Survey Form for PCOS Patients

People suffering from Non-COVID conditions bore the brunt of the pandemic and the lockdown as they were unable to avail health services when movement was restricted across the country. In a bid to understand how the pandemic has affected those with PCOS, we request you to please take five minutes of your time to complete this survey! We will send you the results of the survey through email.

Are you Married?

Do you have Kid/Kids?

You have been diagnosed with PCOS and have been managing with lifestyle changes as per your doctor’s advice.

With the COVID-19 Pandemic and the lockdown since March 2020, has it affected you in any of the following parameters?

Mental Health Issues

1. Have you ever been diagnosed with any of the following conditions by a doctor or therapist?

2. If yes, has it worsened during the pandemic?

3. What according to you is the reason for the worsening of your condition?

4. Were you undergoing any counseling for your mental health issues before the lockdown?

5. Did your treatment stop during the lockdown?

6. Did you do a digital consult with your therapist during the lockdown?

7. Were you satisfied with the digital consult?

8. If No, please mention why?

Menstrual Health

1. Have you had delayed periods in the last 10months?

2. Have you had any painful periods in the last 10 months?

3. Have you had bloating in the last 10 months?

Body Image Issues

1. Have you gained weight in the last 10 months?

2. Have you had difficulty in maintaining a healthy diet in the last 10 months?

3. Have you had difficulty in maintaining your pre-COVID exercise routine in the last 10 months?

4. Have you had any acne problems in the last 10 months?

5. Have you had any abnormally thick hair growth on your face or body in the last 10 months?

6. Were you undergoing any laser treatment before the pandemic?

7. If yes, did have any difficulty in continuing the treatment in the last 10 months?

Fertility Issues

1. Do you have difficulty in getting pregnant?

2. Were you undergoing any treatment to conceive before the lockdown?

3. Did your treatment get interrupted during the lockdown?

4. Did you try any other form of therapy to conceive during the lockdown?

5. Did you get pregnant during the lockdown?

Issues with accessing medical help

1. Did you face any difficulty in connecting with your doctor in the last 10 months?

2. Did you have any teleconsultation with your doctor in the last 10 months?

3. Were you satisfied with the teleconsultion you had with your doctor.

4. If not, please mention the reason and how it could have been better.

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