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CC BY-NC-ND 4.0 · Journal of Diabetes and Endocrine Practice 2022; 05(03): 104-111
DOI: 10.1055/s-0042-1759643
Original Article

Diagnosis and Management of Polycystic Ovary Syndrome: A Survey of Physicians from the Middle East and Africa

Salem A. Beshyah 
1   Department of Medicine, College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates
2   Department of Medicine, Dubai Medical College, Dubai, United Arab Emirates
3   Department of Medicine, Yas Clinic Khalifa City, Abu Dhabi, United Arab Emirates
,
Mohammed Bashir
4   Department of Medicine, Hamad Medical Corporation, Qatar Metabolic Institute, Doha, Qatar
,
Aishah Ekhzaimy
5   Endocrinology Division, Department of Medicine, King Saud University, King Saud University Medical City, Riyadh, Saudi Arabia
,
Abbas Ali Mansour 
6   Faiha Specialized Diabetes, Endocrine and Metabolism Center (FDEMC), University of Basrah, Basrah, Iraq
,
Huda E. Mustafa
7   Health Plus Center for Diabetes and Endocrinology, Abu Dhabi, United Arab Emirates
,
Nancy Elbarbary
8   Pediatric Diabetes and Endocrinology Unit, Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt
,
Ghina Ghazeeri
9   Department of Obstetrics and Gynecology, American University of Beirut Medical Center, Beirut, Lebanon
,
Hisham Mohamed Abdel Rahim
10   Department of Medicine, Ribat University Hospital, Khartoum, Sudan
,
Dima K. Abdelmannan
2   Department of Medicine, Dubai Medical College, Dubai, United Arab Emirates
› Author Affiliations Funding and Sponsorship No funding was received in the publication of this study.
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Abstract

Background Studies from several regions examined the approach to diagnosing and managing polycystic ovary syndrome (PCOS). Limited data are available from the Middle East and Africa (MEA).

Objective The aim of this study was to understand the practice pattern for diagnosing and managing PCOS by relevant specialists across the MEA region.

Methods We used an online survey consisting of an established questionnaire. The questionnaire consisted of 25 questions grouped to capture information on (a) the characteristics of the respondents, (b) patients with PCOS seen by respondents, (c) the diagnostic criteria, (d) biochemical parameters for differential diagnosis of hyperandrogenism, (e) long-term concerns, and, finally (f) management choices.

Results A total of 190 questionnaires were available for final analysis; 73.7% of the respondents were senior physicians; 59.5% and 17.4% were endocrinologists and gynecologists, respectively. Menstrual irregularity was the most frequent criterion used for the diagnosis of PCOS (90.5%), followed by hirsutism (75.7%), and biochemical hyperandrogenism (71.4%). Dehydroepiandrosterone was the most frequent biochemical parameter used for the differential diagnosis of hyperandrogenism (52.4%) followed by total testosterone (45.4%). Obesity and type 2 diabetes mellitus were the principal long-term concerns for PCOS (45.1%), followed by infertility (29.9%). Metformin was the most commonly prescribed treatment (43.8%), followed by lifestyle modification (27.0%), and oral contraceptives (18.9%). Infertility treatments include metformin alone, clomiphene citrate alone, or their combination prescribed by 23.1, 9.9, or 52.7%, respectively, whereas only 3.8% contemplated ovulation induction. Some differences and similarities were observed in previous studies, including gynecologists and endocrinologists.

Conclusions This survey provides a baseline for the perspective in diagnosing and treating PCOS in the MEA region. Some deviation is observed from mainline recommended practices. More education on PCOS diagnostic criteria and treatment of PCOS is needed in line with the recently published evidence international guideline.

Keywords

polycystic ovary syndrome - clinical practices - metabolic syndrome - antiandrogens - MENA region - Africa

Authors' Contributions

The named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship of this manuscript (conception, data collection, and drafting/revision of the article). They take responsibility for the integrity of the work and have given final approval for the version of the manuscript.


Compliance with Ethical Principles

The study was approved by the Institutional Review Board of Sheikh Khalifa Medical City, Abu Dhabi, UAE. Informed consent was received from the participants before they take the questionnaire.


Supplementary Material



Publication History

Article published online:
22 December 2022

© 2023. Gulf Association of Endocrinology and Diabetes (GAED). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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