PCOS: hidden toll of academic pressure on health among young girls

Studies establish a clear link between stress and PCOS and in Indian adolescents, the most common cause of stress is academic.

September 22, 2023 12:10 pm | Updated 02:57 pm IST

Unreasonable pressure to overachieve does lead to ovarian cysts. Image for representational purpose only.

Unreasonable pressure to overachieve does lead to ovarian cysts. Image for representational purpose only. | Photo Credit: Getty Images/iStockphoto

In September, amid PCOS awareness month, a concerning reality emerges: academic pressure may unknowingly contribute to a silent health crisis among young girls. It starts in classrooms but often leads to gynaecologists’ offices, where ultrasound scans reveal ovarian cysts, resulting in a diagnosis of Polycystic Ovary Syndrome (PCOS).

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As a doctor who had recently graduated, I found myself in such an office, confronting this condition, rooted in a high-stress, self-care-deprived lifestyle imposed by my demanding environment. Alongside recommendations for lifestyle changes—like a high-protein diet, daily exercise, and stress reduction—I was told, that my health issue stemmed from my less-than-ideal lifestyle during 15 of my 28 years, enforced by relentless academic pressure.

This narrative echoes through countless young women’s lives in India, raising a pivotal question: Is our competitive education shaping a generation prone to PCOS?

Let’s explore the intricate link between education, lifestyle, and health in India—a matter of great significance.

Various studies and reports, including those by The Hindu, reveal PCOS as an increasingly common health issue among modern Indian women. One in five women in India grapples with PCOS, with 60% of those seeking infertilitytreatments doing so due to PCOS-related problems. Gynaecologists nationwide concur that this condition is on the rise.

PCOS lacks a single known cause. It affects individuals with a genetic predisposition, often marked by a family history of diabetes or obesity, exposed to environments that encourage neither a healthy diet nor regular exercise and are stress-laden.

Research confirms that adolescents raised in environments conducive to healthy choices have a lower risk of developing PCOS. Unfortunately, such environments are scarce, especially for students in the Indian context.

Physical education classes, where they exist, are typically once a week for a mere 30-45 minutes, a trend that has worsened, as revealed by the 2022 India Report Card team. This falls far short of the WHO’s recommendations for adolescent physical exercise, suggesting at least 60 minutes of aerobic activity and strength training three times a week.

Srijana, a student from Guwahati, reflects: “Throughout my schooling, PE classes were often borrowed by a math/science teacher to finish the syllabus. Now, in twelfth grade, I shuttle from tuition to school to home, leaving no time for exercise.”

Mohammad Aslam Ali, a medical professional, adds insight, “The narrative is that non-academic activities are a waste of time. With parents enrolling children in tuition and coaching classes, sometimes from kindergarten, there’s little time or motivation for physical activity. Many women only start exercising when health scares or infertility emerge.”

Experts in neuroscience, however, emphasise that fostering physical activity must start in childhood; those neglecting exercise in youth find it hard to initiate later when health issues arise.

The highly competitive education system not only makes normal expectations for physical activity unattainable but also subjects adolescents to extreme stress. Studies establish a clear link between stress and PCOS and in Indian adolescents, the most common cause of stress is academic.

Dr Aslam points out, “Academic stress can be productive if channelled effectively, but education on coping skills and emotion regulation is overlooked in India. Most Indian schools lack mental health professionals to assist students with stress.”

Indian parents often lack tools to teach healthy resilience, becoming pressure points by imposing unrealistic academic performance expectations.

Stress-induced hormonal changes alter body composition, predisposing young women to PCOS.

PCOS is now the most prevalent endocrine disorder among young Indian women, impacting their lives from diabetes, obesity, and heart disease to mental health challenges like depression and anxiety. It also leaves them grappling with fertility issues and cosmetic concerns, including increased body hair, facial hair, and scalp hair loss.

While education and ambition empower women, we must not neglect health. The growing prevalence of PCOS urges us to consider how our societal narratives affect our children’s future health and well-being.

Encouraging exercise is vital, as is ensuring children have time for it. A robust and universal physical education syllabus which focuses on accessibility is paramount. Parents disentangling themselves from the prestige or status narrative of academic success and understanding that various routes to success exist that do not involve academic excellence is a crucial way to relieve some pressure on the students. Including mental health and stress management skills in the curriculum is not only a necessity but also a responsibility.

Keep in mind that women facing health challenges will face several obstacles to achieving success in life.

(Dr. Christianez Ratna Kiruba is a 29-year-old Internal Medicine doctor with a passion for writing and patient rights advocacy.

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