The silent struggle: PCOS and PCOD on the rise among young Indian women

Business Standard

9 hours ago

Across India, an increasing number of adolescent girls and young women are grappling with Polycystic Ovary Syndrome (PCOS) and Polycystic Ovarian Disease (PCOD) – two hormonal disorders that often go undetected but can have significant long-term health consequences.
Affecting reproductive, metabolic, and psychological well-being, these conditions are becoming more prevalent in the 15–25 age group, largely due to lifestyle factors, urban stress, and lack of awareness.
Health experts estimate that PCOS now affects between 3.7% and 22.5% of Indian women, depending on diagnostic criteria and location. Globally, it is among the most common endocrine disorders, impacting 8–13% of women of reproductive age.
Understanding PCOS and PCOD
Today, the terms PCOS and PCOD are often used interchangeably but medically they are two distinct entities.
Dr. Dhivya Sharona, Consultant – Gynaecology, Rela Hospital Chennai, explains: 'PCOD is a condition where ovulation is affected and there is formation of cysts in the ovaries. Here, the ovaries produce immature and partially mature eggs in large quantities leading to the formation of cysts secreting excess amounts of androgen (male hormone).'
'It is associated with irregular periods, excessive bleeding and painful periods. It is more common than PCOS and affects around 1/3rd women of reproductive age worldwide. It is also less severe than PCOS and has less impact on fertility compared to PCOS. Around 80% women with PCOD are able to conceive with help,' Dr Sharona adds.
On the other hand, PCOS is a syndrome with a spectrum of signs and symptoms including painful periods, weight gain, excessive hair growth, mental health disorder and both presence and absence of cyst formation in the ovaries. The incidence of PCOS is quoted to be between 5-20% in actively menstruating women. It has a high association with obesity along with hypertension, diabetes and heart diseases.
Dr. Nidhi Thakur, Consultant Obstetrician & Gynaecologist, Ujala Cygnus Group of Hospitals says that in some cases, ovaries form fluid-filled cysts when the egg is not released properly, leading to amenorrhea (absence of menstruation), hormonal disruption, and fertility issues. Despite the name, not all women with PCOS have visible ovarian cysts, which often makes diagnosis difficult.
Recent studies show that most people with PCOS have insulin resistance, where the body's cells don't respond properly to insulin, disrupting hormone balance. Testing for this can help rule out other conditions often mistaken for PCOS.
The challenges
Many young women with PCOS or PCOD go undiagnosed for years. Symptoms like irregular periods, hair growth, or weight fluctuations are often normalised or overlooked. This delay in diagnosis means the condition progresses silently, potentially leading to infertility, insulin resistance, obesity, sleep apnea, and mental health issues like anxiety and depression. The social stigma around discussing menstrual or reproductive issues also contributes to underdiagnosis. In many cases, women only discover their condition while struggling to conceive or manage other related health complications.
In 2021, a study was undertaken by the Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh to assess treatment pathways that patients with PCOS have followed. It revealed that even after having initiated treatment, almost 45% of the patients knew nothing about PCOS. Only 9.1% learned anything from their doctors, and almost 85.5% had to visit multiple doctors to gather information. Some patients (approximately 37%) also took to the internet as their primary source of information in trying to learn about their condition.
Many women, in a different ethnographic study, revealed that they received conflicting information from different health-care professionals about their condition, which generates a "trust deficit." That is, women have begun to lose trust in their doctors because they are not confident about the quality of the information provided to them. There is a disconnect that the patients feel, which can only be bridged through clear communication and helping them understand how the condition and its management go hand in hand.
Lifestyle and prevention: The first line of defense
While there's no permanent cure, PCOS and PCOD can be effectively managed through early intervention and lifestyle changes. A healthy diet, weight management, and regular exercise play a crucial role in restoring hormonal balance and improving insulin sensitivity.
Reducing sugar and processed food intake helps control blood sugar and insulin levels.
Moderate physical activity improves metabolism and regulates the menstrual cycle.
Stress-reduction practices like yoga or meditation help manage hormonal fluctuations.
Even a modest weight loss of 5–10% can significantly improve symptoms and restore ovulation in many cases, says Dr. Nidhi Thakur.
Medical management and costs
Medical treatment typically includes hormonal contraceptives to regulate periods and reduce androgen levels, as well as anti-androgen medications to manage symptoms like excess hair growth. In some cases, laparoscopic ovarian drilling is recommended when medications are ineffective.
The cost of managing PCOS can vary:
Hormonal medications: ₹400–₹800 per month
Surgery (if needed): ₹35,000–₹50,000
Total treatment costs may range from ₹20,000 to ₹50,000, depending on the individual case
Though affordable options are available, the cumulative long-term costs can be high if not managed early.
Long-term impact on health and fertility
If left unmanaged, these diseases can significantly affect a woman's long-term health. The risk of developing Type 2 diabetes, metabolic syndrome, cardiovascular diseases, and endometrial cancer increases with time. PCOS is also a leading cause of infertility, due to chronic anovulation and hormonal imbalance.
Beyond physical symptoms, the condition can have a profound psychological impact. The frustration of dealing with chronic symptoms, weight issues, and fertility concerns can lead to low self-esteem, anxiety, and depression, making mental health support an important part of the treatment plan.
Importance of early detection and regular check-ups
PCOD and PCOS are on rise due to high stress, poor social and emotional relatedness, sedentary lifestyle, environmental toxins etc. Dr. Dhivya says that the lack of reproductive health education, taboo around discussing female reproduction along with social and cultural notions of women's ability to bear pain render women unable and unwilling to seek necessary help. Thus, both the conditions are significantly under-diagnosed by practitioners and there is a significant information gap that does not offer people the resources they need. Young women are encouraged to consult gynaecologists if they experience irregular menstrual cycles.
Basic screening tests—such as fasting blood sugar, HbA1c, lipid profiles, BMI, and ultrasound scans—can help detect early signs of PCOS and prevent complications. In some cases, consultation with endocrinologists and nutritionists may also be needed for comprehensive care. To effectively tackle this health crisis, we need a major shift in how the conditions are understood and managed. Closing knowledge gaps, creating evidence-based treatment guidelines, and prioritizing lifestyle changes along with complementary therapies—supported by accessible patient education—are all critical steps forward.
A manageable condition with the right support
PCOS and PCOD are chronic but manageable conditions. With early diagnosis, lifestyle changes, and appropriate medical support, most women can live healthy, fulfilling lives. What's crucial is breaking the silence around menstrual and hormonal health and making gynaecological check ups a routine part of adolescent healthcare.
Raising awareness, both at the family and institutional level, can help young Indian women recognise symptoms early, seek help without stigma, and take control of their health before complications set in.