By Shah Khursheed
SRINAGAR — Bareera, 24, a postgraduate student from Pulwama, remembers the first signs of something being terribly wrong with unsettling clarity. Back when she was in Class 11 and living in a girls’ hostel in Srinagar, her menstrual cycle suddenly stopped altogether. One month passed without incident, followed by a second, and then a third. The sudden, profound silence of her body frightened her deeply. She whispered her growing worry to her roommate, who offered comforting words and urged her not to panic, but the underlying unease never truly left her mind.
When Bareera finally returned home for the school holidays, her mother immediately noticed the anxiety etched onto her face and promptly took her for a medical check-up. That was the day she underwent her very first ultrasound, marking the exact moment her quiet, formless fear took physical shape and a medical name.
“When the doctor told me I had PCOS, I broke down completely,” Bareera recalled, reflecting on the psychological shock of the diagnosis. “I didn’t understand what it meant at the time, only that my body was changing in ways I completely couldn’t control. The acne, the sudden hair fall, and the irregular periods made me feel like I was disappearing piece by piece. The fear that I might never become a mother haunts me every single day.”
Across the Kashmir Valley, Bareera’s poignant story is far from an isolated incident. Behind closed doors, an escalating number of young women are grappling with the hidden, compounding weight of Polycystic Ovary Syndrome, commonly known as PCOS. While the physical manifestations of the condition—such as sudden and unexplained weight gain, severe acne, excessive facial hair growth, and profoundly irregular menstrual cycles—form a major part of the daily trial, they are only part of the overarching struggle. Piling onto the physical toll are heavy social stigmas, rigid and unforgiving beauty standards, and intense family expectations that collectively turn everyday life into a quiet battlefield of anxiety and deep self-doubt.
Saikela Jan, a 21-year-old student from Srinagar’s bustling Hazratbal area whose name has been changed to protect her privacy, describes the silent torment that countless young women live with day in and day out. “I kept my missed periods a secret for months on end,” she said. “I was simply too scared that people would look at me and think something was fundamentally wrong with my womanhood. The facial hair, the persistent acne, and the irregular cycles have made me shrink away from the world. It makes me feel much less feminine.”
The psychological fallout has profoundly disrupted her social existence. “I feel ugly and fat when I look at myself in the mirror, so I deliberately stay away from social media and avoid going out with friends altogether. I stopped taking pictures of myself because I no longer recognize the person looking back, and I miss the old me,” she added, capturing the profound identity crisis often triggered by the condition.
Beyond the Diagnosis: A Hidden Epidemic
Scientific research underscores that these personal accounts are reflective of a much broader, systemic health crisis. A landmark 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 women across Kashmir. Conducted between 2013 and 2015, the comprehensive survey evaluated 964 women aged 15 to 40 across five distinct districts of the region.
The findings were striking: 46.4 percent of the surveyed cohort 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, pointing toward a disproportionate burden of the hormonal disorder in the region.
Parallel research conducted by the Department of Social Work at the University of Kashmir reinforced these findings, discovering that over 30 percent of local women met the strict Rotterdam criteria for diagnosis—a figure significantly higher than the broader national average in India. Researchers identified increasingly sedentary lifestyles, poor dietary habits, and underlying hormonal imbalances as key driving factors behind the trend. Additionally, many of the affected women experienced compounding metabolic issues, such as obesity and insulin resistance, alongside severe psychological challenges, including clinical anxiety and depression.
Iqra Nazir, a senior research scholar in the Department of Social Work at the University of Kashmir, spent two intense months stationed at the Sub-District Hospital Hazratbal to uncover the hidden social and emotional dimensions of these struggles. Her specialized study focused heavily on teenage girls aged 15 to 20, exploring how a PCOS diagnosis alters their emotional well-being, body image, family dynamics, and personal coping mechanisms.
“Families in our society often perceive PCOS as a direct threat to a young woman’s future marriage prospects rather than treating it as a legitimate medical issue,” Nazir observed. “Once a girl is diagnosed, many panicked parents turn immediately to traditional peers or faith healers in search of quick, mystical solutions. Stories and rumors of spiritual healers helping barren couples conceive naturally fuel immense hope, and families cling tightly to that belief rather than pursuing sustained medical treatment.”
Nazir observed that the crushing weight of societal stigma, community judgment, family anxiety surrounding marriage and fertility, and uncompromising cultural beauty standards often crush young girls far more severely than the hormonal condition itself. The psychological toll remains immense, marked by depression, debilitating anxiety, low self-esteem, and acute social withdrawal that accompany the physical changes. Together, these factors form a vicious cycle of silent suffering, leaving these young women largely invisible while their pain goes unnoticed by the mainstream community.
Behind Luck Lies Neglect
Every single morning, the crowded waiting area outside the gynaecology ward at Government Medical College (GMC) Handwara fills up long before the attending physicians even arrive. Young college girls clutching white medical files sit anxiously alongside newly married women who are quietly waiting for definitive answers about their reproductive health.
Inside one of the bustling consultation rooms, Dr. Shakir Khan—an MBBS, MD in Gynaecology and Obstetrics, serving as a Senior Resident at GMC Handwara and Director of the Syeeda Memorial Charitable Health Foundation—begins yet another long, demanding day. “Every second or third woman I examine in my clinic now presents with PCOS,” he said, flipping rapidly through a stack of thick case files. “What worries me the most is how silently and rapidly it is spreading through our population. Most young women do not realize what is actually happening to their bodies until it is already too late.”
Dr. Khan recalled the case of a 22-year-old female student from Kupwara who walked into his clinic complaining of severe acne and sudden hair fall. She had completely ignored her irregular menstrual periods for two full years, incorrectly assuming that academic stress was solely to blame.
“When I finally diagnosed her with PCOS, she looked genuinely surprised and told me that many of her friends also experienced delayed periods, so she thought it was completely normal,” Dr. Khan said. “That singular moment perfectly highlighted how profoundly unaware our young women are. They dismiss these crucial early signs, not realizing it is simply their body’s way of asking for urgent medical help.”
The emotional fallout, Dr. Khan emphasized, frequently carries a weight equal to or greater than the physical symptoms. “One woman who had been struggling for years to conceive told me tearfully that she blames herself entirely for the failure. PCOS fundamentally changes how women view their own bodies. They start feeling unattractive, deeply unworthy, and as if their physical selves have completely betrayed them.”
He recounted another stark case involving a 30-year-old schoolteacher who had been cruelly labeled as banjh—a derogatory local term for barren—by her immediate community. For years, her profoundly irregular periods had been dismissed as normal variations by those around her. When comprehensive medical tests finally revealed severe PCOS accompanied by deep insulin resistance, the underlying truth became glaringly clear. It was never a matter of bad luck; it was a consequence of prolonged medical neglect.
Acting decisively, Dr. Khan placed her on a structured, multi-faceted care plan that incorporated targeted dietary modifications, stress management techniques, and precise medical therapy. Months later, the patient returned to the hospital triumphantly holding a healthy newborn infant in her arms. “That restorative moment reminded me once again that true medical healing is not merely about writing prescriptions; it is fundamentally about restoring a woman’s faith in herself and her body’s capabilities,” he reflected.
PCOS and Delayed Marriages Threaten Kashmir’s Demographic Balance
The rising prevalence of PCOS in Kashmir is occurring against the backdrop of broader, profound social shifts across the valley, creating a complex demographic challenge. While the condition itself can impair natural fertility, these medical hurdles intersect directly with a regional trend toward delayed marriages, which are increasingly driven by higher educational attainment, expanding career ambitions, and evolving cultural practices. Together, these factors significantly narrow the biological window for safe and successful childbearing.
A local study published in 2022 highlighted the growing social dimension of this trend, estimating that nearly 50,000 women across Kashmir have crossed the conventional marriageable age, including more than 10,000 in Srinagar alone. Compounding these figures, data from the fifth round of the National Family Health Survey (NFHS-5, spanning 2019 to 2021) reveals that Jammu and Kashmir’s Total Fertility Rate (TFR) has plummeted to 1.4 children per woman—falling well below the standard replacement level of 2.1 required to maintain a stable population.
Public health experts and medical professionals warn that the combined, compounding impact of rising PCOS rates, delayed marriages, and a sharply declining fertility rate could ultimately shrink the region’s youth population, accelerate demographic aging, and generate severe long-term social and economic pressures. Without timely public health interventions, comprehensive educational campaigns, and greater societal openness toward women’s health issues, these intertwined trends pose a formidable threat to the valley’s future population growth and delicate generational balance.