Srinagar: For 24-year-old Bareera, the first signs of an internal disruption arrived with an unsettling clarity that she still remembers vividly. When she was studying in Class 11 and living away from home in a girls’ hostel in Srinagar, her menstrual cycle suddenly stopped. One month passed, and then another slipped by without a change. The abrupt silence of her body frightened her deeply. She whispered her growing worry to her roommate, who offered words of comfort, attempting to calm her fears, but the underlying unease never truly left her.
When Bareera finally returned home for the school holidays, her mother immediately noticed her visible anxiety and arranged for a medical check-up. That appointment brought her first ultrasound, marking the exact day her quiet, formless fear took physical shape.
"When the doctor told me I had PCOS, I broke down completely," Bareera recalls, describing the overwhelming emotional shock of the diagnosis. "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."
Across the Kashmir Valley, Bareera’s deeply personal and distressing experience is far from unique. Behind closed doors, an alarming number of young women are quietly grappling with the hidden, heavy weight of Polycystic Ovary Syndrome (PCOS). While the clinical manifestations of the condition—such as sudden weight gain, severe acne, excessive facial hair, and highly irregular periods—present significant physical challenges, they form only one part of a much broader and more complex struggle. Societal stigma, entrenched beauty standards, and heavy family expectations routinely turn everyday life into a exhausting battlefield marked by 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, describes the quiet torment that so many young women live with on a daily basis.
"I kept my missed periods a secret for months," Saikela said, reflecting on the fear of judgment that kept her silent. "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."
The psychological toll has profoundly altered how she interacts with her environment. "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.
Beyond the Diagnosis: The Medical Reality in Kashmir
While individual stories highlight the emotional isolation caused by the condition, extensive medical research confirms that PCOS is widespread throughout the region. A landmark study conducted by the Indian Council of Medical Research (ICMR), led 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.
Conducted between 2013 and 2015, the comprehensive survey evaluated 964 women aged 15 to 40 across five different districts. The findings were striking: 46.4 percent of the participants 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.
A parallel study conducted by the Department of Social Work at the University of Kashmir further underscored these numbers, finding that over 30 percent of surveyed women met the Rotterdam criteria—a figure significantly higher than the national average in India. Researchers identified a combination of sedentary lifestyles, poor dietary habits, and underlying hormonal imbalances as key driving factors behind the high rates. Beyond reproductive health complications, many of the affected women also experienced serious metabolic issues such as obesity and insulin resistance, alongside psychological hurdles like chronic anxiety and clinical depression.
Iqra Nazir, a senior scholar in the Department of Social Work, spent two intense months stationed at the Sub-District Hospital in Hazratbal to uncover these hidden struggles. Her academic research specifically focused on teenage girls aged 15 to 20, exploring the profound ways in which PCOS impacts emotional well-being, body image, family dynamics, and individual coping mechanisms.
"Families often perceive PCOS as a threat to marriage prospects rather than a medical issue," Nazir explained based on her field observations. "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 observed that the crushing weight of societal stigma, community judgment, family anxiety surrounding marriage and fertility, and rigid cultural beauty standards often weigh heavier on young girls than the physiological symptoms of the condition itself. The psychological toll is immense, bringing depression, anxiety, low self-esteem, and social withdrawal in the wake of visible physical changes. This creates a vicious cycle of silent suffering where young women remain largely invisible, their daily pain unnoticed by the wider public.
Behind Luck Lies Neglect
Every morning, the waiting area outside the gynaecology ward at Government Medical College (GMC) Handwara fills up long before the attending physicians arrive for their shifts. Young college students clutch crisp medical files containing lab results, while newly married women sit quietly, waiting for answers that could explain their struggles.
Inside one of the consultation rooms, Dr. Shakir Khan, an MBBS and MD in Gynaecology and Obstetrics who serves as a Senior Resident at GMC Handwara and Director of the Syeeda Memorial Charitable Health Foundation, prepares for another long and demanding day of patient care.
"Every second or third woman I see now has PCOS," Dr. Khan said, flipping through a stack of thick 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 student from Kupwara who presented with severe acne and hair fall. She had ignored her irregular menstrual cycles for two years, falsely assuming that academic stress was entirely to blame.
"When I told her it was PCOS, she looked surprised and said many of her friends had delayed periods, so she thought it was normal," Dr. Khan said. "That moment showed how unaware young women are. They dismiss early signs, not realising it’s their body’s way of asking for help."
The emotional impact, Dr. Khan emphasized, is frequently as heavy as the physical burden. "One woman who had been trying to conceive for years told me she thinks it’s her personal failure. PCOS changes how women see themselves. They start feeling unattractive, unworthy, as if their bodies have betrayed them."
He shared the story of a 30-year-old schoolteacher who had been unfairly labeled by her community as banjh—a derogatory term for infertile. For years, her persistently irregular periods were casually dismissed by those around her as a normal variation. When clinical tests eventually revealed severe PCOS complicated by insulin resistance, the underlying reality became clear. It was not a matter of bad luck, but of prolonged medical neglect.
Acting quickly, Dr. Khan placed her on a structured, comprehensive care plan that incorporated vital dietary modifications, stress management techniques, and targeted 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," Dr. Khan reflected. "It’s about restoring a woman’s faith in herself."
PCOS and Delayed Marriages Threaten Kashmir’s Fertility
Beyond individual health struggles and the heavy emotional toll on patients, Kashmir is facing a broader demographic challenge as rising rates of PCOS intersect with shifting social patterns. The condition, which can significantly impair natural fertility, affects women throughout the valley at a time when cultural norms regarding marriage are also undergoing substantial transformations.
Delayed marriages—driven by an increased focus on higher education, professional career ambitions, and evolving socioeconomic practices—are becoming increasingly common. Together, these trends substantially narrow the biological window for safe and successful childbearing.
A local report published in 2022 highlighted a stark demographic reality: nearly 50,000 women in Kashmir have crossed the conventional marriageable age, a figure that includes more than 10,000 unmarried women in Srinagar alone. Meanwhile, data from the National Family Health Survey (NFHS-5, conducted between 2019 and 2021) indicates that the Total Fertility Rate across Jammu and Kashmir has fallen sharply to 1.4, resting well below the standard population replacement level of 2.1.
Public health experts and medical professionals warn that the combined, compounding effects of rising PCOS prevalence, delayed marriages, and declining fertility rates could gradually shrink the region’s youth population. This dynamic threatens to accelerate demographic aging and create long-term social and economic pressures across the territory. Without timely medical intervention, public awareness campaigns, and a shift in how society perceives reproductive health, these intertwined trends pose a serious, ongoing threat to the valley’s future population growth and generational balance.