information and their knowledge and experience regarding various aspects of PCOS. T-test and chi-square test were performed. Statistical significance was set at P<0.05.

Results: Out of the 133 physicians, 77 (57.9%) were endocrinologists, 21 (15.8%) gynaecologists, and 35 (26.3%) family doctors. 93.5% (n=72/77) of endocrinologists, 70.0% (n=14/20) of gynaecologists, and 84.8% (n=28/33) of family doctors perceived PCOS as an endocrine condition (P=0.015). however, 51.9% (n=40/77) of endocrinologists referred patients to gynaecologists, and 33.3% (n=7/21) of gynaecologists referred patients to endocrinologists (P<0.001). Less than half of both specialists (49.4% [n=38/77] of endocrinologists and 47.6% [n=10/21] of gynaecologists) used Rotterdam criteria, while 14.3% (n=11/77) of endocrinologists and 4.8% (n=1/21) of gynaecologists responded with ‘don’t know’ (P=0.474). For initial evaluation, more endocrinologists used metabolic parameters, compared with gynaecologists (P<0.05). Only 12.0% (n=9/75) of endocrinologists and 19.0% (n=4/21) of gynaecologists offered lifestyle modifications for PCOS on a regular basis. 5.7% (n=38/75) and 36.0% (n=27/75) of endocrinologists most frequently offered metformin and oral contraceptives for PCOS, as opposed to 4.8% (n=1/21) and 66.7% (n=14/21) of gynaecologists for the same treatment options, respectively (P=0.001). Lastly, 61.0% (n=47/77) of endocrinologists and 85.7% (n=18/21) of gynaecologists disagreed with the statement ‘name ‘polycystic ovary syndrome’ is confusing and should be changed’ (P=.034).

Conclusions: The knowledge and practical approaches with regards to PCOS differ across specialities and are inconsistent with the current international recommendations. Future studies are warranted to propose relevant improvements and evaluate the effectiveness of implemented mechanisms in Georgia to promote better patient care. Further perspective would be to explore the perceptions and attitudes towards PCOS among women with this condition to better understand their needs.