CLINICAL AND CULTURAL PERSPECTIVES ON POLYCYSTIC OVARY SYNDROME IN WOMEN BASED ON SYMPTOM CLUSTERING AND DIAGNOSTIC TRENDS.
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BACKGROUND: Polycystic ovary syndrome (PCOS) is a heterogeneous endocrine disorder associated with reproductive, metabolic, and psychosocial complications. In Iraq, limited data are available on symptom patterns, diagnostic experiences, and treatment behaviors, particularly from data-driven analyses of subgroup heterogeneity. OBJECTIVE: This study aimed to explore symptom profiles, diagnostic pathways, and treatment behaviors among a convenience sample of Iraqi women reporting PCOS-related features, and to identify phenotype-like subgroups using unsupervised machine learning. METHODS: A cross-sectional survey was conducted among 402 Iraqi women recruited through clinics, campuses, and social media platforms. Data were collected on demographic characteristics, menstrual irregularity, hirsutism, acne, body weight, fertility-related concerns, diagnosis history, and treatment practices. Because recruitment relied on convenience sampling, the sample was predominantly young, unmarried, and likely urban/suburban, educated, and internet-connected. Principal component analysis (PCA) was used for dimensionality reduction, followed by K-means clustering to identify phenotype-like subgroup patterns. RESULTS: Among this convenience sample, 59.9% of participants reported a prior laboratory-supported diagnosis of PCOS, 30.2% reported a clinical diagnosis, and 9.7% reported symptoms without a prior diagnosis. Complementary or traditional medicine use was common in this sample (96.0%), and 93.3% expressed concern regarding future fertility. Symptom burden was observed across BMI categories. Unsupervised clustering identified three phenotype-like subgroups: a mild/lean profile, an acne-predominant/moderate profile, and a higher-weight profile with more marked hirsutism. CONCLUSION: This study provides an exploratory view of PCOS-related symptom patterns, diagnostic pathways, and treatment behaviors among a predominantly young convenience sample of Iraqi women. Given the sampling strategy and reliance on self-reported information, the findings should be interpreted cautiously as hypothesis-generating rather than nationally representative of Iraqi women. Nevertheless, the observed heterogeneity and fertility-related concerns may help inform culturally sensitive counseling and future larger, more representative studies in Iraq.