Why more women under 30 are facing PCOS and hormonal imbalance, experts explain

A growing number of young women are experiencing hormonal imbalance and fertility-related concerns earlier than previously observed, with experts pointing to a combination of biological changes and modern lifestyle factors.

Doctors say clinical patterns are shifting, with conditions that were once more common among women in their late 30s now increasingly being diagnosed in those in their 20s.

Priti Arora Dhamija, senior consultant and lead IVF specialist at Sitaram Bhartia Institute of Science and Research, told PTI that the trend reflects a broader change in women’s health.

“There is a clear and concerning shift in women's health today, where issues related to hormonal imbalance and fertility are appearing much earlier than we traditionally observed,” she said.

Dhamija noted that one contributing factor is the earlier onset of puberty.

“Many girls now attain menarche as early as 8–9 years, which can lead to a relatively earlier decline in ovarian reserve,” she said.

Studies published in journals such as The Lancet Child and Adolescent Health have documented a gradual decline in the age of puberty onset over recent decades, linked to improved nutrition as well as rising obesity and environmental exposures.

Experts said that biological factors alone do not explain the trend, with lifestyle patterns contributing significantly.

Dhamija pointed to high-stress environments, irregular sleep cycles, excessive screen time, poor diet and limited physical activity as key factors.

“These factors contribute to rising rates of obesity, PCOS, and metabolic disturbances in the early 20s,” she said.

She added that chronic stress can disrupt the body’s hormonal regulation systems, leading to irregular ovulation and imbalance.

“Environmental exposure to hormone-like substances through food and pollution is an emerging concern as well,” Dhamija told PTI.

Juhi Bharti, additional professor in the Department of Obstetrics and Gynaecology at AIIMS, Delhi, said clinicians are increasingly observing reduced ovarian reserve in younger women.

“We are now observing diminished ovarian reserve in women in their late 20s, a trend that was previously more common in the late 30s,” she said, adding that early awareness and intervention are important.

Data from the Indian Society of Assisted Reproduction and international studies also indicate a rise in cases of diminished ovarian reserve and Polycystic Ovary Syndrome among women under 30.

PCOS is estimated to affect nearly one in five women of reproductive age in India, according to various studies.

Experts emphasised that reproductive health is closely linked to overall well-being.

“Poor sleep doesn’t just cause fatigue, it disrupts hormonal signalling, may accelerate reproductive ageing, and impacts fertility potential,” Bharti said, highlighting the importance of maintaining regular sleep patterns.

Echoing similar concerns, Bhawani Shekhar, associate consultant at Sir Ganga Ram Hospital, said doctors are increasingly seeing symptoms such as irregular menstrual cycles, PCOS and early signs of ovarian ageing in younger patients.

She attributed this to unhealthy diet, sedentary lifestyle, lack of exercise, along with smoking and alcohol consumption.

“Chronic stress increases cortisol levels and poor sleep affects the circadian rhythm, further impacting hormone levels and ovarian health,” she said.

Focus On Prevention

Despite the concerning trend, experts said many of the contributing factors are modifiable.

“The focus needs to shift towards prevention. Prioritising balanced nutrition, regular physical activity, adequate sleep and stress management can help maintain hormonal balance and reproductive health,” Shekhar told PTI.