Polycystic ovary syndrome (PCOS) is a hormonal disorder associated with increased risks of type II diabetes and cardiovascular disease. It is also the leading cause of female infertility worldwide. Both lifestyle and genetic factors have been tied to the condition, and in the last couple of decades, it has been affecting a growing number of urban Indian middle-class women; whereas global prevalence is in the 4–11% range, studies in India suggest a prevalence of around one in four urban middle-class women. In this article, I focus on the lived experiences of women with the condition. Drawing from ethnographic fieldwork in Mumbai, India, I use an ecosocial approach to examine barriers to the management of PCOS commonly experienced by women. Such an examination reveals potential bases for intervention to improve management outcomes, particularly as they relate to strengthening the patient–practitioner relationship and improving the clinical encounter.
AcharyaA., ReddaiahV.P., & &BaridalyneN. (2006). Nutritional status and menarche in adolescent girls in an urban resettlement colony of South Delhi. Indian Journal of Community Medicine, 31(4), 302–303.
2.
Amsterdam ESHRE/ASRM-Sponsored 3rd PCOS Consensus Workshop Group. (2012). Consensus on women’s health aspects of polycystic ovary syndrome (PCOS). Human Reproduction, 27(1), 14–24.
3.
AppaduraiA. (1981). Gastro-politics in Hindu South Asia. American Ethnologist, 8(3), 494–511.
4.
BaggaA., & KulkarniS. (2000). Age at menarche and secular trend in Maharashtrian (Indian) girls. Acta Biologica Szegediensis, 44(1–4), 53–57.
5.
BalenA., DresnerM., ScottE. M, & DrifeO J. (2006). Should obese women with polycystic ovary syndrome receive treatment for infertility. British Medical Journal, 332, 434.
6.
BalenA., HomburgR., & FranksS. (2009). Defining polycystic ovary syndrome. British Medical Journal, 338(7692), 426.
7.
BalenA., & RutherfordA. (2007). Managing anovulatory infertility and polycystic ovary syndrome. British Medical Journal, 335, 663.
8.
BoomsmaC. M., FauserB., & MacklonN. S. (2008). Pregnancy complications in women with polycystic ovary syndrome. Seminars in Reproductive Medicine, 26(1), 72–84.
9.
CussonsA., StuckeyB., WalshJ. P., BurkeV., & &NormanR. (2005). Polycystic ovariansyndrome: Marked differences between endocrinologists and gynaecologists in diagnosis and management. Clinical Endocrinology, 62(3), 289–295.
10.
DambhareD., WaghS., & DudheJ. (2012). Age at menarche and menstrual cycle pattern among school adolescent girls in Central India. Global Journal of Health Science, 4(1), 105–111.
11.
DeshpandeS. (Ed.). (2003). The centrality of the middle class. In Contemporary India: A sociological view (pp. 125–150). Penguin.
12.
DonnerH., & de NeveG. (2011). Introduction. In DonnerH. (Ed.), Being middle-class in India: A way of fife (pp. 1–22). Routledge.
13.
DumesicD. A., OberfieldS. E., Stener-VictorinE., MarshallJ.C., LavenJ. S., & LegroR. S. (2015). Scientific statement on the diagnostic criteria, epidemiology, pathophysiology, and molecular genetics of polycystic ovary syndrome. Endocrine Reviews, 36(5), 487–525.
14.
EcksS. (2010). Spectacles of reason: An ethnography of Indian gastroenterologists. In EdwardsP. H. J., & WadeP. (Eds.), Technologized images, technologized bodies (pp. 117–135). Bergahn Books.
15.
EhrmannD.A. (2005). Polycystic ovary syndrome. New England Journal of Medicine, 352, 1223–1236.
16.
FeeE., & KriegerN. (1993). Understanding AIDS: Historical interpretations and the limits of biomedical individualism. American Journal of Public Health, 83(10), 1477–1486.
17.
FernandesL. (2006). India’s new middle class: Democratic politics in an era of reform. University of Minnesota Press.
18.
FernandesL., & HellerP. (2006). Hegemonic aspirations: New middle-class politics and India’s democracy in comparative perspective. Critical Asian Studies, 38, 495–522.
19.
FranksS. (1995). Polycystic ovary syndrome. New England Journal of Medicine, 333, 853–861.
20.
GhoshJ. (2009). Tuition culture. Frontline, 26(22), Oct 24–Nov 6.
21.
GoranM.I., & GowerB. A. (2001). Longitudinal study on pubertal insulin resistance. Diabetes, 50(11), 2444–2450.
22.
InhornM. (2015). Cosmopolitan conceptions: IVF Sojourns in global Dubai. Duke University Press.
23.
JoshiB., MukherjeeS., PatilA., PurandareA., ChauhanS., & VaidyaR. (2014). A cross-sectional study of polycystic ovarian syndrome among adolescent and young girls in Mumbai, India. Indian Journal of Endocrinology and Metabolism, 18(3), 317–324.
24.
KitzingerC., & WillmottJ. (2002). ‘The thief of womanhood’: Women’s experience of polycystic ovarian syndrome. Social Science & Medicine, 54, 349–361.
25.
KhadilkarV. V., StanhopeR.G., & &KhadilkarV. (2006). Secular trends in puberty. Indian Pediatrics, 43, 475–478.
26.
KhannaG., & KapoorS. (2004). Secular trend in stature and age at menarche among Punjabi Aroras residing in New Delhi, India. Coolegium Anthropologicum, 28(2), 571–575.
27.
KriegerN. (1994). Epidemiology and the web of causation: Has anyone seen the spider? Social Science & Medicine, 39, 887–903.
28.
KriegerN. (2001). Theories for social epidemiology in the 21st century: An ecosocial approach. International Journal of Epidemiology, 30(4), 668–677.
29.
LeibelN. I., BaumannE. E., KocherginskyM., & &RosenfieldR. L. (2006). Relationship of adolescent polycystic ovary syndrometo parental metabolic syndrome. The Journal of Clinical Endocrinology and Metabolism, 91(4), 1275–1283.
30.
MazzarellaW. (2005). Middle class. In DwyerR. (Ed.), South Asia keywords. School of Oriental and African Studies. https://www.soas.ac.uk/south-asia-institute/keywords/file24808.pdf
31.
MisraA., & KhuranaL. (2008). Obesity and the metabolic syndrome in developing countries. The Journal of Clinical Endocrinology & Metabolism, 93(11), S9–S30.
32.
NichterM. (1996). Popular perceptions of medicine: A South Indian case study. In M. Nichter & M. Nichter (Eds.), Anthropology and international health: Asian case studies (pp. 203–238). Kluwer Academic Publishers.
33.
NichterM., Nichter&, & (Eds.)M.. (1996). Modern methods of fertility regulation: When and for whom are they appropriate?Anthropology and international health: Asian case studies (pp. 71–108). Gordon and Breach Publishers.
34.
PanigrahiS. (2012, 15 Dec.). System fails, tuition culture in thing. New Indian Express.
35.
PathakG., & NichterM. (2015). Polycystic ovary syndrome in globalizing India: An ecosocial perspective on an emerging lifestyle disease. Social Science & Medicine, 146, 21–28.
36.
RokadeS., & ManeA. (2008). A study of age at menarche, the secular trend and factors associated with it. Internet Journal of Biological Anthropology, 3(2). https://ispub.com/IJBA/3/2/7469
37.
Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. (2004). Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Human Reproduction, 19(1), 41–47.
38.
SheehanM. T. (2004). Polycystic ovarian syndrome: Diagnosis and management. Clinical Medicine and Research, 2(1), 13–27.
39.
Sir-PetermannT., AngelB., MaliqueoM., CarvajalF., SantosJ., & Pérez-BravoF. (2002). Prevalence of type II diabetes mellitus and insulin resistance in parents of women with polycystic ovary syndrome. Diabetologica, 45(7), 959–964.
40.
SoulezB., DidierD., & RosenfieldR. L. (1996). Polycystic ovary syndrome: A multidisciplinary challenge. Endocrinologist, 6(1), 19–29.
41.
StokkenR. (2009). The patient educated patient: A health-care asset of problem? Social Theory & Health, 7, 81–99.
42.
SwaminathanS., SelvamS., ThomasT., KurpadA. V., & VazM. (2011). Longitudinal trends in physical activity patterns in selected urban South Indian school children. Indian Journal of Medical Research, 134(2), 174–180.
43.
WijeyaratneC., UdayanganiD. S.A., & &BalenA. (2013). Ethnic-specific polycystic ovary syndrome: Epidemiology, significance, and implications. ExpertReview of Endocrinology and Metabolism, 8(1), 71–79.
44.
WilsonC. (2010). ‘Eating, eating is always there’: Food, consumerism and cardiovascular disease. Some evidence from Kerala, South India. Anthropology and Medicine, 17(3), 261–275.
45.
YajnikC. S., & YudkinJ. S. (2004). The Y-Y paradox. The Lancet, 363(9403), 163.
