Graphic by Sunny Wei ‘23
By Shloka Gidwani ’22
Contributing Writer
When Sara Ali Khan, a famous Bollywood actress in India, endorsed a fitness app called “HealthifyMe,” her face was emblazoned on billboards all across the city of Mumbai. Khan claimed that she had lost over 80 pounds during her fitness journey. Khan has been candid about her struggle with Polycystic Ovarian Syndrome, a hormonal disorder that causes irregular periods, weight gain, acne and [the production of] excess androgens due to the presence of cysts in the ovaries.
As a person who struggles with PCOS, it is disheartening to see reductive ads like these claim to “solve” a chronic condition. Khan, of course, had all the resources available to her to lose weight for Bollywood’s unrealistic standards of beauty. It invisibilizes the rest of us, who suffer from a myriad of underlying symptoms, such as diabetes, infertility, excess body hair and male-pattern baldness. People with reproductive health issues are in dire need of a treatment plan that steers away from fitness apps like “Healthify”.
Ad campaigns such as Khan’s point to the commercialization of PCOS, a disease that affects an estimated 5 million women of childbearing age in the U.S., according to Penn Medicine. The Journal of Clinical Endocrinology and Metabolism estimated that PCOS treatment cost $8 billion nationwide in 2020, including fertility treatments, weight loss programs and hair removal procedures. The fitness and hair removal industries’ existence as a part of this treatment highlights that people with PCOS are being used as a target audience for ad campaigns, rather than patients afflicted with a condition that needs to be treated.
The problem of fatphobia and sexism in the medical community further worsens this issue because providers often focus on treating symptoms such as weight gain, hair loss and hirsutism rather than other underlying concerns related to PCOS. In my own experience, doctors dismissed my claims of painful periods and PMS, claiming that I had “Lean PCOS,” a term for people with PCOS who do not experience severe symptoms of weight gain. Often, mental health issues related to PCOS also go undiagnosed, as the condition is associated with an increased risk of depression, anxiety and low self-esteem, according to the National Center for Biotechnology Information.
“I definitely think that there should be more of a focus on mental health while diagnosing PCOS, especially since birth control is a common treatment for the condition,” Isabel McIntyre ’22, who has PCOS, said. “This isn’t talked about a lot, but birth control causes detrimental side effects to mental health, and [this] needs to be addressed.”
According to Perla Health, people with PCOS are also more likely to experience low self-esteem, psychological distress and eating disorders due to the physical manifestations of the disease. Appearance-based symptoms such as weight gain, acne and hirsutism lead to issues with body image.
“I remember being 12 years old, and all of a sudden, I was gaining weight and … had a lot of acne I did not have before. At the same time, I was seeing in the media that those characteristics are considered bad,” McIntyre said. She concluded that it would have been helpful to have seen affirming messages that her body is “okay and valid and worthy no matter what it looks like.” What people with PCOS need are not fitness apps and targeted ads, but rather a sensitive, holistic approach to their health.
The fact that appearance-based symptoms are the only symptoms treated in the context of reproductive health sends a harmful message. It reinforces the idea that people with uteruses are only valued for their appearance, and diminishes their personal struggles. This creates problems with “invisible” reproductive illnesses such as endometriosis, which often goes undiagnosed due to the lack of appearance-based symptoms, as stated by Endometriosis News.
“There is a general lack of full picture information when it comes to reproductive health,” co-president of Mount Holyoke’s Planned Parenthood Generation Action JoJo Zeitlin ’22 said. “In general, stigmas around reproductive health also contribute to these issues.” PPGA’s co-president Cait Mallery ’22 added that the combined stigmas surrounding mental health and reproductive health tie together and impact patient diagnosis and treatment plans. The lack of healthy conversations around reproductive health incentivizes corporations to prey on patients looking for concrete solutions to their issues. A report on the Global PCOS treatment market by Bristol-Myers Squibb Company valued the PCOS market at over $3 billion, with health care corporations such as Bristol-Myers Squibb Company, Bayer AG, Pfizer, Inc. and Abbott Laboratories taking advantage of this.
“The answer is listening to the voices of the people who are facing these conditions,” Mallery said.
On addressing the lack of mental health awareness in reproductive health, Mallery said, “Reproductive justice is not only about bringing awareness to how mental health is compounded by physical health issues. It is also how circumstances such as lack of access to health care [and] lack of a safe community to raise a family contribute to mental illnesses.”
As a person with PCOS, I expect that the medical community take my diagnosis seriously, and treat mental health and internal symptoms along with appearance-based ones. The commercialization of reproductive health needs to stop, and the medical community should be responsible for keeping corporations in check by promoting messaging that puts patient care first.