Symptom manifestation and diagnosis timing of PCOS among KSMU female students from India, the Maldives, and Nigeria.

Abstract

Background: Polycystic ovary syndrome (PCOS) is a prevalent yet frequently underdiagnosed endocrine disorder among women of reproductive age, characterized by symptoms such as irregular menstruation, hirsutism, acne, and weight gain. Delayed diagnosis often results from lack of awareness, stigma, and variable symptom presentation. This study aimed to examine symptom onset, diagnosis timelines, and health-seeking behavior among female students from India, the Maldives, and Nigeria studying at Kursk State Medical University (KSMU).
Materials and Methods: A cross-sectional survey was conducted using a standardized self-administered questionnaire among 141 female students aged 17–26. Participants were divided into two groups: those with a formal PCOS diagnosis and those with symptoms but no diagnosis. Data collected included symptom profiles, age of onset, diagnostic status, family history, and healthcare behavior.
Results: Of the 141 participants, 33 (23.4%) had been formally diagnosed with PCOS, with the highest diagnosis rate among Indian students (31.91%), followed by those from the Maldives (21.28%) and Nigeria (17.02%). The most commonly reported symptoms were hair loss (17.51%), acne and excessive hair growth (14.42% each), and weight gain (11.33%). Symptom onset typically began in adolescence, with irregular menstruation appearing as early as age 14. Diagnostic timelines varied, with Nigeria showing the longest delays. Among the undiagnosed group, 36 participants reported PCOS-like symptoms, but 77.77% had not sought medical care due to stigma, fear, or normalization of symptoms.
Conclusion: The findings reveal significant underdiagnosis of PCOS despite high symptom prevalence, particularly among Nigerian students. Early-onset symptoms and long delays in seeking care emphasize the need for institutional awareness campaigns, routine gynecological screenings, and psychosocial support. Addressing stigma and promoting menstrual health literacy are essential steps toward improving reproductive health outcomes in this population.