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Questionnaire
Assessment of knowledge regarding Polycystic Ovary Syndrome
Name: age:
Married /unmarried: overweight /underweight:
1) Did you hear about Polycystic Ovary Syndrome (PCOS) before?
a) Yes b) No
2) Does any other girl in your family suffering from Polycystic Ovary Syndrome (PCOS)?
a) Yes b) No
3) What was the first symptom you noticed while having Polycystic Ovary Syndrome (PCOS)?
a) Missed Periods b) Excess body hairs
c) Weight gain d) Acne or oily skin
4) To what extent have you felt that the growth of visible hair on your chin has been a problem
for you during last two weeks?
a) A severe problem b) Moderate problem
c) Little problem d) No problem
5) Have you felt concerned about being overweight?
a) All of the time b) Some of the time
c) Hardly any of the time d) none of the time
6) Do you face acne problems due to polycystic ovary syndrome?
a) Yes b) No
7) Do you ever face difficulty in conceiving while having polycystic ovary syndrome?
a) Yes b) No c) Sometimes
8) By which method Physician diagnosedPolycystic Ovary Syndrome (PCOS)?
a) Symptoms b) Physical exam
c) Blood tests d) Pelvic Ultrasound
9) In relation to your last menstruation, was abdominal bloating a problem for you?
a) A major problem b) A moderate problem
c) Hardly any problem d) No problem
10) Does Polycystic Ovary Syndrome (PCOS) damage your other organs or overall health?
a) Yes b) No c) Don’t know
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11) Do you face pressure from society for not conceiving due to polycystic Ovary Syndrome
(PCOS)?
a) Yes b) No
12) Did you face infertility problems due to Polycystic Ovary Syndrome (PCOS)?
a) All the time b) Some of the time
c) Hardly any of the time d) none of the time
13) Which physician’s method is proving beneficial for you?
a) Lifestyle changes b) Medications c) Any other
14) Are medications important to treat polycystic Ovary Syndrome (PCOS)?
a) Yes b) No c) Don’t know
15) What type of medications thedoctor prescribed you?
a) Clomiphene + clomid b) Metformin (Glucophage) S
c) Eflornithine + Vaniqua d) All of the above
16) Does contraceptive pills cure Polycystic Ovary Syndrome (PCOS)?
a) Yes b) No
17) Lifestyle changes which are suggested by your Physician;
a) Diet b) Exercise
c) Mental health d) any other
18) How your periods are effected by polycystic ovary syndrome (PCOS)?
a) Late periods b) Early periods