1. Introduction

In the pristine valleys of Jammu and Kashmir, where the mountains echo stories of nature and resilience, a silent health crisis is emerging among women—Polycystic Ovarian Disease (PCOD). Long misinterpreted or hidden behind the veils of cultural hesitance, PCOD is now showing an alarming rise, especially among adolescent girls and women in their reproductive years. Medical professionals and gynaecologists across the region have reported a spike in consultations and diagnoses related to irregular periods, acne, weight gain, and infertility—all signs pointing toward a deeper endocrinological imbalance.

Fuelled predominantly by hormonal disruption and increasingly sedentary lifestyles, PCOD is transforming from a condition into an epidemic. And in Jammu and Kashmir, a region with its unique sociocultural dynamics, the implications are even more significant. The region’s transition from traditional to semi-urban and urban lifestyles has not just impacted its environment and economy but is now deeply affecting the health of its women. This article explores this complex issue in-depth, unraveling medical, social, psychological, and policy dimensions of PCOD's rise in J&K.

2. What is PCOD?

Polycystic Ovarian Disease (PCOD), often confused with Polycystic Ovary Syndrome (PCOS), is a disorder of the ovaries characterized by the formation of multiple small cysts. These cysts result from the ovaries' failure to release eggs regularly, leading to hormonal imbalances. The key difference between PCOD and PCOS lies in severity—PCOD is more about irregular menstruation and cyst formation, whereas PCOS often involves higher androgen levels, metabolic issues, and long-term risks like diabetes and cardiovascular diseases.

In PCOD, the ovaries typically enlarge and secrete excessive amounts of androgens, which can disrupt menstrual cycles, affect fertility, and lead to unwanted symptoms like facial hair, acne, and weight gain. Although not entirely curable, PCOD can be managed effectively through lifestyle changes, diet, medication, and in some cases, hormonal therapies.

Traditionally, awareness around PCOD was limited, with many women normalizing irregular periods or infertility. But with increasing diagnosis, the condition is gaining recognition—especially as it starts affecting younger girls. Alarmingly, studies suggest that one in every five women in India may have PCOD. The rate in J&K is rising faster than the national average, prompting immediate attention. 

3. Hormonal Imbalance: The Biological Disruptor

Hormonal imbalance is the fulcrum on which PCOD pivots. At the core of PCOD lies a disruption in the delicate interplay of female reproductive hormones—estrogen, progesterone, luteinizing hormone (LH), and follicle-stimulating hormone (FSH). In a healthy ovulation cycle, LH and FSH regulate the release of the egg. But in PCOD, the balance tilts, causing the ovaries to produce immature follicles that don’t release eggs but rather form fluid-filled cysts.

Elevated insulin levels also contribute to excess androgen production. When insulin becomes less effective at controlling blood sugar, the body compensates by producing more. This increase stimulates the ovaries to secrete more testosterone, leading to many of the distressing symptoms women experience.

In Kashmir, hormonal imbalances are exacerbated by dietary shifts, late marriages, stress from sociopolitical unrest, and lack of physical activity. Environmental pollutants, pesticide exposure from agricultural valleys, and even water quality could be potential contributors. These elements cumulatively disturb endocrine health, causing downstream effects on fertility and metabolism.

4. The Role of Sedentary Lifestyle in Women’s Reproductive Health

With the rise of digital life and academic pressures, physical movement has drastically reduced in the last decade. Young girls, once engaged in daily chores or outdoor activities, now spend long hours indoors—on phones, laptops, and screens. This sedentary routine slows down metabolism, increases insulin resistance, and leads to weight gain—all of which exacerbate PCOD symptoms.

In Jammu and Kashmir, harsh winters and safety concerns often restrict outdoor activities for women. Urbanization has also replaced traditional chores like gathering firewood or farming, which earlier offered natural physical exertion. Instead, processed foods, minimal activity, and disturbed sleep cycles dominate modern life.

Lack of exercise not only leads to obesity but also impairs hormonal regulation. Regular movement helps reduce insulin resistance, balance androgen levels, and improve ovulation. Sedentariness, on the other hand, anchors the very foundation of PCOD progression, making physical activity one of the most critical, yet under-discussed, interventions.

5. PCOD in the Context of Jammu & Kashmir

Jammu and Kashmir present a unique terrain—both geographically and socially—making healthcare challenges here distinct. PCOD, which may seem like a common urban issue, has begun to percolate into rural communities of Kashmir due to shifts in food habits, education systems, and lifestyle.Gynaecologists from Srinagar to Baramulla report a rising number of young girls as young as 13 showing PCOD symptoms. In some areas, up to 30–40% of patients in gynaecology outpatient departments (OPDs) report menstrual irregularities and hormonal issues.

The region’s tumultuous past has left psychological scars—chronic stress, displacement, and insecurity have elevated cortisol levels, another hormone which indirectly impacts reproductive health. Women who have faced trauma are often more likely to report reproductive health issues. Add to this the pressure of marriage at a certain age and the stigma around infertility, and PCOD becomes a sociopsychological burden in J&K.

6. Case Studies and Medical Insights from Local Gynaecologists

Dr. Rifat Qureshi, a senior gynaecologist at a government hospital in Srinagar, shares that almost 50% of her adolescent patients now complain of irregular menstruation and acne. Upon further tests, a significant portion are diagnosed with PCOD. Many of these girls are from well-educated families with access to the internet but little awareness about reproductive health.Another case involves a 16-yearold from Pulwama who developed hirsutism (unwanted facial hair) and sudden weight gain. Initial consultations were brushed off by relatives as “normal teenage problems,” but further screening revealed multiple ovarian cysts and elevated testosterone.

Such case studies point to one core issue—late diagnosis. Most families ignore or are unaware of early symptoms. When girls do seek help, they are often referred only when symptoms become visibly distressing. Doctors unanimously call for better awareness and early screening to tackle the disease before it affects fertility or mental health.

7. Diet, Urbanization, and Lifestyle Shifts

The traditional Kashmiri diet was once rich in fiber, antioxidants, and good fats—from Haak (collard greens) to walnuts and fish. But globalization and urbanization have transformed dietary habits drastically. Refined sugars, bakery items, sugary tea, and fast food dominate the plate today.

Women are consuming more carbohydrates and less protein than required. Low micronutrient intake (such as Vitamin D, B12, Magnesium) further aggravates hormonal disruption. In PCOD, insulin resistance plays a major role, and the modern diet is contributing to it directly.

Moreover, eating patterns have changed. Skipping breakfast, binge eating at night, and irregular meal timings further disturb metabolic function. Urban lifestyle doesn’t just mean city living—it means disconnection from traditional routines, both in food and body movement, thus promoting PCODfriendly environments.

8. The Mental Health Connection

PCOD is not just a physical condition. It deeply impacts mental health—causing anxiety, depression, low self-esteem, and body image issues. The hormonal imbalances directly influence neurotransmitter activity, which explains the frequent mood swings, irritability, or even panic attacks seen in women with PCOD.

In Kashmir, mental health remains a fragile topic. Due to sociocultural barriers, very few women seek therapy or psychiatric support. However, several studies indicate that more than 60% of women with PCOD report symptoms of depression and generalized anxiety disorder (GAD).

Hair fall, weight gain, acne, and infertility are not merely cosmetic issues—they hit the very core of a woman’s identity. Without psychological support, PCOD becomes a double-edged sword: harming both the body and mind. The need for integrated care—where gynaecologists and mental health professionals collaborate—is more urgent than ever in the valley.

9. Youth and Early Onset PCOD

Previously, PCOD was seen predominantly in women aged 25–35. Today, girls as young as 11 or 12 are being diagnosed. This early onset poses severe long-term risks—infertility, Type-2 diabetes, endometrial cancer, and heart disease.

Puberty already brings hormonal shifts. But junk food, zero exercise, and prolonged gadget use amplify the problem. Many young girls with PCOD also face bullying in schools due to acne or facial hair, leading to self-isolation.

There’s an urgent need for school-based health screenings and reproductive health education in J&K. Teachers and school counselors must be trained to identify at-risk students and guide them toward timely medical help.

10. Societal Stigma and Delayed Diagnosis

One of the major hurdles in PCOD management in Kashmir is stigma. Discussions around menstruation, fertility, or weight are often brushed under the carpet. Many women avoid seeking medical help due to shame or fear of judgment.

In conservative households, symptoms like infertility or weight gain are linked to marital prospects. Women silently suffer, and parents often focus more on marriage than medical intervention. The result is delayed diagnosis and compounded complications.

Community-level education, especially through mosques, schools, and local NGOs, can break this stigma. Religious and cultural leaders must be involved in promoting awareness that seeking help is not a sin but a step toward healing.

11. Role of Public Health Campaigns

Despite the alarming rise in PCOD cases in Jammu & Kashmir, public health campaigns on reproductive issues remain minimal. Existing efforts are either sporadic, urban-centric, or embedded under general women’s health programs without tailored messaging.

PCOD requires specific and consistent awareness drives—ones that clarify symptoms, debunk myths, and explain both prevention and management strategies. Campaigns led by government health departments, in partnership with NGOs, schools, and media, can help demystify the condition.

In urban centers like Srinagar or Jammu, there is some reach via social media or hospitals. However, in rural belts of Kupwara, Anantnag, or Kishtwar, women remain underserved. Mobile health vans, radio broadcasts in local dialects, or workshops in anganwadis and primary health centers could act as gamechangers. The message needs to be simple, culturally appropriate, and repetitive for deep impact.

12. Prevention: From School to Home

Preventing PCOD is entirely possible—especially if interventions begin early. Schools must integrate reproductive health into their curriculum, not just for girls but for all students. Knowledge builds empathy, and when boys and girls understand menstrual health as a science rather than a taboo, stigma fades.

Physical education classes need to be emphasized with mandatory participation, especially for adolescent girls. Kashmiri winters may restrict outdoor play, but indoor yoga, dance, or fitness routines can be implemented even in small school halls.

At home, parents must encourage balanced meals, regular sleep schedules, and screen-free time. Mothers should talk openly about periods and help girls track their menstrual cycles. Fathers, too, should be sensitized, as their support is crucial in enabling daughters to seek medical help without fear or shame.

Prevention also means empowering girls with tools—period tracking apps, nutrition plans, and peer support circles. Early education about PCOD can transform a vulnerable generation into a vigilant one.

13. Natural and Medical Treatment Approaches

Managing PCOD is not a one-size-fits-all approach. Depending on the severity, symptoms, and goals (fertility vs. metabolic health), treatment varies from lifestyle changes to medication and sometimes surgery.

Medical Approaches:

Doctors often prescribe birth control pills to regulate menstruation, anti-androgens to reduce facial hair or acne, and metformin to combat insulin resistance. In infertility cases, ovulation-inducing medications like clomiphene may be given. But medicines are only effective if lifestyle changes accompany them.

Lifestyle Interventions:

• Diet: A low-glycemic index diet with whole grains, legumes, lean protein, and healthy fats.
• Exercise: 30–45 minutes of moderate physical activity (walking, cycling, swimming) daily.
• Stress Management: Meditation, journaling, or counselling.
• Sleep: Regular and adequate sleep boosts hormonal balance.

Natural Remedies:

In Kashmir, many traditional herbs like Shatavari, Ashwagandha, or green tea are gaining interest for PCOD management. However, patients should consult doctors before using herbal supplements. Yoga asanas such as Baddha Konasana and Dhanurasana have also shown positive effects on hormonal health.

14. The Way Forward: Policy, Education & Empowerment

The fight against PCOD in Jammu and Kashmir needs to move beyond hospitals. It needs to enter schools, streets, and homes. Here are strategic actions needed at various levels:

Policy:

• Introduce state-level reproductive health programs specifically targeting PCOD.
• Offer free screening camps in government hospitals and colleges.
• Train ASHA workers and community health nurses in identifying early symptoms.
• Include PCOD in adolescent healthcare schemes under NHM (National Health Mission).

Education:

• Make menstrual health education compulsory in all schools by age 10–12.
• Conduct workshops for teachers, counsellors, and parents.
• Integrate digital literacy around health apps and menstrual tracking.

Empowerment:

• Normalize conversations around periods and infertility through local media.
• Encourage young women to lead awareness drives in colleges.
• Create peer support groups in universities or mohallas.
• Offer subsidized gym or fitness center access for girls.
• Women’s health is not just a medical issue—it’s a development issue. A society cannot progress when half its population is silently battling hormonal disorders.

15. Conclusion

The serene mountains of Kashmir may look untouched by the fast-paced chaos of the outside world, but within its homes, schools, and clinics, a new health crisis is rising quietly—PCOD. Fueled by hormonal disruptions and lethargic lifestyles, it is impacting young girls and women in ways far deeper than just irregular periods or facial hair.

It is affecting self-worth, fertility, mental health, and even the economic participation of women. Yet, PCOD remains poorly understood and grossly under-addressed in public discourse.

Breaking the silence begins with knowledge. Understanding PCOD is the first step to defeating it. For Jammu and Kashmir, where societal norms are strong and public health infrastructure is still evolving, the battle against PCOD must be waged through awareness, acceptance, and action.

As more gynaecologists raise alarms and more women share their journeys, we inch closer to creating a society where reproductive health is no longer taboo but a shared responsibility. Let this article be a small part of that transformative dialogue, because behind every menstrual struggle is a story waiting to be heard, and a life waiting to be healed.

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Bibliography:

1. Azziz, R., Carmina, E., Dewailly, D., Diamanti-Kandarakis, E., Escobar-Morreale, H. F., Futterweit, W., ... & Witchel, S. F. (2006). "Positions Statement: The Androgen Excess and PCOS Society criteria for the polycystic ovary syndrome: the complete task force report." Fertility and Sterility, 91(2), 456–488. https://doi.org/10.1016/j.fertnstert.2008.06.035
2. Teede, H. J., Misso, M. L., Costello, M. F., Dokras, A., Laven, J., Moran, L., ... & Hoeger, K. (2018). "International evidence-based guideline for the assessment and management of polycystic ovary syndrome 2018." Monash University, Melbourne, Australia. https://www.monash.edu/__data/assets/pdf_file/0004/1412644/
   PCOS-Evidence-Based-Guidelines.pdf
3. Indian Council of Medical Research (ICMR). (2020). "Prevalence and Management of PCOS in Indian Women: A Multi-Centric Study." Department of Health Research, Government of India. https://main.icmr.nic.in
4. Ministry of Health and Family Welfare, Government of India. (2022). "National Health Profile and Adolescent Health
   Initiatives." https://www.mohfw.gov.in/
5. National Institute for Research in Reproductive Health (NIRRH). (2019). "Polycystic Ovary Syndrome: Clinical Insights and Indian Data." https://nirrh.res.in
6. Khan, A., & Bhat, R. A. (2021). "Epidemiology of PCOS in Kashmir: An Emerging Health Concern." Journal of Health and Medical Sciences, 12(3), 221–229.
7. Rashid, A., & Qadri, S. S. (2020). "Awareness and Lifestyle Assessment in Kashmiri Women with PCOS." International
   Journal of Reproductive Medicine, 25(2), 75–82.
8. World Health Organization (WHO). (2022). "Sedentary lifestyle: A global public health challenge." https://www.who.int/news-room/fact-sheets/detail/physical-activity
9. American College of Obstetricians and Gynecologists (ACOG). (2019). "Polycystic Ovary Syndrome (PCOS): FAQ and Patient Guidelines." https://www.acog.org/womens-health/faqs/polycystic-ovary-syndrome
10. Srinagar Municipal Corporation & Kashmir Health Mission.
    (2023). "Urban Health Survey on Women's Reproductive Health
     in Kashmir Valley." Internal Government Report.
11. Koul, M., & Sheikh, M. A. (2023). "Digital and Social Media Use Among Adolescents in Kashmir and its Health Impacts." Kashmir Journal of Social Sciences, 19(1), 39–52.
12. Sharma, N., & Kaur, R. (2018). "PCOD: Lifestyle and Dietary Patterns Among Young Indian Women." Nutrition and Health, 24(4), 297–304.
13. National Family Health Survey (NFHS-5), India. (2020–21). "State Report: Jammu & Kashmir." https://rchiips.org/nfhs/NFHS-5_FCTS/Jammu%20and%20Kashmir.pdf
14. Pathak, L., & Singh, A. (2022). "Menstrual Disorders and Reproductive Health Education in Rural North India." International Journal of Gynecology & Obstetrics, 158(2),
    213–218.
15. Ali, F., & Ahmad, M. (2022). "Traditional Kashmiri Diets and Hormonal Health: An Ethnomedical Study." Indian Journal of Ethnopharmacology, 14(2), 120–129.