PCOD in Urban India: The Silent Crisis - Why Millions of Women Don’t Know They Have It

Polycystic

Ovarian Disorder (PCOD), often used interchangeably with Polycystic Ovary Syndrome, is emerging as one of the most pressing women’s health concerns in urban India. Once considered a niche reproductive issue, it is now widely recognised as a complex metabolic and hormonal disorder influenced by lifestyle, environment, and genetics. With rising urbanisation, sedentary habits, and chronic stress, experts warn that a significant proportion of women may be at risk, many without even knowing it.Also read: Heatwave Alert: 5 DIY Tests to Detect Dehydration Early

Understanding PCOD: More than a hormonal disorder

PCOD affects women during their reproductive years and is characterised by hormonal imbalance, irregular menstrual cycles, and multiple small cysts in the ovaries. However, its impact goes far beyond reproductive health. It is closely linked with insulin resistance, weight gain (especially abdominal obesity), acne, excessive hair growth, and even mental health challenges. Globally, the prevalence of PCOD is estimated at 10 to 13 per cent. In India, studies show a wider range - from 3.7 per cent to 22.5 per cent - depending on diagnostic criteria and population studied. This variation highlights a crucial issue: underdiagnosis and lack of awareness. “As much as 70 per cent of the world’s women suffering from PCOS do not know that they are living with it. Moreover, PCOD risk factors, such as insulin resistance, abdominal obesity, and metabolic disorders, are highly common among urban women in India,” said Dr. Anjali Kumar, Director - Obstetrics and Gynaecology, CK Birla Hospital.

Why are urban Indian women at higher risk?

Urban lifestyles are a key driver behind the rising PCOD burden. Women in cities often face a combination of risk factors:

Sedentary routines

Desk jobs and reduced physical activity lower insulin sensitivity.

Unhealthy diets

High intake of processed foods, refined carbohydrates, and sugar contributes to metabolic imbalance.

Chronic stress

Work pressure and irregular schedules disrupt hormonal regulation.

Sleep deprivation

Poor sleep affects endocrine function and weight regulation. A 2024 study from Delhi-NCR reported a prevalence of 17.4 per cent among women aged 18 to 25 years - an alarming statistic that underscores the vulnerability of young, urban populations. “Urbanization has greatly contributed to the increasing risk of PCOD in the Indian population. Research conducted shows that the prevalence rate in urban areas is significantly higher than in rural areas because of lifestyle factors like sedentary activity and stress,” said Dr. Kumar.

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The 8 in 10 at-risk reality

While not every woman will develop PCOD, a large number exhibit risk factors such as insulin resistance, central obesity, or hormonal imbalance. This is why the phrase “8 in 10 at risk” resonates, as it reflects the widespread presence of underlying metabolic triggers, not just confirmed diagnoses. Many women may dismiss early symptoms like irregular periods or acne, delaying diagnosis until complications arise. At the core of PCOD lies insulin resistance - a condition where the body’s cells do not respond effectively to insulin. This leads to higher insulin levels, which in turn stimulate excess androgen (male hormone) production. The result is a cascade of symptoms, including irregular ovulation, weight gain, and skin changes. Even women with a normal body mass index (BMI) can have abdominal fat and metabolic dysfunction, making PCOD a “hidden” condition in many cases.

Long-term health risks beyond fertility

PCOD is not just about irregular periods or difficulty conceiving - it is a lifelong condition with serious health implications like increased risk of Type 2 diabetes, hypertension, and cardiovascular disease, dyslipidemia or abnormal cholesterol levels, and even mental health issues like anxiety and depression – all of which lead to reduced quality of life. Ignoring PCOD can lead to a cascade of chronic health issues, making early detection and management critical. “It should be understood that PCOD is more than just irregular menstruation or reproductive challenges since it is a lifetime problem. Women diagnosed with PCOD have an increased likelihood of suffering from type 2 diabetes, hypertension, dyslipidemia, and cardiovascular problems. There are psychological repercussions, including anxiety, depression, and poor quality of life, as well,” Dr. Kumar added.

What works for prevention and management?

ccording to Dr. Aastha Dayal, Director, Obstetrics and Gynaecology, CK Birla Hospital, early intervention is important for positive outcomes. “The good news is that early intervention through lifestyle correction, regular screening, and timely medical guidance can significantly improve outcomes and prevent long-term health consequences,” she said. PCOD is highly manageable, especially with early intervention. Lifestyle modification remains the cornerstone of both prevention and treatment:

• Regular physical activity: Improves insulin sensitivity and hormone balance
• Balanced diet: Focus on low glycemic index foods, fibre, and healthy fats
• Weight management: Even a 5 to 10 per cent reduction can significantly improve symptoms
• Quality sleep: Supports hormonal regulation and metabolic health
• Stress reduction: Yoga, mindfulness, and relaxation techniques can help

Medical treatment may include hormonal therapy or insulin-sensitising drugs, depending on individual needs. Dr. Dayal says early diagnosis not only helps improve the quality of life but can also prevent long-term complications. Women should seek medical advice if they notice irregular or missed periods, persistent acne or excessive hair growth, and sudden weight gain or difficulty losing weight. Screening may involve hormonal tests, ultrasound imaging, and metabolic assessments.

A growing public health concern

PCOD is increasingly being recognised as a lifestyle disorder rather than just a reproductive condition. As urbanisation continues to reshape daily life, the number of women at risk is expected to rise. Public awareness, workplace wellness initiatives, and accessible healthcare screening are essential to address this growing epidemic. PCOD in urban India is a silent but significant health challenge. While not every woman will develop the condition, many carry risk factors that can lead to long-term complications if ignored. The path forward is clear: awareness, early detection, and sustainable lifestyle changes. In a fast-paced urban world, prioritising hormonal and metabolic health is no longer optional – it is essential.