INTRODUCTION:

Adolescence is a period of transition between childhood and adulthood, a time of profound biological, intellectual, psychological and economic changes. During this period individual reaches physical, sexual maturity and develop more sophisticated reasoning abilities. The changes of adolescence have important implications for understanding the kinds of health risks to which young people are exposed, health enhancing, risk taking behavior in which they engage and the major opportunities for health promotion among this population.¹

Adolescence is the most pivotal period of life and vulnerable times for physical ailments. Adolescents (13-19 years) form a large section of population about 22.5% i.e., about 225 million. According to recent statistics one fifth of the world’s population is adolescents (WHO 1995) and in India one third of the population is between the age of 10 and 24.²

The transition from childhood to adolescence is a journey with full of surprises both for the parents and the children along with many adolescent problems when they need more guidance and care.³ Gynecological diseases are fairly common but most of the adolescents ignore the symptoms, or they are unaware till the time when the problem really worsens.⁴ A growing percentage of adolescent problems are irregular period. Historically puberty has been heavily associated with teenagers, the onset of adolescent development.⁵

Today is a period of modernization and its effect along with technological advancement reflects in everyday life. Changes in lifestyle and food intake more concentrated on sugar, fast food and soft drinks and less on healthy, traditional fare. This unhealthy food habits and lack of exercise leads to many diseases in adolescents, especially polycystic ovarian disease.⁶ Polycystic ovarian disease (PCOD) is a common endocrine disorder which is alarmingly increasing in teenage girls during their early reproductive years with prevalence of 4-12% globally.⁷

Polycystic ovarian disease was first described in 1935 by American gynecologists Irving F. Stein and Michael L. Leventhal^6,8 as a syndrome manifested by amenorrhea, hirsutism and obesity associated with enlarged polycystic ovary, from whom its original name of Stein–Leventhal syndrome is taken.^6,8 It is a heterogeneous, multifactorial and polygenic disorder characterized by excessive androgen production by the ovaries. Other names include polycystic ovarian syndrome, functional ovarian hyperandrogenism, ovarian hyperthecosis, sclerocystic ovarian syndrome and Stein Leventhal syndrome. A polycystic ovary has an abnormally large number of developing eggs visible near its surface looking like many small cysts or a string of pearls.⁹ Obesity is a major risk factor for PCOD.⁷

There are two main reasons for the increase of PCOD diagnoses in Indian women: the adoption of unhealthy eating habits and a sedentary lifestyle. Many young Indian girls today eat a steady diet of junk food, when combined with an extremely aggressive academic load, they are notable to burn off the increased calories to maintain a healthy weight, whereas older generations of Indian adolescents eat traditional, lower calorie foods with less sugar.¹⁰

Manifestation of polycystic ovarian disease occurs around the time of menarche as lengthened or irregular menstrual cycles. It goes undiagnosed at this time because most girls have irregular menstrual cycles and remain undiagnosed till the time when they come to seek treatment for infertility. Efforts should be made for early diagnosis and treatment of PCOD which help to control the symptoms and prevent health related problems since adolescents shows less care in their health issues.¹¹The main concerns in caring for the adolescence with PCOD are twofold involves cyclic control of irregular menstrual cycles and the avoidance of long-term problem that are associated with obesity, insulin resistance, glucose intolerance and type 2 diabetes.⁹

NEED OF THE STUDY:

The World Health Organization (WHO) defines adolescents are people between 10 and 19 years of age. The great majority of adolescents are included in the age-based definition of “child” adopted by the Convention on the Rights of the Child, as a person under the age of 18 years.¹²

In India, the prevalence of PCOD in adolescence is 9.13 % and witnessed about 30% rise in PCOD cases in the last couple of years. In Karnataka, incidence of PCOD among adolescent is estimated to be 11-26%.¹³The diverse and complex female endocrine disorder affects 1 in 15 women worldwide, is a major economic health burden expand together with obesity.¹⁴

The “cysts” are immature follicles developed from primordial follicles, but the development has arrested at an early antral stage due to the disturbed ovarian function.⁹ Polycystic ovaries develop when the ovaries are stimulated to produce excessive amounts of male hormones (androgen) due to genetic susceptibility, release of excessive luteinizing hormone (LH) by the anterior pituitary gland and through high levels of insulin in women whose ovaries are sensitive to this stimulus.¹² Symptoms like hirsutism, obesity, anovulation, amenorrhea appears in 50% of women and as heavy uterine bleeding, menstrual disturbances in 30% of women and 20% of women with PCOD have normal menstruation. Other symptoms are like male pattern hair growth, bald spots, skin discoloration, abnormal blood chemistry like high levels of low-density lipoprotein, triglycerides, low levels of high-density lipoprotein, hyperinsulinemia and infertility.¹⁵

PCOD requires “control” rather than “cure” that focus on treatment changes with the age of the women seeking treatment. Management and treatment approaches are directed to address specific symptoms. To prevent long-term complications, the treatment is individualized, and the drugs used include steroid hormones, anti- androgens or insulin sensitizing agents. Home treatment measures help to manage the symptoms of PCOD and live a healthy life through weight loss or weight control, exercise, balanced diet and quit smoking.18 Realistic and achievable weight loss can be sufficient to restore regular ovulation and improve fertility in obese women with this disorder.⁵

An inclusive study to observe the trends in polycystic ovarian disease in young girls in India revealed that 1 in 5 adolescent girls suffer from PCOD problem and East India leads the chart with 1 in 4 women suffering from PCOD. Metropolis health care Ltd conducted a comprehensive study on 27,411 samples of testosterone over a period of 18 months and the result showed that around 4,824(17.60%) of the females face hormonal associated risk with PCOD. The increasing trend of PCOD is predominantly seen in the age group 15 to 30 years. Among the samples tested in East India shows alarming levels of 25.88% women affected by PCOD followed by 18.62% in North India which can be largely attributed to lack of awareness among young women and ignorance.¹¹ In India researchers found that obese women are having a hard time conceiving. According to an article in The Times of India from 90 percent of them, 35 percent of women are within their childbearing age suffer from polycystic ovarian disease (PCOD).¹⁰ One community-based prevalence study using the Rotterdam criteria found that about 18% of women had PCOD and that 70% of them were previously undiagnosed. One study in the United Kingdom concluded that the risk of PCOD development was higher in lesbian women than in heterosexuals. Ultrasonographical findings of polycystic ovaries are found in 8-25% of normal women, 14% women on oral contraceptives.¹⁵

Adolescent girls are the backbone of our society, so health of the adolescent is more important. For better health better knowledge is essential. Attitude of each person will be different from one another. There should be good attitude towards any health issues to overcome the health problem. So before providing any awareness or educational programme it’s necessary to identify level of knowledge and attitude of adolescent girls towards health, diet, lifestyle, changes during their adolescent period. Here majority of girls are facing menstrual irregularity along with PCOD so there is need to assess the level of knowledge and their attitude towards the PCOD. These discussions made the investigator to understand that there is necessity to assess knowledge and attitude of adolescent girls prior to imparting more knowledge and improve the attitude. Hence the investigator felt the need to undertake the study to assess knowledge and attitude on PCOD among adolescent girls of selected schools of Anand- Kheda district, Gujarat.

OBJECTIVES:

1. To determine the level of knowledge of adolescent girls on Polycystic Ovarian Disease.

2. To assess the attitude towards Polycystic Ovarian Disease among adolescent girls.

3. To find the association between level of knowledge of adolescent girls regarding Polycystic Ovarian Disease with selected demographic variables.

HYPOTHESIS:

^H0^{-There is no significant association between level of knowledge of adolescent girls}on Polycystic Ovarian Disease with selected demographic variables at p < 0.05 level of significance.

ASSUMPTIONS:

1. Adolescent girls may have some knowledge regarding Polycystic Ovarian Disease.

2. Knowledge of adolescent girls can be measured by a knowledge questionnaire.

3. Adolescent girls may have some attitude towards Polycystic Ovarian Disease.

MATERIALS AND METHODS:

The study was designed to assess knowledge and attitude Regarding Polycystic Ovarian Disease among Adolescent Girls of Selected Colleges of Anand- Kheda district, Gujarat.

A Quantitative approach was used for the study. A cross sectional research design was employed. The target population was adolescent girls. This population was selected by non-probability convenient sampling technique. The total samples under the study were 500 adolescent girls. Data was collected using Performa of demographic variables, Structured knowledge questionnaire regarding Polycystic ovarian disease and attitude scale for Polycystic ovarian disease.

RESULT:

Section I: Findings Related to Demographic Variables of Adolescent Girls:

Table 1: Frequency and percentage distribution of Demographic Variables N=500

Sr. No	Demographic variables	Frequency (f)	%
1.	Age
1.1	17-19 years	65	13
1.2	20-22 years	06	1.2
1.3	23-25 years	29	5.8
1.4	26 year and above	400	80
2.	Religion
2.1	Hindu	345	69
2.2	Muslim	85	17
2.3	Christian	63	12.6
2.4	Other	07	1.4
3.	Education
3.1	1^st Year	210	42
3.2	2^nd Year	204	40.8
3.3	3^rd Year	71	14.2
3.4	4^th Year	15	03
4.	Type of Family
4.1	Nuclear	178	35.6
4.2	Joint	235	47
4.3	Extended	87	17.4
5.	Monthly Income
5.1	<15000 Rupees	253	50.6
5.2	15000-30000 Rupees	226	45.2
5.3	>30000 Rupees	21	4.2
6.	Area of Residence
6.1	Rural	148	29.6
6.2	Urban	352	70.4
7.	Previous training of PCOD
7.1	Yes	31	6.2
7.2	No	469	93.8
8.	Family history of PCOD
8.1	Yes	17	3.4
8.2	No	483	96.6

Table No. 1 shows that majority of the participants 400 (80%) were 26 years and above while 65(13%), 29 (5.8%) and 6(1.2%) were belongs to the age of 17-19 years, 23-25 years, 20-22 years respectively. Maximum participants 345(69%) were belongs to Hindu religion while 85(17%) were Muslim, 63(12.6%) were Christian and only 07(1.4%) were others (Jain). Majority of the participants 210(42%) were belongs to 1st year while 204(40.8%), 71(14.2%) and 15(03%) were from 2nd year, 3rd year and 4th year respectively. Maximum 235 (47%) participants were belonging to joint family while 178(35.6%) and 87(17.4%) were leave in Nuclear and extended family respectively. Majority of the participants 253(50.6%) were having monthly income of <15000 rupees while 226(45.2%) and 21(4.2%) were having income of between 15000 to 30000 and >30000 rupees respectively. Majority of the participants 352 (70.4%) were from urban area while only 148 (29.6%) were belonging to rural area of residence. Majority of the participants 469(93.8%) have not received any previous training regarding PCOD while only 31(6.2%) had received previous training regarding PCOD. Majority of the participants 483 (96.6%) does not have family history of PCOD while only 17(3.4%) have family history of PCOD.

SECTION II

Findings Related To Knowledge of Adolescent Girls Regarding Polycystic Ovarian Disease

Figure 1 Percentage distribution of knowledge regarding Polycystic ovarian disease

Figure no. 1 shows that majority of the participants 213 (42.6%) were having poor knowledge of Polycystic ovarian disease while minimum 78(15.6%) were having good knowledge and 209(41.8%) were having Average knowledge of Polycystic ovarian disease.

SECTION III

Findings related to attitude of adolescent girls regarding polycystic ovarian disease

Table 2: Frequency and percentage of attitude leveln= 500

Category	Frequency(f)	Percentage%
Unfavourable attitude (0-13)	06	1.2
Neutral attitude (14-26)	439	87.8
Favourable attitude (27-40)	55	11

Table No. 2 shows that majority of the participants 439 (87.8%) were having Neutral attitude towards Polycystic ovarian disease while 55 (11%) were having Favourable attitude towards Polycystic ovarian disease and only 6 (1.2%) were having Unfavourable attitude towards Polycystic ovarian disease.

Section IV: Findings Related to Association Between Knowledge of Adolescent Girls Regarding Polycystic Ovarian Disease with Selected Demographic Variables

Significant at 5% level (p <0.05 level)

Table No. 3 shows that Education (χ²=52.26, df=3, p< 0.05), Type of family (χ²=7.83, df=2, p< 0.05) Monthly income (χ²=33.21, df=2, p<0.05), Area of residence (χ²=11.73, df=1, p<0.05), and Family history of PCOD (χ²=5.54, df=1, p<0.05) were significantly associated with knowledge regarding Poly cystic ovarian disease while Age (χ²=5.16, df=3, p<0.05), Religion (χ²=4.02, df=3, p<0.05) and, Previous training of PCOD (χ²=2.37, df=1, p<0.05) does not have any statistical significance with knowledge score.

DISCUSSION:

The findings of this study indicate a significant gap in knowledge about Polycystic Ovarian Disease (PCOD) among adolescent girls in the selected colleges of Anand-Kheda district. The majority of participants (42.6%) reported poor knowledge, and only a small proportion (15.6%) demonstrated good understanding of the disease. This highlights the need for comprehensive educational interventions to raise awareness about PCOD, especially in the adolescent population, who are at risk of developing the condition. The neutral attitudes observed in the study (87.8%) further suggest that while participants are not entirely indifferent to PCOD, they lack sufficient knowledge to form a more informed and proactive stance on the condition. The significant association between education, family type, monthly income, area of residence, and family history of PCOD with knowledge levels emphasizes the importance of tailoring health education programs to these demographic factors. Adolescents from joint families, urban areas, and those with a higher income and family history of PCOD exhibited better awareness, highlighting that social and economic factors play a crucial role in shaping health knowledge.

Interestingly, despite the large proportion of participants who had not received prior training on PCOD, no significant correlation was found between previous training and knowledge. This finding suggests that the existing training or awareness programs may be insufficient in providing lasting and impactful knowledge. The lack of significance with variables like age, religion, and previous training also points to the complexity of factors influencing knowledge and attitudes toward PCOD. This study underlines the urgent need for improved, accessible, and targeted educational initiatives that consider socio-cultural and economic factors. It also suggests that education should be delivered in multiple formats, including both academic settings and community-based outreach, to effectively reach all adolescents. Such initiatives could help bridge the knowledge gap and foster more favourable attitudes towards managing and preventing PCOD.

CONCLUSION:

The findings of this study reveal a significant lack of knowledge regarding Polycystic Ovarian Disease (PCOD) among adolescent girls in the selected colleges of Anand-Kheda district. A large majority of participants exhibited poor to average knowledge about PCOD, highlighting a substantial gap in awareness about this common reproductive health condition. Furthermore, while most participants held neutral attitudes towards PCOD, only a small percentage demonstrated favorable attitudes. These results emphasize the need for more effective educational interventions targeted at increasing knowledge and improving attitudes toward PCOD, particularly in adolescent populations.

The study also identified several factors significantly associated with knowledge about PCOD, including education, family type, monthly income, area of residence, and family history of the disease. These demographic factors suggest that health education programs should be tailored to different socio-economic groups to be more impactful. The findings underscore the importance of integrating PCOD awareness into educational curricula and community-based initiatives. By doing so, we can enhance knowledge, foster positive attitudes, and encourage proactive health-seeking behaviors among adolescent girls, ultimately improving their reproductive health outcomes.

CONFLICT OF INTEREST:

The authors have no conflicts of interest regarding this investigation.

REFERENCES:

1. Hockenberry W. Nursing care of infants and children, 8th ed, New Delhi: Elsevier Publishers;2007.

2. Wiley J. Medical Definition of Ovary [Internet]. MedicineNet. 2008.Available from: http://www.medicinenet.com/script/main/art.asp?articlekey=4705

3. Goswami S, Dutta R, Sengupta S. J Obstet Gynaecol India; 2005 Jul/Aug;55(4):353-5.

4. Feldman R. Understanding PCOD. 6th ed. New Delhi. Grew hill publishers; 2004

5. UK Essays. Adolescent is a stage of Physical and Mental Human Development Psychology Essay [Internet]. England: UK essays; November 2013. Available from: http://www.ukessays.com/essays/psychology/stage-of-physical-and- mental-hu man-development-psychology-essay.php

6. Marrinan G. Imaging in Polycystic Ovary Disease: Overview, Radiography, Magnetic Resonance Imaging [Internet]. Emedicine.medscape.com. 2011. Available from: http://emedicine.medscape.com/article/404754-overview

7. Wikipedia contributors. Ovary [Internet]. Wikipedia, The Free Encyclopedia; 22 November 2001. Available from: https://en.wikipedia.org/w/index.php?title=Ovaryandoldid=706038129.

8. Scott-Lucidi R. Polycystic Ovarian Syndrome: Practice Essentials, Background, Etiology [Internet]. Emedicine.medscape.com. Available from: http://emedicine.medscape.com/article/256806-overview#showall

9. Contributor W. Polycystic ovary syndrome [Internet]. En.wikipedia.org. 2011. Available from: https://en.wikipedia.org/wiki/Polycystic_ovary_syndrome#cite_noteemedicine_imaging-34

10. Divine C. Women of India and PCOS. https://www.divinecaroline.com/self/wellness/women-india-and-pcos

11. Moghul S. 1 In 5 Women Affected by PCOS In India! But Fret Not, We Have the Solution [Internet]. indiatimes.com. 2015. Available from: http://www.indiatimes.com/health/healthyliving/1-in-5-women-affected-by- pcos-in-india-but-fret-not-we-have-the-solution-244753.html

12. Gutenberg P. Polycystic ovary syndrome | Project Gutenberg Self-Publishing - eBooks | Read eBooks online [Internet]. Self.gutenberg.org. 2011. Available from: http://self.gutenberg.org/articles/eng/Polycystic_ovary_syndrome

13. Biam N, Bhuvaneshwari. P. International Journals of Novel Research in Healthcare and Nursing. 2015 Sep-Dec;2(3):66-9.

14. Science Daily. Science News from research organizations; Polycystic Ovary Syndrome: 1 In 15 Women Affected Worldwide and Burden Likely to Increase; September 3, 2007. Available from: www.sciencedaily.com/releases/2007/08/070831204314.html

15. Smith HA, Markovic N, Matthews AK, Danielson ME, Kalro BN, Youk AO, Talbott EO. A comparison of polycystic ovary syndrome and related factors between lesbian and heterosexual women. Womens Health Issues. 2011; 21(3): 191–8.

Received on 27.11.2024 Revised on 17.03.2025

Accepted on 20.05.2025 Published on 16.08.2025

Available online from August 25, 2025

Int. J. Nursing Education and Research. 2025;13(3):145-150.

DOI: 10.52711/2454-2660.2025.00031

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. Creative Commons License.

Sr No	Demographic variables	Chi square χ2 (calculated value)	Chi square χ2 (table value)	df	Significance level
1	Age	5.16	7.81	3	Not significant
2	Religion	4.02	7.81	3	Not significant
3	Education	52.26	7.81	3	Significant
4	Type of family	7.83	5.99	2	Significant
5	Monthly Income	33.21	7.81	2	Significant
6	Area of residence	11.73	3.84	1	Significant
7	Previous training of PCOD	2.37	3.84	1	Not significant
8	Family history of PCOD	5.54	3.84	1	Significant