Polycystic Ovary Syndrome (PCOS) comes across as a clichéd disorder, but the rate at which it’s now devouring wombs in Kashmir is a sad departure from April 11 Safe Motherhood Day’s motto. Besides creating mental crisis, the disorder is also breeding marital discords in the valley.
When a reputed Kashmiri doctor floated a newspaper advertisement for his office maid job in 2017, he soon received an unconventional candidate for the interview. It was a bright college girl, turning up for a Rs 5,000/month job. The doctor was surprised, as the well-meaning and learned college-goer was ready to make coffee for him—even clean his workplace, including his toilet!
As it soon turned out, the girl wanted to study and earn money at the same time. Coming from a ‘decent’ family, she wanted to sustain her treatment, which was becoming “unaffordable” for her parents.
Two years later, Saika looks a tad jittery as a person, while talking about the day and her desperation for the job. She has put up a lot of weight and looks much older than her age.
“I’m suffering from PCOS,” she makes it short, lowering her head, as if feeling sorry for her life. “I’ve visited many doctors but nothing seems to help. Even after taking medicines religiously for years, my condition is still there. My family cannot afford my treatment. I know if I don’t do anything in order to help myself through a job, I won’t be able to get married.”
Back in her school days, she would fight a constant PCOS-induced emotional battle with herself. “I had facial-hair growth,” she continues narrating her anguish. “It made me look ugly and different. I tried to remove it, but it still made my face look abnormal. Compared to other schoolgirls, I would turn eyeballs with my subtle bearded appearance. The very feeling would leave me numb.”
Due to PCOS, Kashmiri girls do face tremendous pressure in schools, colleges or after marriage, says Dr Junaid, Registrar Endocrinology Department, Shri Maharaja Hari Singh Hospital (SMHS).
“They’re mostly obese, with a history of diabetes in their parents. 10 percent are even lean,” the doctor says. “On an average, around 20 PCOS patients varying from age 16-30 visit the hospital every day.”
Fearing Saika’s fate and feeling, many young girls are now increasingly seeking medical help. They mainly report, as Dr Junaid explains, irregular menstrual cycle, extreme acne or facial growth. While some married women diagnosed with PCOS receive treatments like in-vitro fertilization (IVF) to conceive, many see no hope ahead.
“Infertility in women is either primary or secondary,” Dr Junaid says. “In primary infertility, a woman can’t conceive; while in secondary infertility, she eventually conceives after PCOS symptoms are treated.”
However, the major cause of concern remains the alarming rise in PCOS cases in the valley, especially from the last 10 years.
“The growth is parallel to the growing obesity among women,” Dr Junaid says. “The main cause behind this syndrome is lethargic lifestyle changes and dietary habits among Kashmiris.”
According to a study conducted by Dr Sheema Samreen from Department of Community Medicine, Government Medical College, the prevalence of PCOS in Kashmiri women was found out to be 5.6 per cent in the year 2015-2016.
“Various studies have been conducted in Kashmir which put the percentage of women suffering from PCOS anywhere between 5-10 per cent and still increasing which is a really disturbing trend,” Sheikh Umar Ahmad, a research scholar at CSIR IIIM, Jammu, writes in an article on PCOS.
Even Indian National Family Survey (NFHS) indicates that at least 60 per cent of married Kashmiri women report one PCOS or more reproductive health problems which are significantly higher in comparison to the All-India average of 40 per cent.
While the disorder leads to extreme stress levels in women perennially waiting to have children of their own, a study on 112 PCOS afflicted women by SKIMS Soura found that one among five women nurse psychiatric disorders. The disorder often leads to marital disputes.
“I love babies,” says Sameena, a PCOS patient. “Their smell, the size of their body, the way they become everything to you. But, it has been eight years since I got married and I’m not blessed with a child.”
Much of this hopelessness has to do with the fact that only symptoms of PCOS can be treated, says Dr Bilquis Jan, a gynaecologist, who on an average attends around 5 females per day related to the disease.
“Sometimes, women don’t even know before marriage that they have this syndrome,” the doctor says. “Later they face marital issues and eventually feel a void in their lives.”
But instead of treating the symptoms, believes Dr Rabbanie Tariq Wani, it’s always better to get to the root cause and address that.
“PCOS needs to be dealt by lifestyle modifications,” says Dr Wani, a Lifestyle Medicine Specialist. “If we won’t alter our lifestyle, then infertility in our women will only increase.” And when such cases come to fore, it only creates a domestic crisis, like it did for Sakeena (not her real name).
“Happily married” at the age of 27, she’s not able to reach the stage of ovulation. For ovulation, she needs a regular menstrual cycle, which given her PCOS, remains disturbed due to hormonal imbalance.
“It was a love marriage,” she recalls. “My husband is very caring and understanding. The problem started when I had my first miscarriage after a year of our marriage. It was a terrible experience. I was very depressed with the episode. There was not only the grief of miscarriage but one of my fallopian tubes had also burst,” she narrates her ordeal in a research done by Bisma Bhat, a Srinagar-based journalist.
It was only after her miscarriage that she knew about PCOS, Sakeena told Bisma.
“The doctor told me that I’ve small cysts in my ovaries. This thing is eating me inside. I can’t express what I’m feeling. My husband is also tense, but he never expresses his feelings in front of me; he can’t see me depressed. Before marriage, I was not aware of changes occurring inside of me. There were irregularities in my monthly cycles but I never took that seriously and I never discussed it with my aunt and I thought it might be some kind of weakness. But I did not know this shyness and reluctance would curse my life. Our wedding anniversary is coming and we don’t have a child. I’m not able to conceive due to PCOS. I’ve been visiting doctors and going to Delhi for every possible treatment but till now all in vain. I’ve tried every possible medicine and what not but nothing happens.”
Desperate for motherhood, some PCOS women easily fall into trap of the so-called faith healers, who end up “looting them”. S
akeena too had her encounter with a con faith healer, during her train journey once. The woman had overheard her talking to her husband over phone: “I would give anything to have a baby.”
Alerted by otherwise Sakeena’s heartbroken remark, the woman had approached and given her an amulet, before vanishing with the craving-for-motherhood woman’s gold earrings.
“Since then, eight years have passed and we’re still a childless couple,” Sakeena laments. “Now, I often tell him [her husband] that you should go for second marriage. He never agrees to it, but that is the only option left with us now.”
The author is a Network of Women in Media, India (NWMI) 2019 fellow and a senior reporter at Free Press Kashmir.
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