Cureus · 2025
Approach to Diagnosis and Management of Polycystic Ovary Syndrome in Bangladesh: A Nationwide Cross-Sectional Survey of Physicians.
СтатьяНазвание и аннотация: Перевод в очереди
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Mustari Marufa, Raunak Ahmed Ifrad Bin, Mahjabeen Samira, Mahmood Syed Azmal, Afsana Faria, Saifuddin M, Haq Tahniyah, Islam Sunjida, Hossain Tanjina, Mohiuddin S M, Akter Nazma, Ahammed Afsar, Sobhan Rezwana, Rahman Shahin Ibn, Sarkar Sourav, Pathan Md Faruque, Rahman Muhammad Hafizur, Tanni Afia Zainab, Selim Shahjada
Аннотация
BACKGROUND: Polycystic ovary syndrome (PCOS) is the most prevalent endocrine disorder among women of reproductive age. This nationwide cross-sectional study aimed to assess physicians' diagnostic and management practices for PCOS in Bangladesh, with a particular focus on adherence to established guidelines.
METHODS: This nationwide cross-sectional survey was conducted between April and October 2024 among general practitioners and specialists using a semi-structured questionnaire. Information on demographic characteristics, diagnostic and therapeutic practice patterns, and use of clinical guidelines was collected. Descriptive statistical methods were applied.
RESULTS: Among the 643 practicing physicians, 553 (86%) were specialists in Gynecology and Obstetrics, followed by general practitioners (7.8%), endocrinologists (4%), and others. The European Society for Human Reproduction and Embryology (ESHRE) was the most commonly followed guideline (37%), along with other evidence-based guidelines. Infertility, irregular menstrual cycles, and hirsutism were frequent presenting symptoms, while infertility, type 2 diabetes, and obesity were identified as major long-term risks. Lifestyle modifications (515, 80%) and metformin (466, 72.5%) were the most common treatment strategies. Overall, 573 (89.1%, 95% CI: 86.7%-91.5%) physicians reported applying at least one recognized guideline. However, advising follow-up varied, with only 180 (52%) recommending follow-ups within 12 weeks. Furthermore, 465 (74.6%) participants who wanted a referral system supported the establishment of a structured referral system, with endocrinologists and gynecologists as the preferred specialists.
CONCLUSION: While most physicians reported familiarity with international guidelines, variations in adherence and follow-up practices were observed. The development of a unified, context-specific national guideline is recommended to strengthen standardization of care and improve patient outcomes in Bangladesh.
METHODS: This nationwide cross-sectional survey was conducted between April and October 2024 among general practitioners and specialists using a semi-structured questionnaire. Information on demographic characteristics, diagnostic and therapeutic practice patterns, and use of clinical guidelines was collected. Descriptive statistical methods were applied.
RESULTS: Among the 643 practicing physicians, 553 (86%) were specialists in Gynecology and Obstetrics, followed by general practitioners (7.8%), endocrinologists (4%), and others. The European Society for Human Reproduction and Embryology (ESHRE) was the most commonly followed guideline (37%), along with other evidence-based guidelines. Infertility, irregular menstrual cycles, and hirsutism were frequent presenting symptoms, while infertility, type 2 diabetes, and obesity were identified as major long-term risks. Lifestyle modifications (515, 80%) and metformin (466, 72.5%) were the most common treatment strategies. Overall, 573 (89.1%, 95% CI: 86.7%-91.5%) physicians reported applying at least one recognized guideline. However, advising follow-up varied, with only 180 (52%) recommending follow-ups within 12 weeks. Furthermore, 465 (74.6%) participants who wanted a referral system supported the establishment of a structured referral system, with endocrinologists and gynecologists as the preferred specialists.
CONCLUSION: While most physicians reported familiarity with international guidelines, variations in adherence and follow-up practices were observed. The development of a unified, context-specific national guideline is recommended to strengthen standardization of care and improve patient outcomes in Bangladesh.