Knowledge Level on the Association Between Body Mass Index (BMI), Menstrual Cycle and Lifestyle Patterns in Contributing the Development of Polycystic Ovarian Syndrome (PCOS) Among Female University Students


  • Nurhazirah Zainul Azlan Department of Basic Medical Sciences for Nursing, Kulliyyah of Nursing, International Islamic University Malaysia, Pahang, Malaysia
  • Siti Zulaika Bustaman Kuantan Medical Centre, Pahang, Malaysia
  • Redzuan Nul Hakim Abdul Razak Department of Basic Medical Sciences for Nursing, Kulliyyah of Nursing, International Islamic University Malaysia, Pahang, Malaysia



knowled, body mass index, menstrual cycle, lifestyle pattern, polycystic ovarian syndrome (PCOS), student


Introduction: Polycystic ovarian syndrome (PCOS) is a heterogeneous endocrine disorder characterized by anovulation, hyperandrogenism, infertility and metabolic dysfunction, that affect ladies in their adolescent period until menopause, specifically at reproductive age. The objective of this study was to determine the knowledge level of PCOS and the association between BMI, menstrual cycle and lifestyle pattern in contributing the development of PCOS and its relationship with sociodemographic characteristics among female students at International Islamic University Malaysia (IIUM), Kuantan, Pahang.
Methods: A quantitative cross-sectional study using convenience sampling method was conducted among 245 female undergraduate students of IIUM Kuantan Campus, from April to May of 2021. Data were collected using Google Forms platform and a quantitative questionnaire which was available in English Language and distributed to all female undergraduate students in the campus. The set of questionnaires were taken from a research paper by Thomas et al. (2018). Data analysis was done by using SPSS version 21.0.
Results: The majority of the participants have above-average knowledge level regarding PCOS and its association with BMI, menstrual cycle and lifestyle pattern (58.0%). The mean score on knowledge on the association between BMI and development of PCOS significantly different in between kulliyyah and year of study, with Kulliyyah of Medicine and students from Year 5 are higher compared to other Kulliyyah and year of study, respectively. For the association between menstrual cycle and development of PCOS, the mean score on knowledge is differed significantly across year of study. The mean score on knowledge on the association between lifestyle pattern and development of PCOS differed significantly across kulliyyah with Kulliyyah of Allied Health Science are higher compared to other kulliyyah.
Conclusion: Female undergraduate students have above-average knowledge regarding PCOS and its association with BMI, menstrual cycle, and lifestyle patterns.


Zainal, Z., Ramli, S. R., Badrul Hisham, A. F., Mohd Arsad, A. S., Sahimi, H. I., Mohd Yukhi, S. H., & Seraj Ahmad, F. nasreen. (2018). Malaysian Health at a Glance: 2018. Malaysian Healthcare Performance Unit. Ministry of Health Malaysia, Putrajaya., 2–5.

World Health Organization. (2020). Malaysia and WHO call for more investment in primary health care the 21st century. Retrieved from

Faraj, R. M. L., Jawad, A. H., & Badr, A. H. (2019). Effect of Body Mass Index on Abnormal Ovarian Secretion Hormones among Iraqi Women with Polycystic Ovarian Syndrome (PCOS). Al-Nahrain Journal of Science, 22(1), 40–45.

Anagnostis, P., Tarlatzis, B. C., & Kauffman, R. P. (2018). Polycystic ovarian syndrome (PCOS): Long-term metabolic consequences. Metabolism: Clinical and Experimental, 86, 33–43.

Grigorescu, V. (2019). Polycystic Ovarian Syndrome. Retrieved fromáñez, L., Valls, C., Potau, N., Marcos, M. V., & De Zegher, F. (2001). Polycystic ovary syndrome after precocious pubarche: Ontogeny of the low-birthweight effect. Clinical Endocrinology, 55(5), 667–672.

Joham, A. E., Boyle, J. A., Ranasinha, S., Zoungas, S., & Teede, H. J. (2014). Contraception use and pregnancy outcomes in women with polycystic ovary syndrome: Data from the Australian longitudinal study on women’s health. Human Reproduction, 29(4), 802–808.

A., Ahmad, M., Tufail, S., Ayub, F., Aslam, P., & Mustafa, N. (2020). Frequency of polycystic ovarian syndrome in female medical students of combined military hospital lahore medical college. Pakistan Armed Forces Medical Journal, 70(1), 180–184.

Dashti, S., Abdul latiff, latiffah, Abdul Hamid, H., Mohamad Saini, S., Shah Abu Bakar, A., Binti Sabri, N. A. I., Ismail, M., & Jafarzadeh Esfehani, A. (2019). Prevalence of Polycystic Ovary Syndrome among Malaysian Female University Staff. Journal of Midwifery and Reproductive Health, 7(1), 1560–1568.

Pramodh, S. (2020). Exploration of lifestyle choices, reproductive health knowledge, and polycystic ovary syndrome (Pcos) awareness among female emirati university students. International Journal of Women’s Health, 12, 927–938.

Patel, J., & Rai, S. (2018). Polycystic ovarian syndrome (PCOS) awareness among young women of central India. International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 7(10), 3960.

Thomas, A., Mohamad Raba’ai, M. A., Rahmatullah, N. A., Talip, S. B., & Ahmad Kendong, S. M. (2018). Contributing Factors and Knowledge of Polycystic Ovarian Syndrome (Pcos) Among Pre-Clinical Female Students in Fmhs, Unimas. Journal of Borneo-Kalimantan, 3(1), 20–32.

Sullivan (2020). How Often Should You See Your Doctor for a Checkup? Healthline. Retrieved on July 27th, 2021 from

World Health Organization. (2020). Reproductive Health Indicators: Guidelines for their generation, interpretation and analysis for global monitoring. Retrieved from

World Health Organization. (2020). Obesity and overweight. Retrieved from

Sheik, R. (2015). Awareness of obesity as a risk factor for polycystic ovary syndrome. Journal of Pharmaceutical Sciences and Research, 7(7), 471–473.

Naeimi, N. (2015). The Prevalence and Symptoms of Premenstrual Syndrome under Examination. Journal of Biosciences and Medicines, 03(01), 1–8.

Karaca, I. (2013). Treatment of Premenstrual Syndrome with Progesterone in Women with Polycystic Ovary Syndrome. Gynecology & Obstetrics, 03(03), 10–13.

Epstein, D. A., Lee, N. B., Kang, J. H., Agapie, E., Schroeder, J., Pina, L. R., Fogarty, J., Kientz, J. A., & Munson, S. A. (2017). Examining menstrual tracking to inform the design of personal informatics tools. Conference on Human Factors in Computing Systems - Proceedings, 2017-May, 6876–6888.

Mihm, M., Gangooly, S., & Muttukrishna, S. (2011). The normal menstrual cycle in women. Animal Reproduction Science, 124(3–4), 229–236.

Haq, N., Riaz, S., Nasim, A., & Tahir, M. (2017). Prevalence and Knowledge of Polycystic Ovary Syndrome (PCOS) Among Female Science Students of Different Public Universities of Quetta, Pakistan Gastric Dieulafoy’s Lesion View project Journal of Pharmacy Practice and Community Medicine ( Vie. Imperial Journal of Interdisciplinary Research, 4(June), 718.

Armour, M., Parry, K., Al-Dabbas, M. A., Curry, C., Holmes, K., MacMillan, F., Ferfolja, T., & Smith, C. A. (2019). Self-care strategies and sources of knowledge on menstruation in 12,526 young women with dysmenorrhea: A systematic review and meta-analysis. PLoS ONE, 14(7), 1–18.

El-Hameed, N. A. A. Mohamed, M. S. Ahmed, N. H. Ahmed, E. R. (2011). Assessment of dysmenorrhea and menstrual hygiene practices among adolescent girls in some nursing schools at El-Minia Governorate, Egypt. Journal of American Science, 7(9), 216–223.

Carman, K. B., Arslantas, D., Unsal, A., Atay, E., Ocal, E. E., Demirtas, Z., Saglan, R., Dinleyici, M., & Yarar, C. (2018). Menstruation-related headache in adolescents: Point prevalence and associated factors. Pediatrics International, 60(6), 576–580.

Kollipaka, R., Arounassalame, B., & Lakshminarayanan, S. (2013). Does psychosocial stress influence menstrual abnormalities in medical students? Journal of Obstetrics and Gynaecology, 33(5), 489–493.

Gajapriya, M., Jothipriya, A., & Gayathri Devi, R. (2019). Impact of stress on menstrual cycle. Drug Invention Today, 12(7), 1547–1549.

The American College of Obstetricians and Gynecologists. (2018). Your Changing Body: Puberty in Girls. Retrieved on June 24th, 2021 from

Adika, V.O, Yabga, J, Apiyanteide, F.A, Ologidi, P.W and Ekpo, K. E. (2011). Perception and behaviour on use of sanitary pads during menstruation among adolescent school girls in Bayelsa State , Nigeria. Advances in Applied Science Research, 2(6), 9–15.

Ughade, S. N. (2015). Menstrual Hygiene?: Knowledge and Practice among Adolescent School Girls of Saoner , Nagpur District. January.

Yesuf, T. A., Eshete, N. A., & Sisay, E. A. (2018). Dysmenorrhea among University Health Science Students, Northern Ethiopia: Impact and Associated Factors. International Journal of Reproductive Medicine, 2018, 1–5.

Abusag, M., Ehrmann, D. A., & Hoffman, L. (2016). Genetic Considerations in the Evaluation of Menstrual Cycle Irregularities. In Genetic Diagnosis of Endocrine Disorders (Second Edi). lsevier Inc.

31. Tavallaee, M., Joffres, M. R., Corber, S. J., Bayanzadeh, M., & Rad, M. M. (2011). The prevalence of menstrual pain and associated risk factors among Iranian women. Journal of Obstetrics and Gynaecology Research, 37(5), 442–451.

Khera, A. V., Emdin, C. A., Drake, I., Natarajan, P., Bick, A. G., Cook, N. R., Chasman, D. I., Baber, U., Mehran, R., Rader, D. J., Fuster, V., Boerwinkle, E., Melander, O., Orho-Melander, M., Ridker, P. M., & Kathiresan, S. (2016). Genetic Risk, Adherence to a Healthy Lifestyle, and Coronary Disease. New England Journal of Medicine, 375(24), 2349–2358.

Bates, G. W., & Legro, R. S. (2013). Longterm management of Polycystic Ovarian Syndrome (PCOS). Molecular and Cellular Endocrinology, 373(1–2), 91–97.

Curi, D. D. G., Fonseca, A. M., Marcondes, J. A. M., Almeida, J. A. M., Bagnoli, V. R., Soares, J. M., & Baracat, E. C. (2012). Metformin versus lifestyle changes in treating women with polycystic ovary syndrome. Gynecological Endocrinology, 28(3), 182–185.

Dos Santos, I. K., Ashe, M. C., Cobucci, R. N., Soares, G. M., de Oliveira Maranhão, T. M., & Dantas, P. (2020). The effect of exercise as an intervention for women with polycystic ovary syndrome: A systematic review and meta-analysis. Medicine, 99(16), e19644, 1-11.

Al-Naggar, R. A., Al-Dubai, S. A., Al-Naggar, T. H., Chen, R., & Al-Jashamy, K. (2011). Prevalence and of smoking and associated factors among Malaysian University students. Asian Pacific journal of cancer prevention : APJCP, 12(3), 619–624.

Dorji, T., Srichan, P., Apidechkul, T., Sunsern, R., & Suttana, W. (2020). Factors associated with different forms of alcohol use behaviors among college students in Bhutan: a cross-sectional study. Substance abuse treatment, prevention, and policy, 15(1), 70, 1-8.

Saleh, D., Camart, N., & Romo, L. (2017). Predictors of stress in college students. Frontiers in Psychology, 8(JAN), 1–8.

Hussin, S. N., Hafizah, N., & Kadir, A. (2020). Knowledge, attitude and perception of polycystic ovary syndrome (PCOS) among young students in higher educational institutions, Perak. Journal of Social Science Advanced Research, 1(2), 160–181.

Ebersole, A. M., & Bonny, A. E. (2020). Diagnosis and treatment of polycystic ovary syndrome in adolescent females. Clinical Obstetrics and Gynecology, 63(3), 544–552.

Legro, R. S., Arslanian, S. A., Ehrmann, D. A., Hoeger, K. M., Murad, M. H., Pasquali, R., & Welt, C. K. (2013). Diagnosis and treatment of polycystic ovary syndrome: An endocrine society clinical practice guideline. Journal of Clinical Endocrinology and Metabolism, 98(12), 4565–4592.

Duleba, A. J., Banaszewska, B., Spaczynski, R. Z., & Pawelczyk, L. (2003). Success of laparoscopic ovarian wedge resection is related to obesity, lipid profile, and insulin levels. Fertility and Sterility, 79(4), 1008–1014.

Safa, Jahinger (2013). A STUDY ON KNOWLEDGE & AWARENESS OF POLYCYSTIC OVARIAN SYNDROME AMONG FEMALE NON MEDICAL Submitted To Tilka Fannana Submitted By Safa Jahangir ID?: 2013-3-70-001 Department of Pharmacy East West University. East West University.

Kamboj, S. (2019). Role of counselling in creating awareness about PCOS among female medical student. International Journal of Applied Science, 6(1), 154-159.

Tahir, H., Hassan, A., Khan, Q. U., & Hafeez, F. (2020). Prevalence of Polycystic Ovary Syndrome Awareness Among Female Medical Students. Discoveries Reports, 3(Cmh Lmdc), e10.

Jindal, M., Mahajan, H., Srivastav, S., & Baro, G. (2016). Pros And Cons Of Problem-Based Learning In Medical Education: Students’ Viewpoint. National Journal of Integrated Research in Medicine, 7(4), 77–81.

Cruz, E. B., Moore, A. P., & Cross, V. (2012). A qualitative study of physiotherapy final year undergraduate students’ perceptions of clinical reasoning. Manual Therapy, 17(6), 549–553.

O’Donoghue, G., Cusack, T., & Doody, C. (2012). Contemporary undergraduate physiotherapy education in terms of physical activity and exercise prescription: Practice tutors’ knowledge, attitudes and beliefs. Physiotherapy, 98(2), 167–173.




How to Cite

Zainul Azlan, N., Bustaman, S. Z. ., & Abdul Razak, R. N. H. . (2022). Knowledge Level on the Association Between Body Mass Index (BMI), Menstrual Cycle and Lifestyle Patterns in Contributing the Development of Polycystic Ovarian Syndrome (PCOS) Among Female University Students. INTERNATIONAL JOURNAL OF CARE SCHOLARS, 5(2), 58–74.