BSOG

PCOS Survey - form for Gynaecologist

Name : *

Email : *

Age : *

Year of passing MD/DGO : *

Are you in clinical practice? *

Yes
No

1. How many patients of PCOS have you seen in the last year? *

Less than 50
50 - 100
More than 200
Not Applicable

2a. Of the total number of patients seen by you, approximately what percentage would be PCOS ? *

2b. Of these approximately:............% were lean PCOS *

2c. Of these approximately: ...........% were obese. *

3. Enumerate the 3 most common complaints that PCOS patients visited your clinic for: *

4a. Is family history relevant in these patients? *

Yes
No

4b. If Yes, what family history do you ask for? *

5. Which of the following may be associated with PCOS? *

Sleep Apnea
Single Ovarian Cyst
Menstrual disturbances
Acne / Hirsutism
Difficulty in losing weight

6. Which conditions would you rule out before making a diagnosis of PCOS? *

Thyroid
Migraine
Drug induced PCO picture

Hyper prolactinaemia
Adrenal disorders
Turner's Syndrome

Pituitary tumours
Premature ovarian failure

7. How many of these variables are needed to label a person as PCOS? *

USG showing PCO
Irregular periods
Signs of androgen excess
All of the above

8. On Ultrasound, which of these are significant? *

Ovarian Volume <10 ml
Antral Follicle count ≥ 12

9. Do your patients with PCOS feel social isolation?

Yes
No
I don't know

10a. Do you treat PCOS patients yourself? *

Yes
No

10b. Do you refer your PCOS patients to other specialties? If yes, which ones:

Endocrinologist
Nutritionist

Dermatologist
Exercise expert

Counsellor
Infertility Specialist

11. As a Gynecologist, do you agree that you are the primary physician for PCOS? *

Yes
No