Assessment of Awareness and Prevalenceof Polycystic Ovarian Syndrome RiskFactors in Reproductive-Aged Women inSaudi Arabia

Abstract

Introduction: Polycystic ovarian syndrome (PCOS) is a prevalent endocrine disorder among women of
reproductive age, characterized by hormonal imbalance, menstrual irregularities, and metabolic complications. It
is associated with long-term risks such as infertility, Type 2 diabetes, and cardiovascular diseases. Despite its high
prevalence, especially in Middle Eastern countries, including Saudi Arabia, awareness of PCOS and its risk factors
remains low. Previous studies have shown that limited knowledge among women contributes to delayed diagnosis
and poor management outcomes. Objectives: This study aims to assess the level of awareness and the prevalence
of risk factors associated with PCOS among reproductive-aged women in Saudi Arabia. Methodology: This is a
cross-sectional observational study conducted between July and December 2025 in Saudi Arabia. Participants were
recruited using social media platforms such as Twitter, Instagram, Snapchat, and WhatsApp. Of 430 respondents,
300 eligible women without prior PCOS were analyzed (mean age 25.9 ± 8.6 years; 69.0% aged 18–24). Ten-item
knowledge and ten-item awareness scores (0–10 each) were categorized as poor (<5), moderate (5–8), or high
(9–10). Associations were assessed using Chi-square; correlation between scores was measured using Spearman’s
rho. Results: Knowledge was high overall: 64.7% had high knowledge, 30.7% moderate, and 4.7% poor. Most
participants had heard of PCOS (93.0%) and androgen hormones (84.7%) and recognized increased androgen
levels (86.7%) and polycystic ovarian morphology (85.0%). Symptom recognition was highest for menstrual
irregularity/amenorrhea (95.3%) and hirsutism (89.3%). Awareness was lower: 26.3% high, 59.0% moderate,
and 14.7% poor. Diagnostic awareness was moderate (ultrasound 77.0%; blood tests 61.7%). Awareness of
infertility/reduced fertility (83.0%) and anxiety/depression (91.3%) exceeded awareness of diabetes (59.7%)
and heart disease (36.3%). For treatments, hormonal therapy (75.0%) and symptomatic treatment (75.3%) were
commonly endorsed, whereas metformin awareness was lower (55.7%). Knowledge level differed by age, region,
education, employment status, and weight
(all P ≤ 0.047), but awareness showed no
significant sociodemographic associations (all
P > 0.05). Knowledge level was significantly
associated with awareness level (P < 0.001),
and scores were moderately correlated (ρ
= 0.49, P < 0.001). Conclusion: Saudi
reproductive-aged women demonstrated strong
symptom-focused PCOS knowledge but only
moderate awareness of cardiometabolic risks
and some evidence-based management options supporting targeted education to promote earlier evaluation and long-term risk reduction, particularly regarding metabolic
screening and cardiovascular prevention efforts.