Breaking Barriers: Why Reproductive Health Equity Matters
Mariam is a 19-year-old newlywed. In her culture, women are expected to have a child within the first year of marriage. As Mariam’s first anniversary approaches, she still isn’t pregnant. The elders in her community have started whispering, calling her “barren” and saying, “She must have done things before marriage; that’s why she can’t have children.” At every opportunity, someone mentions her inability to conceive. It has gotten so bad that Mariam now avoids social gatherings. She goes straight to the market and then home, barely seeing her friends. She can’t bear to hear the gossip that follows her everywhere.
Even at home, she doesn’t feel safe. Her husband makes comments about taking another wife if she doesn’t get pregnant soon. Mariam gains weight. People assume she’s expecting, but she isn’t. Then she grows facial hair; whispers turn cruel, calling her “manly” and “cursed.”
She’s in pain daily, cramping and bleeding for weeks, isolated in her shame. Doctors offer no answers for the weight, infertility, hair growth, or long, painful periods. Eventually, her husband marries another woman, leaving Mariam heartbroken and feeling worthless. Years later, she gives birth to one child—the only child she would ever have—still never knowing why her body had “betrayed” her.
Many women share Mariam’s reality. Unbeknownst to her, Mariam had PCOS (Polycystic Ovarian Syndrome), a hormonal disorder affecting many women of reproductive age.
The main symptoms of PCOS include:
Irregular periods
Excess of male hormones (androgens)
Ovarian cysts
How the symptoms can manifest:
Infertility
Acne
Hair loss
Weight gain
Long intervals without a period
Severe cramping
Unwanted body hair growth
For many women like Mariam, the symptoms aren’t just physical. They affect every part of their lives. Pain, shame, and misunderstanding around PCOS make daily life feel unbearable. This is especially true in communities where infertility is stigmatized and not met with compassion. Lack of awareness and medical support turns what should be a manageable disorder into a lifelong struggle.
In 2025, the cause of PCOS remains unknown. According to the Cleveland Clinic, possible causes include an increase in androgens (male hormones), which can prevent ovulation, and insulin resistance, which contributes to diabetes and obesity. People with PCOS also often have chronic inflammation. Because research is limited, it’s difficult to determine whether insulin resistance causes PCOS or vice versa. This disorder can increase the risk of miscarriage, high blood pressure, and preterm birth. These complications may be more severe in less developed African countries, which have the highest global stillbirth rates.
As of 2023, no substantial systemic studies of PCOS had been conducted in Sub-Saharan Africa. This limits the public’s understanding of its effects, especially in Africa. PCOS is estimated to affect 6-13% of reproductive-aged women. That number may be much higher, especially in places where healthcare and research are limited. Statistics show that up to 70% of women with PCOS aren’t diagnosed. This is alarming. Many PCOS symptoms affect women, but they often lack a way to label or explain what is happening to them.
PCOS highlights major gaps in women’s healthcare, especially in parts of Africa. Here, conversations about reproductive health are often silenced by stigma, lack of education, and cultural expectations. In many communities, infertility is viewed as a woman’s fault. Medical explanations are rarely sought or even accessible. Women like Mariam become victims of both biology and social pressure. Without proper diagnosis or treatment, they’re blamed, shamed, and isolated for something beyond their control. Mariam’s story reflects more than one woman’s pain. It shows a public health failure. It also reveals how the lack of reproductive health education, trained specialists, and awareness can cause trauma, marital instability, and health complications. If reproductive disorders like PCOS were prioritized in African healthcare, women like Mariam wouldn’t have to suffer in silence. They could get early diagnoses, treatment, and most importantly, support!
References
Mayo Clinic Staff. (2022, March). Polycystic ovary syndrome (PCOS) — Symptoms & causes. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/pcos/symptoms-causes/syc-20353439
Yasmin, A., Roychoudhury, S., Choudhury, A. P., Ahmed, A. B. F., Dutta, S., Mottola, F., Verma, V., Kalita, J. C., Kumar, D., Sengupta, P., & Kolesarova, A. (2022). Polycystic ovary syndrome: An updated overview foregrounding impacts of ethnicities and geographic variations. Life, 12(12), 1974. https://doi.org/10.3390/life12121974
World Health Organization. (2025, February 7). Polycystic ovary syndrome. https://www.who.int/news-room/fact-sheets/detail/polycystic-ovary-syndrome
