Srinagar: For 24-year-old Bareera, a postgraduate student from Pulwama, the first signs of a deeper medical crisis arrived with unsettling clarity during her high school years. While living away from home in a girls’ hostel in Srinagar during her Class 11 studies, her menstrual cycle suddenly stopped. One month passed, and then another, plunging her into a quiet panic as the silence of her body frightened her. Hesitant and distressed, she confided in her roommate, who offered words of reassurance, yet the underlying unease never truly faded.
When Bareera finally returned home for the school holidays, her mother immediately noticed her mounting anxiety and intervened, taking her for a thorough medical examination. That pivotal doctor’s visit involved her very first ultrasound, marking the exact day her formless, quiet fears crystallized into a medical reality.
“When the doctor told me I had PCOS, I broke down completely. I didn’t understand what it meant, only that my body was changing in ways I couldn’t control. The acne, hair fall, and irregular periods made me feel like I was disappearing piece by piece. The fear that I might never become a mother haunts me every day,” she recalled.
Across the valley of Kashmir, Bareera’s personal ordeal is far from an isolated incident. Behind closed doors and away from public discourse, countless young women are grappling with the hidden, compounding weight of Polycystic Ovary Syndrome (PCOS). While the physical symptoms of the condition—such as rapid, unexplained weight gain, severe acne, excessive facial hair, and highly irregular menstrual cycles—are challenging enough, they represent only a fraction of the overall struggle. The condition is deeply exacerbated by social stigma, rigid conventional beauty standards, and heavy family expectations, which collectively transform everyday life into a continuous psychological battlefield of anxiety and self-doubt.
Saikela Jan, a 21-year-old resident of Srinagar’s Hazratbal area whose name has been changed to protect her privacy, described the quiet torment that so many young women live with daily. She admitted that she kept her missed periods concealed for months out of intense fear and shame.
“I was too scared people would think something was wrong with my womanhood. Facial hair, acne, and irregular cycles have made me shrink from the world. It makes me feel less feminine,” she said, detailing the profound psychological toll the condition has taken on her self-perception and social life.
“I feel ugly and fat when I see myself in the mirror, so I stay away from social media and avoid going out with friends. I stopped taking pictures because I no longer see the old me,” she added, echoing a sentiment of self-alienation common among those diagnosed with the syndrome.
Beyond the Diagnosis
Medical research indicates that this quiet crisis is widespread throughout the region. A comprehensive study conducted by the Indian Council of Medical Research (ICMR), spearheaded by Dr. Mohd Ashraf Ganie at the Sher-i-Kashmir Institute of Medical Sciences (SKIMS), revealed an alarmingly high prevalence of PCOS among Kashmiri women. The research, carried out between 2013 and 2015, surveyed 964 women ranging in age from 15 to 40 across five different districts. The findings were striking: 46.4 percent of the surveyed women were identified as probable PCOS cases. Furthermore, 35.3 percent were confirmed under the Rotterdam criteria, 28.9 percent under the National Institutes of Health (NIH) criteria, and 34.3 percent under the Androgen Excess (AE PCOS) criteria.
Supporting these findings, a parallel study conducted by the Department of Social Work at the University of Kashmir found that over 30 percent of women met the Rotterdam diagnostic criteria, a figure significantly higher than the national average in India. Researchers identified sedentary lifestyles, poor dietary habits, and underlying hormonal imbalances as key driving factors behind the high rates. Beyond the physical manifestations, many of the surveyed women experienced severe metabolic complications, including obesity and insulin resistance, alongside debilitating psychological challenges such as chronic anxiety and clinical depression.
Iqra Nazir, a senior scholar in the Department of Social Work, spent two months stationed at the Sub District Hospital Hazratbal to uncover the hidden struggles faced by teenage girls. Her academic research focused specifically on young women aged 15 to 20, exploring how a diagnosis of PCOS fundamentally alters their emotional well-being, body image perceptions, family dynamics, and daily coping mechanisms.
“Families often perceive PCOS as a threat to marriage prospects rather than a medical issue. Once a girl is diagnosed, many parents turn to peers or faith healers for quick solutions. Stories of healers helping couples conceive fuel hope, and families cling to that belief,” Nazir explained.
Her observations highlighted that the combined weight of social stigma, societal judgment, family anxiety regarding future marriages and fertility, and uncompromising beauty standards often crushes young girls far more severely than the biological condition itself. The psychological toll is immense, bringing depression, anxiety, low self-esteem, and social withdrawal in tandem with physical transformations, creating a continuous cycle of silent suffering. Yet, despite the severity of these challenges, the affected girls remain largely invisible within the broader community, their pain and distress going largely unnoticed and untreated.
Behind Luck Lies Neglect
Every single morning, the crowded waiting area outside the gynaecology ward at Government Medical College (GMC) Handwara fills to capacity long before the medical staff arrives for consultations. Young college students clutching tightly to folded medical reports sit side by side with newly married women waiting anxiously for answers about their reproductive health.
Inside one of the bustling consultation rooms, Dr. Shakir Khan—an MBBS and MD in Gynaecology and Obstetrics, serving as a Senior Resident at GMC Handwara and Director of the Syeeda Memorial Charitable Health Foundation—begins another demanding day of patient care.
“Every second or third woman I see now has PCOS,” Dr. Khan remarked, pausing as he flipped through a stack of active case files. “What worries me most is how silently it spreads. Most don’t realise what’s happening to their bodies until it’s too late.”
He recalled the case of a 22-year-old female student from Kupwara who presented with severe acne and hair fall. She had completely ignored her irregular menstrual periods for two full years, mistakenly assuming that academic stress was entirely to blame for the bodily changes.
“When I told her it was PCOS, she looked surprised and said many of her friends had delayed periods, she thought it was normal. That moment showed how unaware young women are. They dismiss early signs, not realising it’s their body’s way of asking for help,” he said.
The emotional fallout, Dr. Khan emphasized, often weighs as heavily on patients as the physical symptoms.
“One woman who had been trying to conceive for years told me she thinks it’s her problem. PCOS changes how women see themselves. They start feeling unattractive, unworthy, as if their bodies have betrayed them.”
He recalled another patient, a 30-year-old schoolteacher who had been disparagingly labeled as “banjh”—a derogatory local term for barren—by her community. For years, her profoundly irregular periods had been dismissed as normal variations by those around her. When clinical tests finally revealed that she was suffering from severe PCOS coupled with insulin resistance, the true nature of her condition became clear. It was not a matter of bad luck, but rather a consequence of prolonged medical neglect.
Recognizing the root cause, Dr. Khan initiated a structured, multi-faceted care plan incorporating targeted dietary modifications, stress management techniques, and appropriate medical therapy. Months later, the patient returned to the clinic holding a healthy newborn baby in her arms.
“That moment reminded me that healing is not just about medicine, it’s about restoring a woman’s faith in herself,” he reflected.
PCOS and Delayed Marriages Threaten Kashmir’s Fertility
The localized health crisis unfolding across the valley is further compounded by broader demographic and social shifts. Kashmir is currently facing a complex demographic challenge as rising rates of PCOS intersect with changing societal milestones. While the endocrine condition inherently impairs fertility in a significant portion of women, contemporary trends toward delayed marriages—driven by higher educational attainment, pursuit of professional careers, and evolving cultural practices—drastically narrow the biological window available for childbearing.
A local report published in 2022 highlighted that nearly 50,000 women in Kashmir have crossed the conventional marriageable age, including a substantial concentration of over 10,000 unmarried women in Srinagar alone. Compounding these figures, data from the National Family Health Survey (NFHS-5, conducted between 2019 and 2021) demonstrates that the Total Fertility Rate across Jammu and Kashmir has dropped to 1.4 children per woman, falling well below the standard demographic replacement level of 2.1 required to maintain stable population numbers.
Public health experts and medical professionals warn that the combined, compounding impact of rising PCOS prevalence, increasingly delayed marriages, and a sharply declining fertility rate could ultimately shrink the region’s youth population. This trend risks accelerating demographic aging and creating severe, long-term social and economic pressures across the valley. Without proactive public health interventions, awareness campaigns, and accessible medical support, these intertwined trends pose a serious, enduring threat to Kashmir’s future population growth and generational balance.