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Impact of PCOS Screening Education on PCOS Screening Uptake among Women of Reproductive Age in Nigeria

Abstract

Polycystic ovary syndrome (PCOS) is a common endocrine and reproductive health condition among women of reproductive age and may be associated with irregular menstrual cycles, ovulatory dysfunction, infertility, acne, excessive hair growth, weight-related concerns, insulin resistance, and increased long-term metabolic risks. Despite its potential effects on reproductive and general health, PCOS may remain undiagnosed because of limited awareness of its symptoms, misconceptions about menstrual irregularities, normalization of reproductive health concerns, fear of diagnosis, financial barriers, and limited access to appropriate healthcare services. PCOS screening education provides an opportunity to improve women's understanding of the condition, recognize potential symptoms and risk factors, and encourage appropriate use of available screening and clinical assessment services. Against this background, this study investigates the impact of PCOS screening education on PCOS screening uptake among women of reproductive age in Nigeria. The study will be anchored on the Health Belief Model, Health Literacy Theory, and Social Ecological Model. The Health Belief Model explains how women's perceptions of susceptibility to PCOS, perceived severity of its reproductive and metabolic consequences, perceived benefits of screening, perceived barriers, self-efficacy, and cues to action may influence screening decisions. Health Literacy Theory emphasizes women's ability to obtain, understand, evaluate, and use reliable health information to make informed decisions about PCOS assessment and reproductive healthcare. The Social Ecological Model highlights the influence of individual, family, community, healthcare-system, socioeconomic, and environmental factors on women's access to and utilization of PCOS-related healthcare services. Collectively, these theoretical perspectives provide a suitable framework for explaining how PCOS screening education may influence PCOS screening uptake among women of reproductive age in Nigeria. The study will adopt a quantitative quasi-experimental or analytical cross-sectional research design. The study population will comprise women aged 18–49 years residing in selected urban, semi-urban, and rural communities across Nigeria. A multistage sampling technique will be used to select geopolitical zones, states, local government areas, communities, households, healthcare facilities, and eligible women. PCOS screening education will be assessed using indicators such as exposure to PCOS education sessions, frequency and duration of education, knowledge of PCOS, awareness of menstrual irregularities, ovulatory problems, infertility, acne, excessive hair growth, weight-related symptoms, insulin resistance, metabolic risks, family history, available screening and diagnostic procedures, appropriate healthcare facilities, and referral pathways. PCOS screening uptake will be assessed using indicators such as awareness of the need for professional assessment, attendance at recommended healthcare facilities, participation in PCOS risk assessment, completion of appropriate clinical evaluation where indicated, willingness to undergo recommended investigations, actual use of available screening or assessment services, follow-up attendance, and receipt of appropriate professional evaluation following identification of concerning symptoms. Data will be collected using structured questionnaires, PCOS knowledge assessment tools, screening-uptake records where available, reproductive-health service records, and pre-test and post-test assessments where a quasi-experimental intervention is adopted. Descriptive statistics will be used to summarize participants' demographic and socioeconomic characteristics, reproductive-health experiences, PCOS awareness, sources of health information, and patterns of healthcare utilization. Inferential statistical techniques, including chi-square tests, paired and independent t-tests, correlation analysis, and logistic or multiple regression analysis where appropriate, will be used to determine the impact of PCOS screening education on PCOS screening uptake. Where a quasi-experimental design is adopted, screening-uptake indicators before and after the educational intervention may be compared with those of a comparison group to determine changes associated with the intervention. Diagnostic tests will also be conducted to assess the reliability, validity, and robustness of the findings. The study is expected to find that PCOS screening education has a significant positive impact on PCOS screening uptake among women of reproductive age in Nigeria. Women exposed to structured and evidence-based PCOS screening education are expected to demonstrate greater awareness of PCOS symptoms and a higher likelihood of utilizing appropriate screening or clinical assessment services than women without comparable exposure. Education may improve women's understanding of menstrual irregularities, ovulatory problems, infertility, hyperandrogenic symptoms, weight-related concerns, and potential metabolic risks associated with PCOS. It may also reduce misconceptions that irregular menstruation or difficulties with fertility are always normal and encourage women to seek professional assessment when persistent or concerning symptoms occur. Practical education, symptom-based case scenarios, community reproductive-health sessions, and clear information about available healthcare services may further improve women's confidence in seeking assessment. However, financial barriers, limited availability of reproductive-health specialists, inadequate diagnostic facilities, fear of diagnosis, cultural beliefs, misinformation, stigma, transportation difficulties, and limited access to healthcare services may reduce the effectiveness of education alone. The study therefore expects accessible, culturally appropriate, evidence-based, and sustained PCOS screening education, supported by affordable and accessible reproductive-health services, to contribute significantly to improved PCOS screening uptake among women of reproductive age in Nigeria. The study is expected to contribute to the literature on polycystic ovary syndrome, PCOS screening, reproductive health, women's health, menstrual health, infertility prevention, health education, health literacy, healthcare utilization, endocrine health, and public health in Nigeria. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, state ministries of health, hospitals, primary healthcare centres, reproductive-health clinics, gynaecologists, endocrinologists, nurses, midwives, community health workers, women's health organizations, development partners, and policymakers regarding strategies for improving PCOS awareness and early assessment. The study will also provide evidence-based recommendations for integrating PCOS education into reproductive-health programmes, strengthening community awareness of PCOS symptoms and risk factors, improving access to appropriate screening and diagnostic services, strengthening referral pathways, reducing misconceptions and stigma, and developing sustainable women's health programmes that promote timely PCOS assessment across Nigeria.

Keywords: PCOS screening education, PCOS screening uptake, polycystic ovary syndrome, women of reproductive age, reproductive health, women's health, menstrual health, infertility, health education, health literacy, Nigeria, public health.