Understanding PCOS in young women

 Polycystic Ovarian Syndrome (PCOS) rarely announces itself clearly. It shows up as delayed periods, stubborn weight gain, persistent acne, or unwanted hair, often leaving young women confused, anxious, and searching for answers online. In a time when lifestyle pressures are high and misinformation spreads easily, understanding PCOS has become crucial.

In this interview, renowned obstetrician and gynaecologist and authority on PCOS, Prof (Dr) Bilquees Jameela explains what PCOS really is, why it is increasingly common among young women, and how timely awareness, lifestyle changes, and medical guidance can help restore health, confidence, and control.

 Q1. Many young girls today are being diagnosed with PCOS. What exactly is this condition?

Dr BJ:You have asked a very good question. PCOS means Polycystic Ovarian

Syndrome. Many people think that it is a problem of cysts, but it is not actually a cyst related problem. It is a hormonal abnormality, or we can say a hormonal imbalance.

In PCOS, one hormone which we call the male hormone, androgen, increases. The androgen level rises in PCOS. Along with this, estrogen increases and progesterone decreases. When this hormonal imbalance occurs, several changes happen in the body.

Weight gain increases, periods become irregular. Sometimes periods come after two or three months, and sometimes they do not come at all. Medicines have to be given for periods to occur, which we call withdrawal bleeding.

It has been observed that this condition is more common in girls who have a sedentary lifestyle. Nowadays, girls prepare for exams or focus on building their careers, so they adopt a sedentary lifestyle. Sitting in one place for long hours increases hunger, and instead of eating healthy food, they consume junk food like chips, chocolates, and cold drinks. These are what we call empty calories. They only increase calories and provide no nutritional benefit. This is one of the reasons they become obese.

The second reason is lack of exercise. There is no physical activity. Sitting in one place, eating food, and not burning it leads to fat accumulation, which increases obesity.

The third factor is hormonal abnormality, due to which girls become obese and develop acne. There is excessive hair growth on the face and body, which makes girls very conscious. This also leads to psychological issues, which further worsen the condition.

That is why, to manage PCOS, we have to remove the cause. Lifestyle changes are very important. Diet control is necessary. One should consume a diet that is low in calories but high in nutrition, such as green leafy vegetables and fruits with low sugar content. Fruits like banana and mango should be avoided. Fruits with a sour taste can be taken, as they have fewer calories.

Exercise is the most important factor. Girls must take time out for themselves at least half an hour to one hour daily. Younger girls can do jogging or treadmill exercises. Those who have access can join a gym. They can also consult a dietician, who can provide a proper PCOS diet plan. 

Q2. How important is early awareness and lifestyle management in preventing PCOS?

Dr BJ: I see many girls whose parents are genuinely very worried and ask why this is happening. They are especially concerned because of menstrual abnormalities, undue weight gain, and hair fall. The girls also become very conscious about these changes.

Parents themselves say that their daughter consumes a lot of junk food. In such cases, both the parents and the girl are advised to increase physical activity. We provide them with a food chart, clearly mentioning what foods should be eaten and what should be avoided.

Along with academics, it is very important to manage lifestyle as well. Early guidance and awareness play a crucial role in preventing such hormonal disorders. 

Q3. According to WHO, about 6–13% of women worldwide are affected by PCOS, and recent Indian studies estimate the prevalence to be around 11%. Considering that a large percentage of women facing infertility in India are diagnosed with PCOS, what are the current treatment options available for those who wish to conceive despite the condition?

Dr BJ:The most important issue in such patients is menstrual abnormality, because they do not have regular cycles. Regular menstrual cycles are always a good sign, as they indicate normal ovarian function.

In PCOS, cycles are abnormal, due to which ovulation does not occur, a condition we call anovulation. If, through lifestyle management, the patient’s weight is reduced, regular periods can return spontaneously, and they can conceive naturally.

However, in many patients, lifestyle management alone does not work. In such cases, we give specific medications for PCOS and for induction of ovulation. If these treatment regimes are followed religiously, very good results are seen, because PCOS is a condition that responds well to treatment.

There are a small percentage of patients who have resistant anovulation. In such cases, we motivate them to opt for Assisted Reproductive Techniques (ART), including IVF, through which they can successfully conceive. 

Q4. PCOS often affects a woman’s confidence because of physical symptoms like weight gain, acne, or facial hair, and at the same time, hormonal imbalance can lead to anxiety or depression. How do these physical and emotional challenges together impact a woman’s overall mental health, and what kind of support should she receive from family and society?

Dr BJ:Women need to be encouraged and supported. Whatever advice the doctor has given should be followed religiously. If exercise has been advised, the family should help her understand what kind of exercises are recommended and encourage her to do them regularly.

It should not be like following a diet or exercise routine for a few months and then stopping it. If it is discontinued, the problem recurs. Lifestyle management has to be regular and consistent.

Only then will the outcome be successful whether the woman wants to conceive, have regular menstrual cycles, or improve her body shape. 

Q5. Many women rely on social media remedies or unverified diets for PCOS. What’s your advice to those who are confused between medical guidance and social media myths?

Dr BJ:Medical guidance is very important. The remedies or diets shown on social media often push women towards extreme practices, which come with their own complications.

They should strictly follow what their doctor or dietician has advised. I strongly feel that women should not follow social media remedies or diets and must rely on proper medical guidance.

 Q6. Can PCOS be completely cured, or is it a condition that can be effectively managed with the right treatment and lifestyle changes? Many women feel hopeless when they hear it’s lifelong how would you reassure them about living a healthy and fulfilling life with PCOS?

Dr BJ:If ovulation occurs and a woman becomes pregnant, in many cases the condition spontaneously reverses, and regular cycles return. Such women can lead a normal life. However, PCOS can recur and may have implications later in life.

Women with PCOS are more prone to developing diabetes. During pregnancy, they may develop gestational diabetes and can also have complications like preterm labour.

Despite proper medication and lifestyle management, if a woman does not conceive after considering body weight and completing infertility investigations, IVF becomes the only option.

 Q7. Are there any surprising factors, like certain habits or foods, that can trigger PCOS in young women that people usually don’t know about?

Dr BJ:Junk food is a major trigger for PCOS. High carbohydrate intake also plays a role, so carbohydrate consumption should be monitored.

There is also a genetic factor involved. PCOS tends to run in families, especially where there is a family history of diabetes.

Interviewer Arooj Bilal, Department of Media Studies, Amar Singh College