Prescribed without explanation: A Kashmiri woman’s fertility journey

In Kashmir, a woman does not need to be a certain age for the pressure to begin. Whether she is in her late 20s, early 30s, or approaching her late 30s, once she is married, expectations follow.

“When are you planning?” “Don’t delay.” “Time is running.”

The whispers, advice, and family reminders grow louder with each passing month, creating a quiet but constant pressure to conceive.

For many women, hope is mixed with urgency and urgency often pushes them straight into medical treatment.

One educated Kashmiri woman, after trying for 1 year, decided in January 2024 to seek help. She believed she was making a responsible, informed choice.

She trusted that doctors would guide her carefully and ethically. She trusted the system.

She consulted two local doctors in Srinagar District in Kashmir, and after brief appointments, she was prescribed Letrozole.

What she was not clearly told is that Letrozole was originally developed and approved for hormone-sensitive breast cancer.

While it is also sometimes used in fertility treatment to stimulate ovulation, patients deserve to know both facts.

She was not informed that this medication works by lowering oestrogen levels, which can affect bone strength, mood, and overall hormonal balance.

There was little explanation of potential side effects or monitoring requirements, and almost no opportunity to ask questions.

The doctors never discussed her health properly, neither with her nor with her partner or family.

No one explained why this treatment was necessary, what the medicine would do, or for how long she would need to take it.

There was no overall discussion about her condition or how it could be treated safely. Instead, the approach was always the same: prescribe medicine, perform tests, and expect compliance.

Even the tests were linked to the doctor’s own clinic, and the medicines had to be purchased from the same place. For the clinic, this was business; for the patient, it was her life.

Alongside this medication, she received strong hormonal injections.

The process felt clinical, mechanical, and rushed. Instructions were given confidently, but the reasoning behind them was not explained.

Alternatives were not discussed, and the long-term impact was not considered.

Within months, her body began to protest. She developed severe anxiety and struggled to sleep.

Mood swings disrupted her emotional stability. Bone and joint pain, as well as neurological discomfort, began to interfere with her daily life.

These were not minor inconveniences; they altered her relationships, her work, and her sense of self.

Yet the treatment cycles continued. The underlying issue, endometriosis, was not addressed surgically first.

Instead, the focus remained on repeated medication cycles. Social and familial pressure made it even harder for her to pause and question whether this approach was appropriate.

Later, after relocating to another country, she sought a second opinion. The difference was immediate and striking. The new doctor listened attentively to her full medical history before recommending any tests.

Every procedure was explained in detail. Every medication, including Letrozole, was discussed transparently, including its original purpose, its fertility use, and potential side effects.

She was encouraged to ask questions and her concerns were treated as valid.

When reviewing her previous treatment, the doctor explained that while Letrozole can be used safely in fertility care, it is a powerful medication that requires careful monitoring.

Given her prolonged exposure, the doctor conducted comprehensive evaluations, including breast and cervical screening, to ensure there were no complications.

For several days, she lived with quiet fear, aware that she had been taking a strong medication without fully understanding its purpose or risks.

Thankfully, the results were clear. She was cancer-free. Her endometriosis was properly evaluated and surgically treated. She is now recovering and slowly healing, both physically and emotionally.

This story is not about blaming a single doctor. It is about a broader reality that many women quietly face.

In some healthcare environments, consultations are rushed, explanations are minimal, financial incentives may blur ethical clarity, and patients feel they must comply rather than question.

In such a system, women’s reproductive health becomes a race against time, rather than a carefully considered medical journey.

Normal delivery is becoming rare in many private hospitals.

Women are often pushed toward C-sections, not necessarily for medical reasons, but because it is a trend or is more profitable for the hospital.

In this process, a woman’s health is rarely prioritised, and she may not be fully informed about the risks or alternatives.

Men are often unaware of these practices, and women sometimes follow the trend blindly, trusting what seems popular rather than what is best for their own bodies.

In many cases, women’s voices and rights in their own healthcare are overlooked.

Women trying to conceive deserve transparency. They deserve to know when a medication was originally designed for cancer treatment.

They deserve to understand how it works, its hormonal effects, and what side effects may occur.

They deserve monitoring when powerful drugs are prescribed. Asking questions is not disrespectful. Seeking second opinions is not disloyal. Wanting clarity is not arrogance.

In a society where motherhood carries enormous emotional weight, medical urgency should never replace careful explanation.

A woman’s body is not a business model. Her womb is not a statistic. Her future should never be decided without her full understanding.

The author is a Social Worker and Women Rights activist.