https://doi.org/10.15218/ejnm.2025.12 Erbil j. nurs. midwifery, Vol. 8, No. (2), Nov 2025 Original Article Female Student’s Knowledge and Perception Regarding Polycystic Ovarian Syndrome at Koya Technical Institute ABSTRACT Background and Objective: Polycystic ovarian syndrome is the most common endocrine disease in women of reproductive age. It is one of the major reproductive health issues, and it is considered a significant health problem. Institutional students represent the fu- ture of healthcare, equipped with essential knowledge that can be leveraged to educate their peers and patients, especially on this vital topic. This study aimed to determine fe- male students' knowledge and perception regarding polycystic ovarian syndrome who are studying at Koya Technical Institute, Kurdistan, Iraq. Method: A quantitative, descriptive, cross-sectional study was conducted. The study was carried out at Koya Technical Institute from October 1st, 2024, to December 25th, 2024, with convenience samples consisting of 393 female institutional students. The data were gathered through both an online link and a paper-based survey questionnaire and ana- lyzed using SPSS software for statistical analysis, version 27. Chi-square and Fisher’s exact tests were used to determine the association between variables; a p-value ≤ 0.05 is con- sidered statistically significant. Result: In the present study, 393 samples participated; the mean age was 20.97 ±2.62, and more than half of the participants were in the 18-21 age group. 51.7% of the partici- pants had fair knowledge. 44.3% had good knowledge, and only 4% had poor knowledge. 75.3% of the study samples had positive perceptions, and only 24.7% had negative per- ceptions, which revealed there is a significant association between the overall knowledge levels of study samples with socio-demographic characteristics of age (P -value = 0.032) and study year (P - value = 0.04). Conclusion: The findings of this study show that students had an adequate level of knowledge and positive perceptions regarding PCOS and demonstrate a significant asso- ciation between knowledge levels and both age and study year. In contrast, there is no significant association found between overall knowledge and marital status, residence, or department of study. Keyword: Polycystic Ovarian Syndrome; Medical Student; Knowledge and Perception. Iman Fadhil Omar; Department of Midwifery, Erbil Medical Technical Institute, Erbil polytechnic University, Erbil, Kurdistan Region, Iraq. (Correspondence: iman.omer@epu.edu.iq ) Gulala Abubakr Husein; Department of Nursing, College of Nursing, Raparin University, Erbil, Kurdistan Region, Iraq. Zhyan Hussein Khdhir; Department of Nursing, College of Nursing, Raparin General Directorate of Health, Ministry of Health, Erbil, Kurdistan Region, Iraq. 112 Received: 10/02/2025 Accepted: 31/05/2025 Published: 30/11/2025 Copyright ©2025The Author(s). This is an Open Access article which licensed under the terms and conditions of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. It permits no additional restrictions on use, distribution, and reproduction in any medium provided the original work is properly cited. mailto:.%20iman.omer@epu.edu.iq?subject=.%20iman.omer@epu.edu.iq mailto:jawdat.baker@hmu.edu.krd?subject=jawdat.baker@hmu.edu.krd%20%20%20 https://creativecommons.org/licenses/by-nc-sa/4.0/ https://doi.org/10.15218/ejnm.2025.12 Erbil j. nurs. midwifery, Vol. 8, No. (2), Nov 2025 Original Article Polycystic ovarian syndrome is a significant global health challenge and is classified as a multifaceted, heterogeneous endocrine disorder. It affects approximately 6–20% of women of reproductive age worldwide, representing a critical concern in public health [1]. This condition arises from an imbalance in female sex hormones, re- sulting in diverse clinical manifestations, including menstrual irregularities, ovarian cyst formation, infertility, and other sys- temic health complications. PCOS is partic- ularly prevalent among adolescents and young women, with an estimated preva- lence of 5–10% among those in their repro- ductive years [2].The clinical presentation of PCOS is highly variable, encompassing oligomenorrhea or amenorrhea, infertility, obesity, hirsutism, acne, acanthosis nigri- cans, and male-pattern alopecia. These features underscore its heterogeneity [3]. Approximately 60% of individuals with PCOS experience obesity and insulin re- sistance, while up to 40% develop diabetes by the age of 50. Dyslipidemia is also a common comorbidity. Cumulatively, these metabolic and endocrine abnormalities significantly elevate the risk of cardiovas- cular diseases, particularly among post- menopausal women with a history of PCOS [4]. Infertility is a notable complication, with anovulation attributed to PCOS ac- counting for up to 73% of infertility cases. Given its complexity, the accurate diagno- sis and individualized management of PCOS are imperative to mitigate its long- term health implications [5].The National Health Service (NHS) highlights that life- style interventions, particularly weight re- duction, play a pivotal role in managing PCOS. Evidence suggests that even a mod- est weight loss of 5% can significantly im- prove symptomatology. Pharmacological treatments, including progesterone-only or combined oral contraceptives, are frequently employed to restore menstrual regularity. Furthermore, fertility challenges are addressed using agents such as clomiphene, letrozole, or metformin, often used off-label [6].Cultural and societal bar- riers pose additional challenges to the effective management of PCOS. In conser- vative societies, particularly in Arab regi- ons, discussions about reproductive health issues such as irregular menstruation, hirsutism, or low libido are often stigma- tized. Moreover, some traditional educati- on systems exacerbate this knowledge gap by excluding comprehensive biology and anatomy education [7].Existing literature on health-related knowledge, beliefs, and self-efficacy among women with PCOS is limited and often contradictory. While so- me studies suggest that women with PCOS exhibit distinct health perceptions com- pared to unaffected individuals, they con- sistently report poorer health outcomes and greater functional impairment [8].The increasing prevalence of polycystic ovarian syndrome is largely attributed to insuffi- cient awareness and suboptimal lifestyle practices. Addressing these gaps through early diagnosis, timely intervention, and comprehensive public education can signi- ficantly reduce the burden of PCOS and its associated complications [9].Female stu- dents in academic institutions represent a critical demographic for targeted poly- cystic ovarian syndrome education and a- wareness initiatives. As future mothers, their health literacy has the potential to shape the well-being of subsequent gene- rations. Ironically, many university stu- dents remain asymptomatic or unaware of their polycystic ovarian syndrome status until faced with reproductive challenges later in life. This highlights the need for focused research to evaluate their know- ledge, attitudes, and perceptions 113 Copyright ©2025 The Author(s). This is an Open Access article which licensed under the terms and conditions of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. It permits no additional restrictions on use, distribution, and reproduction in any medium provided the original work is properly cited. INTRODUCTION https://creativecommons.org/licenses/by-nc-sa/4.0/ https://doi.org/10.15218/ejnm.2025.12 Erbil j. nurs. midwifery, Vol. 8, No. (2), Nov 2025 Original Article 15 questions about students’ knowledge of PCOS. Responses were evaluated as fol- lows: correct = 1 and incorrect = 0. For items (1,2,3,4,5,6,7,9,14 and 15). For items (8,10,11,12 and 13) (which are vice versa): Incorrect=1, correct=0 Students’ responses to questions regarding poly cystic ovarian syndrome knowledge were divided into three categories and scored as follows: Poor knowledge (1 to 5), Fair knowledge (6 to 10), and Good knowledge (11 to 15).The fourth part consisted of nine items evalu- ating the perceptions of the participants regarding polycystic ovarian syndrome. Responses were ranked as follows: Disa- gree = 1, Neutral = 2, and Agree =3. For items (1,2,3,4,5, and 10). For items (6,7,8 and 9) (which are vice versa): Disagree =3, Neutral=2 and Agree=1. Perceptions were divided into two categories and scored as follows: positive (20 to 30) and negative (10 to 19). The final part mentions the source of information from which the study samples obtained their information about polycystic ovarian syndrome, such as physicians, medical textbooks, maga- zines, television, etc. The content validity of the tools was evaluated by four experts from different specialties for instance (community health medicine, biostatistics, pediatrics of nursing and maternity nurs- ing) across various universities in Kurdi- stan. The experts assessed the tool for clarity of sentences, consistency, and con- tent appropriateness, and no modifications were required. The reliability of the tools was also tested, with a Cronbach's alpha of 0.75 for knowledge and 0.77 for percep- tion. Prior to data collection, formal per- mission was obtained from the ethical ap- proval of the ethical committee at poly- technic university/Erbil, Erbil Technical Medical Institute on 1st Oct 2024. Oral in- formed consent was obtained from the students before data collection, after the explanation of the purpose of the study, regarding polycystic ovarian syndrome. This study aimed to determine female stu- dents' knowledge and perception regard- ing polycystic ovarian syndrome who are studying at Koya Technical Institute. A quantitative, descriptive cross-sectional study was conducted. The study was car- ried out at Koya Technical Institute from October 1st, 2024, to December 25th, 2024, with convenience samples consisting of 393 of female students who were study in the departments such as nursing, mid- wifery, medical laboratory,and community health at Koya Technical Institute. The study included the female institutional stu- dents who were willing to participate in the study; male and other departments were excluded from the study. The data were gathered through both an online link and a paper-based survey questionnaire. The survey was designed on an online platform and shared with students via so- cial media such as Viber ,WhatsApp and Messenger. Additionally, hard copies were translated into the Kurdish language and distributed to students during their free time (self-study hours) on campus by some of the researchers. A drop box was placed in the investigator’s office for collecting the completed forms. The survey was anony- mous, and no personal information was collected. The online version was also shared with students through social media platforms. Students were instructed to re- spond only once, either online or via the physical survey. The questionnaire consists of four parts. The first part included the socio-demographic characteristics of the study sample, such as age, residency, mari- tal status, departments, and year of the study and the second part was related to reproductive information, such as regular menstrual cycles, intervals between each menstruation. The third part consisted of 114 Copyright ©2025The Author(s). This is an Open Access article which licensed under the terms and conditions of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. It permits no additional restrictions on use, distribution, and reproduction in any medium provided the original work is properly cited. METHODS https://creativecommons.org/licenses/by-nc-sa/4.0/ https://doi.org/10.15218/ejnm.2025.12 Erbil j. nurs. midwifery, Vol. 8, No. (2), Nov 2025 Original Article benefits, rights to privacy, and rights to withdraw at any time. The researchers have promised to keep the data infor- mation for confidentiality and anonymity. The data were analyzed using SPSS soft- ware for statistical analysis, version 27, to calculate descriptive statistical analysis (frequency and percentage). Inferential statistical analysis (chi-square and fisher’s exact test) was used to determine the asso- ciation between variables; the p-value ≤ 0.05 is considered statistically significant. Table 1: In the present study, 393 partici- pants took part, with a mean age of 20.97±2.62 years. More than half of the participants were in the 18-21 age group. The majority of the sample (86.5%) were single, and 41.2% of participants were en- rolled in the midwifery department. Over half (62.1%) were in the second stage of their studies. A significant portion (94.1%) of the students reported having no chronic diseases. Table 2: Regarding menstrual cy- cles, (65.5%) had regular cycles, while (34.5%) experienced irregular cycles. Addi- tionally, 57.0% of participants had men- strual intervals between 25-34 days, and 2.1% had a history of infertility. Table 3 il- lustrates the students' knowledge of poly- cystic ovarian syndrome. According to the results, students demonstrated strong knowledge regarding the signs and symp- toms, causes or diagnosis, and treatment of PCOS. A majority of the participants (83.0%) were well-informed about PCOS being diagnosed through ultrasound. Addi- tionally, four-fifths of the respondents (81.4%) recognized that an unusual amount of hair growth on different body parts is a symptom of PCOS, and (80.4%) understood that obesity is a main cause of the condition. However, more than three- fourths of participants (76.8%) were unaware that mood swings are a symptom of polycystic ovarian syndrome. Table 4 presents the participants' perceptions of polycystic ovarian syndrome. The results show that students generally had a posi- tive perception of the condition. More than two -thirds (66.5%) of students thought that polycystic ovarian syndrome can be managed through diet and exercise. Additionally, (58.5%) of participants disa- greed with the idea that polycystic ovarian syndrome is a permanent condition that cannot be cured. 55.7 % of the participants believed that polycystic ovarian syndrome patients require social support. Moreover, (53.9%) of the respondents thought wom- en who have polycystic ovarian syndrome can have children.While (36.4%) of stu- dents agreed that hirsutism caused by pol- ycystic ovarian syndrome can lead to a de- crease in social performance. 115 Copyright ©2025 The Author(s). This is an Open Access article which licensed under the terms and conditions of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. It permits no additional restrictions on use, distribution, and reproduction in any medium provided the original work is properly cited. RESULT Table 1: Socio-Demographical data of the students regarding PCOS N= 393 Varibles F % -Do you have regular menstrual cycle Yes 257 (65.5) No 136 (34.5) -Interval between menstruation (days) <25 d 90 (22.9) 25-34 d 224 (57.0) 35-60 d 52 (13.2) more than 60 d 27 (6.9) -Having history of infertility Yes 22 (2.1) No 28 (10.7) unmarried 343 (87.3) -If you are married are you using oral contraceptives Yes 11 (2.8) No 39 (9.9) Unmarried 343 (87.3) T Total 393 (100) https://creativecommons.org/licenses/by-nc-sa/4.0/ https://doi.org/10.15218/ejnm.2025.12 Erbil j. nurs. midwifery, Vol. 8, No. (2), Nov 2025 Original Article 116 Copyright ©2025 The Author(s). This is an Open Access article which licensed under the terms and conditions of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. It permits no additional restrictions on use, distribution, and reproduction in any medium provided the original work is properly cited. Table 2: Reproductive information of the students regarding PCOS N= 393 Variables subgroups F (%) Age group 18-21 267 (67.9) 22-25 97 (24.7) 26-29 29 (7.4) Marital status Married 50 (12.7) single 340 (86.5) Separated and divorced 3 (0.8) Department Nursing 144 (36.7) Medical laboratory 63 (16.0) Midwifery 162 (41.2) Community Health 24 (6.1) study year First stage 149 (37.9) Second stage 244 (62.1) Residence Urban 190 (48.3) Sub-urban 148 (37.7) Rural 55 (14.0) Having Chronic disease Yes 23 (5.9) -No 370 (94.1) Table 3: Knowledge of the study samples regarding PCOS N=393 Variables Correct F. (%) Incorrect F. (%) 1-In PCOS there is an increased level of androgen hormone 227(57.8) 166(42.2) 2-Cigarette smoking may cause PCOS 154(64.6) 139(35.4) 3-Obesity may cause PCOS 316(80.4) 77(19.6) 4-Insulin resistance (due to decrease insulin action in the body) may cause PCOS 248(63.1) 145(36.9) 5-PCOS may lead to anxiety and depression 326(83.0) 67(17.0) 6-Unusual amount of hair growth on different body parts is a symp- tom of PCOS 320(81.4) 73(18.6) 7-Severe acne problems during the menstrual (periods) cycle are a symptom of PCOS 263(66.9) 130(33.1) 8-Mood swings is not a symptom of PCOS(-) 302(76.8) 91(23.2) 9-PCOS diagnosis can be confirmed by ultrasound 326(83.0 ) 67(17.0) 10-Hair loss from the scalp more than normal is not a symptom of PCOS(-) 238(60.4) 155(39.4) 11-Specific blood tests cannot be used for diagnosis of PCOS (-) 183(46.6) 210(53.4) 12-PCOS is not lead to infertility (inability to have children) (-) 191(48.6) 202(51.4) 13-PCOS is not curable(-) 140(35.6) 253(64.4) 14-Anti-diabetic medications (metformin) may be used to treat PCOS 227(57.8) 166(42.2) 15-Weight loss is among the main treatment options for PCOS 302(76.8) 91(23.2) (-) Refers for negative statements https://creativecommons.org/licenses/by-nc-sa/4.0/ https://doi.org/10.15218/ejnm.2025.12 Erbil j. nurs. midwifery, Vol. 8, No. (2), Nov 2025 Original Article between marital status and overall knowledge of polycystic ovarian syndrome (P > 0.159). Additionally, the findings re- vealed no significant relationship between medical departments, residence, and over- all knowledge of polycystic ovarian syn- drome, with P-values greater than 0.259 and 0.807, respectively. 117 Table 5 presents the relationship between the age group of the study sample and their overall knowledge of poly cystic ovarian syndrome. The results indicate a significant relationship between the par- ticipants' age and academic year with their overall knowledge of polycystic ovar- ian syndrome (P-value = 0.032) and aca- demic year (P-value = 0.04). However, no significant association was found Copyright ©2025The Author(s). This is an Open Access article which licensed under the terms and conditions of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. It permits no additional restrictions on use, distribution, and reproduction in any medium provided the original work is properly cited. Table 4:Perception of the students regarding PCOS N=393 Variable Agree F.(%) Neutral F.(%) Disagree F.(%) 1-PCOS patients require social support. 219(55.7) 117(29.8) 57(14.5) 2- PCOS can be managed through diet and exercise. 261(66.5) 56(14.2) 76(19.3) 3-PCOS patients have control over the disease . 218(55.5) 52(13.2) 123(31.3) 4-PCOS patients need support and help from others. 224(57.0) 91(23.2) 78(19.8) 5-PCOS patients can have children (women’s fertility). 212(53.9) 68(17.3) 113(28.8) 6-Hirsutism due to PCOS can decrease social performance(-) 143(36.4) 93(23.7) 157(39.9) 7-PCOS patients have trouble associating with other people(-) 126(32.1) 114(29.0) 153(38.9) 8-PCOS patients are depressed(-) 75(19.1) 69( 17.6) 249(63.3) 9-PCOS is a permanent condition(-) 92(23.4) 7(18.1) 230(58.5) 10-PCOS can be controlled. 182(46.3) 38(9.7) 173(44.0) (-) refers to negative statements Table 5:The association of the overall knowledge of the study samples with some variables of socio- Demographical data Variables ------------------ Age group Poor Knowledge -------------------- F.(%) Fair Knowledge ---------------------- F.(%) Good Knowledge --------------------- F.(%) Total ---------------- F.(%) P-value ------------ 18-21 14(5.2) 135(50.6) 118 (44.2) 267(67.9) 22-25 1(1.0) 50(51.5) 46 (47.4) 97(24.7) 0.032 26-29 1(3.4) 18( 62.1) 10 (34.5) 29(7.4) Marital status Married 1(2.0) 26(52.0) 23(46.0) 50(12.7) 0.159 Single 14(4.1) 176(51.8) 150(44.1) 340(86.5) Separated and di- vorced 1(33.3) 1(33.3) 1(33.3) 3(0.8) Study year First stage 14(5.7) 12(52.9) 10( 41.4) 244(62.1) 0.04 Second stage 2(1.3) 74(49.7) 73(49.0) 149(37.9) Department Nursing 4(2.8) 73(50.7) 67(46.5) 144(36.6) Medical Laboratory 3(4.8) 38(60.3) 22(34.9) 63(16.1) 0.259 Midwifery 9(5.6) 76( 46.9) 77(47.5) 162(41.2) Community Health 0(0.0) 16(66.7) 8(33.3) 24(6.1) Residence Urban 8(4.2) 92(48.4) 90(47.4) 190(48.3) Sub-urban 6(4.1) 80(54.1) 62(41.9) 148(37.7) 0.807 Rural 2(3.6) 31(56.4) 22(40.0) 55(14) https://creativecommons.org/licenses/by-nc-sa/4.0/ https://doi.org/10.15218/ejnm.2025.12 Erbil j. nurs. midwifery, Vol. 8, No. (2), Nov 2025 Original Article had good knowledge, and only 4% had poor knowledge. regarding PCOS, while (24.7%) had nega- tive attitudes (57.8%) obtained information from televi- sion, (26.2%) from internet sources, (3.3%) from physicians, and (1.3%) from medical textbooks. Figure 1 shows that 51.7% of all students had fair knowledge regarding polycystic ovarian syndrome, while 44.3% Figure 2 indicates that (75.3%) of the study samples had positive perceptions Figure 3: The figure demonstrates the re- spondents' sources for gaining and devel- oping their knowledge regarding PCOS. More than half of the study participants 118 Copyright ©2025The Author(s). This is an Open Access article which licensed under the terms and conditions of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. It permits no additional restrictions on use, distribution, and reproduction in any medium provided the original work is properly cited. Figure 1: Illustrates overall knowledge of study samples regarding PCOS N=393. Figure 2: Illustrates overall perception of study samples regarding PCOS N=393. Figure 3: Illustrates Medical students, source of information regarding PCOS. https://creativecommons.org/licenses/by-nc-sa/4.0/ https://doi.org/10.15218/ejnm.2025.12 Erbil j. nurs. midwifery, Vol. 8, No. (2), Nov 2025 Original Article between (25 to 34) days. This finding is consistent with a study conducted in Jor- dan, where more than one-third of the participants also had menstrual intervals within the (25 to 34) day range. [18].Assessing the knowledge of students regarding polycystic ovarian syndrome Ad- equate knowledge about polycystic ovari- an syndrome is essential for students to develop a deeper understanding of poly- cystic ovarian syndrome and its complica- tions. A recent study revealed that more than three-fourths (83.0%) of participants were aware that polycystic ovarian syn- drome can be diagnosed via ultrasound. Additionally, (83%) of students believed that polycystic ovarian syndrome could lead to anxiety and depression. A similar finding was reported by Abu-Taha M in a related study [19]. In a recent study, (81.4%) of participants were aware that one of the symptoms of polycystic ovarian syndrome is an unusual amount of hair growth on different body parts. A similar study reported the same finding. [18].In the current study, 80.4% of respondents recognized obesity as one of the main causes of PCOS. This finding is comparable to a study conducted by Noman Ul Haq in Pakistan, where the majority of female stu- dents (87.1%) also identified obesity as a primary cause of polycystic ovarian syn- drome. Additionally, our results show that more than half of the participants (57.8%) obtained information about PCOS through television, followed by internet sources (26.2%). In contrast, a cross-sectional study conducted at Nepal Medical College among final-year medical students found that most students had good knowledge of polycystic ovarian syndrome, with (76.5%) acquiring information from friends, (26%) from mass media, and only (9.5%) from healthcare professionals. This study em- phasized that knowledge-sharing among medical students plays a crucial role in The socio-demographic characteristics of students regarding polycystic ovarian syn- drome Polycystic ovarian syndrome (PCOS) is a complex and chronic endocrine disor- der commonly diagnosed in women of re- productive age. It is associated with an in- creased risk of a range of complications, including hematologic, oncologic, meta- bolic, reproductive, and psychological is- sues. In 1935, Stein and his colleagues were the first to identify a cluster of symp- toms related to anovulation. They studied seven patients who experienced amenor- rhea, excessive hair growth (hirsutism), and enlarged polycystic ovaries. Their find- ings revealed that all seven patients re- sumed menstruation, and two were able to conceive after undergoing bilateral wedge resection of the ovaries [10]. This study aimed to gain a better understand- ing of students' knowledge and percep- tions regarding polycystic ovarian syn- drome. Given that many women in our community are currently affected by poly- cystic ovarian syndrome, it is essential to assess how knowledgeable our students are about the condition, as they could play a key role in guiding the community and helping women manage it. Our study re- vealed that more than half of the partici- pants were between the ages of 18 and 21, the mean age of those studied being (±20.97). This aligns with a cross-sectional study conducted in the department of Ob- stetrics and Gynecology at a tertiary care center in southern India. The study in- volved 88 students aged between 18 and 22 years, with an average age of (21.4) years [11]. In our study, it was revealed that more than three-fourths of the partic- ipants were single (86.5%), which aligns with the findings of a similar study [11]. In the present study, more than half of the respondents reported having regular men- strual cycles, with intervals ranging 119 Copyright ©2025The Author(s). This is an Open Access article which licensed under the terms and conditions of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. It permits no additional restrictions on use, distribution, and reproduction in any medium provided the original work is properly cited. Discussion https://creativecommons.org/licenses/by-nc-sa/4.0/ https://doi.org/10.15218/ejnm.2025.12 Erbil j. nurs. midwifery, Vol. 8, No. (2), Nov 2025 Original Article and related infertility among female stu- dents at Isabella Thoburn College in Luck- now. Their study reported that nearly half of the female students held a negative atti- tude toward polycystic ovarian syndrome [21].Association between overall knowledge and some demographic charac- teristics: The knowledge scores among par- ticipants varied widely, and we identified a significant inverse association between age and overall knowledge among medical stu- dents (p-value = 0.032). This finding is con- sistent with a study conducted in Pakistan by Mehwish Rizvi et al., which examined 646 undergraduate students and also re- ported a significant association between overall knowledge and age group. In our study, no significant association was found between marital status and overall knowledge. However, this contrasts with a descriptive study conducted at obstetric and gynaecological outpatient clinics in a health insurance hospital in Minya Gover- norate, which included 100 female partici- pants. That study reported a significant association between overall knowledge and marital status (p-value = 0.02) [ 16].Additionally, our study found a signifi- cant association between students' overall knowledge of polycystic ovarian syndrome and their year of study (p-value = 0.04). This finding aligns with a study conducted at South Valley University, Egypt, involving 260 female students, which reported simi- lar studies [15].On other other hand an- other study conducted in Egypt by RedaM et al., Knowledge and Attitude of Late Ado- lescent girls, regarding to Polycystic Ovari- an Syndrome, among 239 adolescent girls the result of the study indicated there was a significant association between overall knowledge and academic year the value of (p=0.008)[22].Our recent study found no significant association between overall knowledge and residence or academic de- partments of medical students raising awareness [14].Our study demon- strated that medical students had a fair overall knowledge of polycystic ovarian syndrome, with (57.7%) falling into this cat- egory. Additionally, (44.3%) had good knowledge, while only (4%) of respondents exhibited poor knowledge. This may be attributed to the majority of participants showing an interest in receiving infor- mation about PCOS. These findings are consistent with a study conducted in Ma- laysia by Hussin, S., & Abd Kadir, N. (2020), which found that most younger students had adequate knowledge, along with a pos- itive perception and attitude toward poly- cystic ovarian syndrome [12]. On the other hand, another study conducted among ad- olescent girls used descriptive and inferen- tial statistics to analyse the collected data. The results of the study revealed that be- fore the intervention, only 22 adolescent girls (23.9%) had good knowledge of poly- cystic ovarian syndrome, 46 (50%) had av- erage knowledge, and 24 (26.1%) had poor knowledge [21].Assessment of perception of the participants regarding PCOSOur study revealed that more than half of the participants (55.7%) believed that patients with polycystic ovarian syndrome (PCOS) require social support. Additionally, two- thirds (66.5%) of the participants assumed that PCOS could be managed through diet and exercise. These findings align with those of a similar study [20].The current study showed (75.3%) of the study samples have a positive perception toward polycys- tic ovarian syndrome and only (24.7%) had a negative perception. This perception might be related to medical students living with that situation and a lot of women suffering with polycystic ovarian syndrome. On the contrary, this finding does not align with the research conducted by Chauhan et al. (2021), who assessed the effective- ness of a structured teaching program on knowledge of polycystic ovarian syndrome 120 Copyright ©2025The Author(s). This is an Open Access article which licensed under the terms and conditions of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. It permits no additional restrictions on use, distribution, and reproduction in any medium provided the original work is properly cited. https://creativecommons.org/licenses/by-nc-sa/4.0/ https://doi.org/10.15218/ejnm.2025.12 Erbil j. nurs. midwifery, Vol. 8, No. (2), Nov 2025 Original Article improved long-term health outcomes for women at risk of polycystic ovarian syn- drome. In addition, a multidisciplinary ap- proach that combines physiotherapy and psychological support is essential for en- hancing health outcomes in women with PCOS. None of the writers have any conflicts of interest or sources of financial support. [1] Mohamed RA, Taref NN, Osman NE, Keshta NHA, Alboghdady MA, Marzouk MM, et al. Effect of web-based health education on nursing students’ knowledge, adaptive healthy measures and attitudes regarding polycystic ovary syndrome: a randomized controlled trial. Jornal of BioMed Cental Nursing. 2024 Jul 15;23(1):479. https:// doi.org/10.1186/s12912-024-02015-7 [2] B. S, Nayak S. A Study to Assess the Knowledge Regarding PCOS (Polycystic Ovarian Syndrome) among Nursing Stu- dents at NUINS. Journal of Health and Allied Sciences NU. 2016 Sep;06(03):24–6. DOI: 10.1055/s-0040-1708657 [3] Haq N, Khan Z, Riaz S, Nasim A, Shahwani R, Tahir M. Prevalence and knowledge of poly- cystic ovary syndrome (PCOS) among fe- male science students of different public Universities of Quetta, Pakistan. Imperial Journal of Interdisciplinary Research. 2017;35(6):385–92. ISSN: 2454-1362, http://www.onlinejournal.in [4] McGowan MP. Polycystic Ovary Syndrome: A Common Endocrine Disorder and Risk Factor for Vascular Disease. Curr Treat Op- tions Cardio Med. 2011 Aug 1;13(4):289– 301. Curr Treat Options Cardio Med 13, 289 –301 (2011). https://doi.org/10.1007/ s11936-011-0130-0 [5] Stańczak NA, Grywalska E, Dudzińska E. The latest reports and treatment methods on polycystic ovary syndrome. Annals of Medi- cine. 2024 Dec 31;56(1):2357737. https:// doi.org/10.1080/07853890.2024.2357737 (p-value = 0.807 and 0.259). These findings are consistent with a study conducted among 192 medical students at a medical college. That study used a convenient sam- pling method and a pretested semi- structured questionnaire to assess knowledge and awareness of polycystic ovarian syndrome [17]. In contrast, a study was carried out at the Technical Institute of Nursing at Benha University to evaluate the knowledge and attitudes of late adolescent girls towards polycystic ovarian syndrome. A purposive sample of 239 adolescent girls was used. The results indicated a highly significant correlation between overall knowledge and the area of residence (p- value = 0.001) [23]. The findings of this study indicate that stu- dents possess a satisfactory level of knowledge and hold positive perceptions about PCOS. Television and the internet were identified as their primary sources of information, highlighting the necessity for greater involvement from healthcare pro- fessionals in educating young individuals. Additionally, the study revealed a signifi- cant correlation between knowledge levels and both age and year of study. However, no notable association was found between overall knowledge and factors such as mar- ital status, place of residence, or academic department. These findings underscore the importance of early detection and manage- ment of polycystic ovarian syndrome, em- phasizing the need for targeted education- al programs, particularly within academic institutions. Future research should explore the effectiveness of structured awareness programs in enhancing students’ knowledge retention and preventive be- haviours. Bridging knowledge gaps, espe- cially among healthcare professionals, could foster awareness and contribute to 121 Copyright ©2025 The Author(s). This is an Open Access article which licensed under the terms and conditions of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. It permits no additional restrictions on use, distribution, and reproduction in any medium provided the original work is properly cited. CONCLUSION CONFLICT OF INTEREST REFERENCES https://creativecommons.org/licenses/by-nc-sa/4.0/ https://doi.org/10.15218/ejnm.2025.12 Erbil j. nurs. midwifery, Vol. 8, No. (2), Nov 2025 Original Article [14] Adhikari P, Bhattarai J. Knowledge, Attitude and Practice regarding Polycystic Ovarian Syndrome (PCOS) among final year medical students and interns in a Medical College in Kathmandu Nepal. Journal of Diabetes and Endocrinology Association of Nepal. 2023 Aug 10;7(1):4-12. [15] Maghraby EA, Ahmed NT, Ahmed AA, Has- san MM. Assessment of female nursing stu- dent's knowledge regarding polycystic ovari- an syndrome at South Valley University. 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