Awareness of polycystic ovary syndrome among obstetrician-gynecologists and endocrinologists in Northern Europe

• Main Authors: Piltonen, T. T. (Terhi T.), Ruokojärvi, M. (Maria), Karro, H. (Helle), Kujanpää, L. (Linda), Morin-Papunen, L. (Laure), Tapanainen, J. S. (Juha S.), Stener-Victorin, E. (Elisabet), Sundrström-Poromaa, I. (Inger), Hirschberg, A. L. (Angelica L.), Ravn, P. (Pernille), Glintborg, D. (Dorte), Mellembakken, J. R. (Jan Roar), Steingrimsdottir, T. (Thora), Gibson-Helm, M. (Melanie), Vanky, E. (Eszter), Andersen, M. (Marianne), Arffman, R. K. (Riikka K.), Teede, H. (Helena), Falah-Hassani, K. (Kobra)
• Format: Article in Journal/Newspaper
• Language: English
• Published: Public Library of Science 2019
• Subjects: Norway; Iceland
• Online Access: http://urn.fi/urn:nbn:fi-fe202003198583

Abstract Objective: To date, little is known about differences in the knowledge, diagnosis making and treatment strategies of health care providers regarding polycystic ovary syndrome (PCOS) across different disciplines in countries with similar health care systems. To inform guideline translation, we aimed to study physician reported awareness, diagnosis and management of PCOS and to explore differences between medical disciplines in the Nordic countries and Estonia. Methods: This cross-sectional survey was conducted among 382 endocrinologists and obstetrician-gynaecologists in the Nordic countries and Estonia in 2015–2016. Of the participating physicians, 43% resided in Finland, 18% in Denmark, 16% in Norway, 13% in Estonia, and 10% in Sweden or Iceland, and 75% were obstetrician-gynaecologists. Multivariable logistic regression models were run to identify health care provider characteristics for awareness, diagnosis and treatment of PCOS. Results: Clinical features, lifestyle management and comorbidity were commonly recognized in women with PCOS, while impairment in psychosocial wellbeing was not well acknowledged. Over two-thirds of the physicians used the Rotterdam diagnostic criteria for PCOS. Medical endocrinologists more often recommended lifestyle management (OR = 3.6, CI 1.6–8.1) or metformin (OR = 5.0, CI 2.5–10.2), but less frequently OCP (OR = 0.5, CI 0.2–0.9) for non-fertility concerns than general obstetrician-gynaecologists. The physicians aged <35 years were 2.2 times (95% CI 1.1–4.3) more likely than older physicians to recommend lifestyle management for patients with PCOS for fertility concerns. Physicians aged 46–55 years were less likely to recommend oral contraceptive pills (OCP) for patients with PCOS than physicians aged >56 (adjusted odds ratio (OR) = 0.4, 95% CI 0.2–0.8). Conclusions: Despite well-organized healthcare, awareness, diagnosis and management of PCOS is suboptimal, especially in relation to psychosocial comorbidities, among physicians in the Nordic countries and ...