Clinical Practice Patterns of Polycystic Ovary Syndrome Among Doctors of Different Specialties—An Indian Perspective

Abstract

Aims: The knowledge, awareness, and practice with regards to the management of polycystic ovary syndrome (PCOS) among doctors from India is not currently known. This study aimed to determine current clinical practice with regards to managing PCOS. Methods: Local doctors from New Delhi attending an international-led endocrinology conference in New Delhi (the Society for the Promotion of Education in Endocrinology and Diabetes [SPEED] Annual Conference, February 2019) were evaluated regarding their PCOS treatment preferences using a standardized questionnaire, consisting of 30 multiple-choice questions.The questionnaire evaluated doctors’ knowledge of clinical symptomatology; biochemical, hormonal, and radiologic evaluation; and pharmacotherapy practices for PCOS. Results: A total of 695 questionnaires were distributed and 538 were collected back, 417 of which had >80% of the questions answered and were analyzed (63.31% of participants were general physicians, 10.31% were gynecologists, 10.55% were pediatricians, 6.95% were endocrinologists, and 8.87% had other specialties). The mean age of the doctors was 43.07 ± 13.28 years. The use of screening for non-classical congenital adrenal hyperplasia by measuring serum 17-OH-progestrone in people living with PCOS is rare in India. Endocrinologists and gynecologists are more likely to use hormone pills to manage PCOS. Both oral contraceptive pills and progestogen-only pills are commonly used in PCOS. Spironolactone is the most commonly used anti-androgen; use of other anti-androgens is low. Metabolic complications of PCOS (dysglycemia and dyslipidemia) are more likely to be screened by endocrinologists and general physicians. Depression in PCOS was more likely to be detected by pediatricians. Conclusion: There is heterogeneity in PCOS treatment practices among doctors of different specialties, warranting better coordination among gynecologists, endocrinologists, pediatricians, and general physicians to homogenize and standardize treatment practices.