This blog post is based on insights from Dr. Anjali Kumar’s interview on the Gut Feeling with Dr. Pal YouTube video: “Women’s Health Crisis: PCOS, Infertility & Menopause with Dr. Anjali Kumar”.
What if I told you that 1 in every 3 to 5 women is suffering from a hidden hormonal condition that could steal their fertility, wreck their metabolism, and set them up for diabetes, cancer, and heart disease? Dr. Anjali Kumar, a veteran gynecologist with over 30 years of experience, calls it a “gynecological epidemic”—and she says modern lifestyles are the main culprit.
In this eye-opening interview, Dr. Kumar reveals why half her OPD is now filled with PCOS and infertility cases (a chapter doctors used to skip in medical school), how stress is literally breaking women’s ovaries, and why the solution isn’t another birth control pill—it’s taking back control of your body. Whether you’re 18 and struggling with irregular periods, 30 and planning a family, or 50 and terrified of menopause, this guide will change how you think about women’s health forever.
The Silent Epidemic: Why PCOS & Infertility Are Exploding
What a “Normal” Menstrual Cycle Actually Looks Like
Before we talk about what’s wrong, let’s understand what’s right. Dr. Kumar emphasizes there’s no such thing as a “perfect” 28-day cycle. Normal can vary widely:
| Parameter | Normal Range | When to Worry |
| Cycle Length | 22-35 days | Variation >8 days from your usual |
| Flow Duration | 2-7 days | Needing 3-4 painkillers daily |
| Pain Level | Mild discomfort occasionally | Severe pain requiring medication |
| Bleeding | Only during period | Bleeding between periods, after sex, or post-menopause |
“The periods don’t just happen at the uterus and ovary—it starts at the level of the brain,” Dr. Kumar explains. —Dr. Anjali Kumar, timestamp approx.
The entire menstrual story begins with the HPO axis (hypothalamic-pituitary-ovarian axis). Think of it as a hormonal assembly line:
- Brain (Hypothalamus): Releases hormones that signal the pituitary gland
- Pituitary Gland: Sends follicle-stimulating hormone (FSH) to the ovaries
- Ovaries: Develop follicles, release estrogen, and eventually ovulate
- Uterus: Prepares lining for possible pregnancy
For example, when you’re stressed about exams or work deadlines, your brain essentially shouts “CODE RED!” and short-circuits this entire axis. The result? Missed or irregular periods.
The PCOS Explosion: From Rare to Every Third Woman
“When I did my postgraduation in 1991, PCOS was a small chapter in our books. Today, half my OPD is PCOS and infertility,” Dr. Kumar reveals. —Dr. Anjali Kumar, timestamp approx.
Polycystic Ovary Syndrome (PCOS) isn’t actually a disease—it’s a syndrome, meaning it’s a collection of symptoms with multiple root causes. In PCOS:
- Multiple tiny follicles start developing in the ovary
- None become strong enough to ovulate
- They all secrete bits of estrogen, creating hormonal chaos
- The ovary looks like a “bunch of grapes” on ultrasound
For example, Dr. Kumar describes it like this: “Why is the damn ovary not ovulating? The primary function of the ovary is to ovulate!” —Dr. Anjali Kumar, timestamp approx.
The Stress-Sleep-PCOS Connection
Stress is a major driver of PCOS, but not in the way you think. Dr. Kumar’s research shows:
- High cortisol (stress hormone) and low melatonin (sleep hormone) directly disrupt ovulation
- Women in high-pressure jobs (like IT/BPO) have significantly higher PCOS rates
- The problem often starts in Class 10-11, when girls face academic pressure, social media stress, and poor diet
“We are actually paying the price for being modern in our lifestyles,” Dr. Kumar warns. —Dr. Anjali Kumar, timestamp approx.
For example, Dr. Kumar observes: “Twenty years back, nobody did yoga classes. Our grandmothers never had PCOS. They were physically active all day and never had Swiggy and Zomato.” —Dr. Anjali Kumar, timestamp approx.
Beyond the Pill: Why Medication Isn’t Your Savior
The Birth Control Pill Myth
Dr. Kumar gets visibly upset when talking about how doctors treat PCOS:
“A 14-year-old girl being put on oral contraceptive pills—that’s bad medicine,” she states bluntly. —Dr. Anjali Kumar, timestamp approx.
The problem? Birth control pills don’t cure PCOS. They mask symptoms. Sure, they regulate periods and reduce acne temporarily, but they don’t fix the root cause: insulin resistance.
Insulin resistance means your cells don’t respond properly to insulin, so your pancreas pumps out more. This high insulin:
- Stimulates ovaries to produce excess androgens (male hormones)
- Causes acne, facial hair, and scalp hair loss
- Leads to weight gain, especially around the belly
- Increases risk of diabetes, fatty liver, and heart disease
For example, Dr. Pal shares his own story: “I was 100 kilos before. I lost 30 kilos with fasting, but I didn’t do strength training. I became ‘skinny fat’—my body fat percentage was 29% even though I looked thin.” —Dr. Pal Manikam, timestamp approx.
The Real Solution: Weight Loss & Strength Training
“Weight loss—even 5% of your body weight—can bring about changes in all PCOS markers,” Dr. Kumar insists. —Dr. Anjali Kumar.
For a 100 kg woman, losing just 5 kg can:
- Restart ovulation
- Improve insulin sensitivity
- Reduce acne and hair fall
- Improve mood and energy
But here’s the key: It’s not just about losing weight—it’s about losing fat and gaining muscle.
Dr. Kumar explains sarcopenia (age-related muscle loss):
- You lose 1% muscle mass every year after age 30 unless you actively prevent it
- Strength training is non-negotiable
- “Every woman from age 45 needs to exercise MORE than a 25-year-old,” she emphasizes. —Dr. Anjali Kumar.
For example, Dr. Kumar shares her own routine: “I do yoga 4 days a week and strength training 3 days. I miss only if I’m stuck in the hospital. I’m nearing 60, but menopause has been the BEST phase of my life.” —Dr. Anjali Kumar.
The Gut-Brain-Hormone Connection No One Talks About
How Your Gut Controls Your Ovaries
Here’s a mind-blowing connection: PCOS might start in your gut.
Dr. Pal explains the research:
- High-fat diets increase intestinal permeability (“leaky gut”)
- Bacteria leak into the bloodstream, triggering inflammation
- Inflammation blocks insulin from reaching cells
- High insulin disrupts the HPO axis
- Result: No ovulation, PCOS symptoms
For example, “High-fat diet inhibits bile acids, which are necessary to regulate cholesterol. This increases follicular genesis problems. Instead of giving expensive IL-22 treatments, why not just decrease the fat?” —Dr. Pal Manikam, timestamp approx.
The Indian Diet Advantage (If You Don’t Mess It Up)
“Indian food is extremely healthy—if there’s no adulteration with processed foods,” Dr. Kumar confirms. —Dr. Anjali Kumar.
The problem isn’t dal-chawal-roti-sabzi. It’s:
- Ultra-processed foods (packaged snacks, baked goods)
- Eating out (practically every second day vs. once in 3 months in our grandparents’ time)
- Excessive fats AND carbs (especially refined carbs)
- Artificial sweeteners (alter gut bacteria)
Dr. Pal’s simple formula:
- Each meal: 1 cereal + 1 lentil + 1 fruit + 1 vegetable
- Seasonal and local foods only
- No packaged foods at all
For example, Dr. Kumar’s research found that reducing carbs to just 100g per day (from the typical 300g in Indian diets) could resolve PCOS symptoms so effectively that “we can close all the IVF centers.” —Dr. Anjali Kumar.
Your Fertility Timeline: When to Worry & What to Do
The Sad Truth: Ideal Age vs. Reality
“The ideal time to get pregnant is early 20s,” Dr. Kumar states. —Dr. Anjali Kumar, timestamp approx.
But she acknowledges reality: careers, finding the right partner, and financial stability delay this. The problem? Age is the single most important variable for fertility. There’s an exponential decline after 30.
When to seek help:
- Under 35: Try for 1 year before seeking medical help
- Over 35: Don’t wait—seek help after 6 months
- Over 40: Immediate evaluation
Egg Freezing: Your Biological Insurance Policy
If you’re delaying pregnancy, egg freezing is an option—but Dr. Kumar stresses it’s not a guarantee.
How it works:
- AMH blood test (anti-mullerian hormone) checks ovarian reserve
- Ovarian stimulation with hormones for 10-12 days
- Egg retrieval through vagina (15-minute procedure)
- Freezing eggs at -196°C
Key facts:
- Best age: 25-30 (earlier = better quality eggs)
- How many: Ideally 10-15 eggs for decent success rates
- Success rate: Only 40-50% of frozen eggs become embryos
- Storage: Can be stored indefinitely
For example, Dr. Kumar shares: “A 32-year-old corporate professional came to me with a missed period. Her AMH was 0.1—almost premature ovarian failure. She thought she had time, but her eggs had other plans.” —Dr. Anjali Kumar, timestamp approx.
The Male Factor: Why Men Are 40% of the Problem
“In infertility, 40% is female factor, 40% male factor, 10% both, and 10% unexplained,” Dr. Kumar reveals. —Dr. Anjali Kumar, timestamp approx.
Yet women bear 100% of the invasive procedures. Dr. Kumar is frustrated that vasectomy rates in India are “very, very poor” while women undergo major surgery for tubal ligation.
Sperm issues that cause infertility:
- Low sperm count
- Poor motility (movement)
- Abnormal morphology (shape)
- High DNA fragmentation
Smoking is enemy #1 for sperm health, causing:
- 50% reduction in sperm count
- Poor motility
- Higher DNA damage
- Increased abortion rates
For example, Dr. Kumar describes a typical scenario: “I asked a couple in my OPD if anyone smokes. The mother-in-law immediately jumps in: ‘Oh, my son smokes because of IT stress.’ She’s justifying it! Meanwhile, the daughter-in-law—the one most affected—sits quietly.” —Dr. Anjali Kumar, timestamp approx.
Menopause: The Phase No One Prepares You For
What to Expect (And Why It’s Not All Bad)
“Never get scared of menopause. It’s a natural transition—celebrate the wisdom you’ve acquired,” Dr. Kumar advises. —Dr. Anjali Kumar, timestamp approx.
Common symptoms:
- Hot flashes and night sweats (lasts 2-3 years typically)
- Mood changes
- Weight gain (especially around belly)
- Sleep disturbances
- Decreased libido
The biggest risks after menopause:
- Osteoporosis (bone loss)
- Cardiovascular disease (heart attacks, strokes)
Strength Training: Your Menopause Superpower
“Every woman from age 45 needs to exercise MORE than a 25-year-old,” Dr. Kumar emphasizes. —Dr. Anjali Kumar, timestamp approx.
Why?
- Estrogen drops after menopause, removing natural protection for bones and heart
- Strength training builds muscle, strengthens bones, and improves insulin sensitivity
- “Use it or lose it”—without exercise, you lose 1% muscle mass yearly
Dr. Kumar’s personal routine:
- 4 days/week: Yoga (for flexibility and mental peace)
- 3 days/week: Strength training with bands
- Result: “I’m nearing 60, but menopause has been the best phase of my life. I’m at my fittest.” —Dr. Anjali Kumar.
Hormone Replacement Therapy (HRT): Proceed With Caution
HRT can help severe menopause symptoms, but it’s not for everyone.
Risks include:
- Blood clots (DVT)
- Breast cancer
- Endometrial cancer
Who should NOT take HRT:
- Smokers
- Obese women
- Women with clotting disorders
- Those with strong family history of breast cancer
“Never take HRT just because your friend is taking it. It’s a decision taken after detailed discussion with your doctor,” Dr. Kumar warns. —Dr. Anjali Kumar, timestamp approx.
The Cancer Screenings That Could Save Your Life
Cervical Cancer: The Preventable Killer
India has one of the highest cervical cancer rates in the world, yet it’s 100% preventable with screening.
Screening guidelines:
- Start at age 21 (regardless of sexual activity)
- Pap smear every 3 years OR Pap + HPV test every 5 years
- HPV vaccine: Ages 9-26 (best), 26-45 (rescue vaccination), after 45 (useless)
How pap smear works:
- Takes 2 minutes
- Not painful
- Collects cells from cervix
- Can detect pre-cancer 7-8 years before it becomes cancer
- Simple treatment (cryotherapy, excision) can cure pre-cancer
For example, “A 24-year-old pregnant woman came to me feeling a lump. It was breast cancer. We had to give chemo during pregnancy, deliver early at 32 weeks, then do mastectomy. Pregnancy doesn’t protect you from cancer.” —Dr. Anjali Kumar, timestamp approx.
Breast Cancer: When to Start Mammograms
“Every woman should get annual mammograms starting at age 40,” Dr. Kumar insists. —Dr. Anjali Kumar, timestamp approx.
Common myths debunked:
- Myth: Mammograms cause cancer
Truth: Risk from radiation is much less than missing a diagnosis - Myth: If I have no family history, I’m safe
Truth: Most breast cancer patients have no family history - Myth: Breastfeeding completely protects you
Truth: It reduces risk but doesn’t eliminate it
Self-breast exam: Be breast aware, but don’t rely on it alone. You can only feel lumps >1-2 cm. A mammogram can detect cancer at <1 cm when prognosis is excellent.
Taking Control: Your Action Plan for Lifelong Health
The Four Pillars of Women’s Health
| Pillar | What to Do | Why It Matters |
| 1. Move Your Body | 30-60 min daily (yoga + strength training) | Builds muscle, reduces insulin resistance, strengthens bones |
| 2. Eat Real Food | 1 cereal + 1 lentil + 1 fruit + 1 veg per meal | Balances blood sugar, feeds good gut bacteria |
| 3. Sleep Like Your Life Depends On It | 7-8 hours, 10 PM-6 AM window | Repairs hormones, reduces cortisol, improves ovulation |
| 4. Manage Stress | Meditation, breathing, boundaries | Protects HPO axis, reduces inflammation |
Setting Boundaries: The “Selfish” Skill Every Woman Needs
“For every woman watching this: You must be selfish when it comes to self-care,” Dr. Kumar declares. —Dr. Anjali Kumar, timestamp approx.
Practical ways to set boundaries:
- Schedule your workout like a non-negotiable doctor’s appointment
- Tell family: “This one hour is mine. Don’t disturb me.”
- Learn to cook (it’s a life-saving skill, not a gender role)
- Say no to late-night work emails that disrupt sleep
For example, Dr. Kumar shares: “In my family, everybody knows that one hour is mine. I’ve set those boundaries. Every woman must realize: Your health is your responsibility, nobody else’s.” —Dr. Anjali Kumar, timestamp approx.
Frequently Asked Questions (FAQ)
Q1: Can PCOS be reversed without medication?
A: Yes, but it requires lifestyle changes, not just pills. Dr. Kumar emphasizes that 5% weight loss alone can restart ovulation and normalize hormones. Combine this with strength training, proper sleep, and stress management. Birth control pills only mask symptoms—they don’t cure the insulin resistance at the root.
Q2: What’s the best age to get pregnant, and when should I worry about infertility?
A: Biologically, early 20s is ideal for easiest conception and healthiest pregnancy. However, if you’re under 35 and haven’t conceived after 1 year of trying, see a doctor. If you’re over 35, wait only 6 months. After 40, seek immediate evaluation. If you’re delaying pregnancy, get your AMH tested at 25-30 and consider egg freezing.
Q3: Is Hormone Replacement Therapy (HRT) safe during menopause?
A: HRT can help severe symptoms but carries risks like blood clots and breast cancer. It’s NOT for smokers, obese women, or those with clotting disorders. “Never take HRT just because a friend is taking it,” Dr. Kumar warns. Always discuss with your doctor first.
Q4: How often should I get cancer screenings?
A: Pap smears start at 21 (every 3 years). Mammograms start at 40 (annually). Dexa scans for osteoporosis should begin at menopause or age 50. If you have strong family history, you may need earlier or more frequent screening. Annual health checkups are non-negotiable.
Q5: Can stress alone cause infertility?
A: Stress is a major trigger but works with other factors. High cortisol and low melatonin disrupt the brain-ovary connection (HPO axis), preventing ovulation. Combine stress with poor sleep, processed food, and inactivity, and you create a “perfect storm” for PCOS and infertility. Managing stress through yoga, sleep, and boundaries is critical.
Conclusion: Your Health Is Your Responsibility—Own It
The gynecological epidemic of PCOS, infertility, and early menopause isn’t random—it’s the price of modern lifestyles. But you can fight back. Move your body daily. Eat real, simple food. Sleep 7-8 hours. Manage stress ruthlessly. And most importantly, take control of your health instead of relying solely on pills and doctors.
For every woman watching this: Be selfish about your self-care. Set boundaries. Your health is nobody else’s responsibility. —Dr. Anjali Kumar, timestamp approx.
Which of these four pillars will you start with today? Share in the comments—your journey might inspire another woman to take her first step.
Ready to measure your health? Start with two simple actions this week:
- Track your first and last bite to calculate your eating window
- Add one strength training session (even 15 minutes with resistance bands)
One belly at a time, one woman at a time—we can reverse this epidemic.
Credit & Call-to-Action
This blog post is based on insights from Dr. Anjali Kumar’s interview on the Gut Feeling with Dr. Pal YouTube video: “Women’s Health Crisis: PCOS, Infertility & Menopause with Dr. Anjali Kumar”.
Dr. Anjali Kumar is the founder of Maitri (meaning “friendship”), a platform empowering women with credible, evidence-based health information. Maitri is now a WHO “Voice You Can Trust” and reaches women in 41+ countries.
Dr. Pal shares his own health journey of losing 30 kg and reversing his “skinny fat” condition. Follow his channels Gut Feeling with Dr. Pal for more health transformation stories.
