By The SABI

Walk into any classroom, co-working space, or yoga studio and ask how many women have irregular periods. In a group of ten, two or three will raise their hands. Some will mention acne, hair loss, or unexplained weight changes. Others will confess that they don’t bleed at all without the pill. Almost all of those affected will say the same acronym: PCOS.

Polycystic ovary syndrome is now the most commonly diagnosed endocrine disorder in women of reproductive age. Official estimates place global prevalence at 1 in 10, but newer studies suggest as high as 15–20% (Fertility and Sterility, 2023). In some clinics, PCOS is now the most common diagnosis for adolescent girls presenting with menstrual complaints.

What’s startling isn’t just the number. It’s the age. More and more young women, Gen Z especially, are learning, or told before they’re 20, that their cycles may never be “regular.” And while better diagnostic awareness plays a role, it cannot fully explain the surge. We are not just naming a condition that was previously overlooked. We are watching a generational epidemic unfold…

Lives in Limbo: Three Snapshots

“I went off the pill at 23 and my period just never came back. My doctor said to wait it out, but a year later I still wasn’t cycling. It wasn’t until I found an online PCOS forum that I realised how many women were in the same boat.” - Sofia, 24, London

“For me it started as acne. They put me on antibiotics, then spironolactone, then the pill. Nobody connected the dots until I broke down in a fertility consult at 28. Suddenly PCOS explained everything.” - Daniela, 28, Bogota

“I’m 19 and my cycle has never been regular. Sometimes 60 days, sometimes none at all. My mom says she had the same, but was never diagnosed. It feels like every girl I know has something wrong with their period now.” - Mia, 19, New York

Why the Rise Feels Different

1. Endocrine-Disrupting Chemicals: A Body Under Siege

Today’s young women are exposed to a cocktail of synthetic hormones and hormone-mimicking chemicals at levels unprecedented in human history. Parabens in lotions, phthalates in shampoos, BPA in plastics, PFAS in drinking water, many are classified as EDCs (endocrine-disrupting chemicals) that are known to cause reproductive issues, hormonal disruptions and elevated cancer risk.

A sweeping review in Cells (2022) concluded that EDCs contribute to the development of PCOS, endometriosis, and fertility issues. These exposures begin before birth, microplastics and chemical traces have been found in placental tissue and umbilical cord blood. This means Gen Z may be the first generation whose hormonal balance was disrupted in utero.

2. Metabolic Dysfunction: A Perfect Storm

PCOS is strongly linked to insulin resistance, and insulin resistance is soaring. Ultra-processed diets, cheap refined carbs, sugary drinks, and industrial seed oils now dominate food systems. In the U.S., more than 60% of calories consumed by adolescents come from ultra-processed foods (BMJ, 2021).

Even independent of weight and obesity, insulin resistance is present in up to 70% of PCOS patients (World J Diabetes, 2022) of all weights This creates a vicious cycle: high insulin levels drive ovarian androgen production, which further disrupts ovulation. Gen Z’s metabolic environment is, quite literally, primed for PCOS.

3. Stress and Cortisol: The Always-On Generation

Gen Z is the most anxious, stressed generation on record. According to the APA (2022), 91% report stress-related symptoms, from headaches to insomnia. Cortisol, the stress hormone, directly impairs ovulation and shortens luteal phases. Chronic stress doesn’t cause PCOS alone, but it makes the condition far harder to manage.

4. Circadian Chaos: A Hormonal Disruptor in Plain Sight

Blue light exposure, irregular sleep, social jetlag, and 24/7 connectivity are rarely mentioned in PCOS conversations, but they matter. A Front Endocrinology Study (2022) study found women with irregular sleep patterns were significantly more likely to develop PCOS-like symptoms. Sleep disruption impairs glucose metabolism, destabilises cortisol rhythms, and reduces melatonin, all of which impact ovarian function.

5. Environmental & Social Factors Often Overlooked

Obesogens: Chemicals like BPA and PFOS don’t just mimic hormones; they actively promote fat storage, worsening insulin resistance.
Microbiome disruption: PCOS is linked to gut dysbiosis (Front Endocrinol, 2021). Ultra-processed diets, antibiotics, and stress all alter microbial balance in ways that exacerbate inflammation and androgen excess.
Birth control paradox: Many Gen Z women are prescribed the pill at 13 or 14 for acne or irregular cycles. It masks PCOS symptoms, until they stop in their 20s or 30’s and discover their cycles never normalised and hormones remain unbalanced.
Epigenetics: Maternal exposure to EDCs, stress, or high insulin during pregnancy may “prime” daughters for PCOS, a transgenerational cycle, that seems to be playing out now.

The Consequences: More Than Missed Periods

It’s tempting to dismiss PCOS as an inconvenience, a few missed cycles, some stubborn acne, a tendency to gain weight. But beneath the surface, the syndrome carries lifelong consequences that extend far beyond reproduction.

For many women, PCOS is the leading cause of anovulatory infertility. Some conceive easily, but for countless others, ovulation never returns without medical intervention. Fertility treatments, expensive, invasive, and emotionally draining, become not the exception, but the norm.

Metabolic risks loom just as large. Women with PCOS are four times more likely to develop type 2 diabetes, and their risk of cardiovascular disease rises sharply. What begins as irregular bleeding in adolescence often evolves into insulin resistance, hypertension, and lipid disorders by midlife.

The mental health toll is equally striking. Anxiety and depression affect up to half of women with PCOS (Indian J Psychol Med, 2018). These conditions are not only biochemical, though disrupted cortisol and androgen patterns play a role, but also social. Living with acne, hair thinning, or hirsutism chips away at self-image, layering stigma onto physiology.

And there are more sobering risks still. Decades of anovulation mean unopposed estrogen, raising the chance of endometrial hyperplasia and cancer. What begins in adolescence as “irregular periods” can, if neglected, progress to malignancy later in life.

For Gen Z, the implications are stark. Some are being told at 18 or 20 that their fertility may already be compromised, that their lifelong risk of diabetes is elevated, that their mental health is not just circumstantial but hormonally primed for vulnerability. This is not simply a reproductive issue. It is a generational health crisis.

What Can Be Done

The solutions are neither simple nor singular. But they are urgent, and ignoring them is no longer an option.

1. Regulate and Reduce EDCs.

Europe has banned more than 1,600 cosmetic chemicals. The U.S. bans fewer than 20. That discrepancy isn’t trivial; it shows how women’s hormonal health is being traded for industrial convenience and product sales. Meanwhile, endocrine-disrupting chemicals are found in our bloodstreams, in breast milk, even in placental tissue. The evidence is mounting, yet regulation lags behind.

While policy change is essential, individuals cannot wait decades for lawmakers to act. Swapping plastics for glass, filtering tap water, refusing thermal-paper receipts, choosing truly hormone-safe personal care, these aren’t “lifestyle tweaks.” They are defensive acts in a toxic environment.

2. Rethink Skincare and Everyday Products.

The skin is not a wall or just a barrier; it is an organ that absorbs. What we put on our bodies is absorbed into our bloodstream. And yet the global cosmetics industry remains poorly regulated, saturated with parabens, phthalates, synthetic musks, compounds with proven endocrine activity. For women with PCOS, applying them daily is like dosing the body with accelerants for dysfunction.

Hormone-safe skincare should not be niche. It should be baseline. That’s why at The SABI, our formulations are deliberately free from endocrine disruptors and instead infused with botanicals and adaptogens. These plants do more than avoid harm; they actively strengthen stress responses, calm inflammation, and support the very systems PCOS disrupts. To dismiss this as “green beauty” is missing the point. This is not a wellness trend for a niche audience; it is an urgent form of preventative medicine and a fundamental shift in how we should view our self-care routines and products.

3. Herbal and Nutritional Allies.

What traditional medicine preserved through centuries of lived practice, modern science is only now beginning to validate. These botanicals are are evidence-based allies that directly support the systems PCOS disrupts:

Tulsi (Holy Basil): Long revered in Ayurveda as the “Queen of Herbs,” tulsi is both an adaptogen and a metabolic regulator known for its ability to lower cortisol, steady blood sugar, and improve sleep quality. For women with PCOS, Tulsi’s dual effect on stress and glucose metabolism is critical: it calms the overactive HPA axis while preventing insulin spikes that worsen androgen excess.
Ashwagandha: One of the most studied adaptogens, ashwagandha is particularly potent in restoring balance to the stress-hormone loop. Beyond stress modulation, it has been shown to support ovulatory cycles and improve reproductive hormone profiles. For women with PCOS, ashwagandha works on two fronts: reducing the cortisol-driven suppression of ovulation and improving the quality of rest, making recovery possible at a cellular level.
Inositol: Technically not an herb but a vitamin-like compound, inositol has rapidly become one of the most evidence-backed interventions for PCOS. Both myo- and d-chiro inositol have been shown to restore ovulation, improve oocyte quality, and enhance insulin sensitivity. Inositol addresses the metabolic dysfunction at the core of PCOS, reducing insulin resistance while also improving fertility outcomes. Unlike synthetic drugs, its safety profile is excellent, making it a first-line option for many women navigating irregular cycles.
Red Clover: Rich in isoflavones, plant-based compounds that mimic estrogen in the body, red clover offers a gentle form of hormonal recalibration. Research suggests it can improve cycle regularity, reduce hot flashes and perimenopausal symptoms, and even support cardiovascular health. For women with PCOS, who often experience disordered estrogen metabolism, red clover’s phytoestrogens act as modulators, smoothing out extremes rather than overwhelming the system. It also offers protective effects for the endometrium, an often-overlooked concern in women with chronic anovulation. Always check with your healthcare provider before experimenting with any oestrogen-mimicking herbs if you don’t know which type of PCOS you have (e.g. oestro vs. androgen-dominant).

Cycle-supportive blends like The Gentle Period integrate these allies into daily rituals, transforming them from occasional remedies into consistent, accessible forms of resilience. Instead of waiting for crisis, they become part of a lived rhythm, supporting the body’s natural intelligence day after day.

4. Support Fertility Before Crisis.

Our healthcare system still treats fertility as a problem to be “fixed” at 35, often after a decade or more of suppression through hormonal contraception. By then, for women with conditions like PCOS, years of missed intervention can make the path to pregnancy far harder.

What gets lost in this conversation is the value of ovulation itself. A healthy cycle is not just about bleeding; it’s about ovulating. Ovulation is how we produce progesterone, regulate mood, maintain bone density, and protect long-term cardiovascular health. If you are not ovulating, your cycle is not functioning, even if your period appears regular.

This is why fertility education can’t wait until there’s a “problem.” It needs to begin much earlier - at 18, 20, 25 - when awareness, lifestyle shifts, and even herbal support can preserve ovulatory health. For women with PCOS, early recognition and support can mean the difference between years of struggle and sustainable, functional fertility.

PCOS does not have to equal infertility. But without early awareness of ovulation as a health marker, too many women only discover the truth when it feels too late.

5. Treat Hormonal Health as Public Health.

We treat heart disease as urgent. We fund cancer research in the billions. We talk endlessly about diabetes prevention. And yet PCOS - a condition tied to all three - receives only a fraction of research attention. In the U.S., NIH funding for PCOS remains dwarfed by allocations for erectile dysfunction, despite affecting exponentially more women. This is not science following evidence. This is science following bias.

Until hormonal health is treated as a foundation of systemic health, we will continue to pay the price, not just in individual suffering, but in the economic cost of preventable chronic disease.

Why This Needs to Be Loud

The risk is not just the epidemic itself. The risk is that we normalise it. That we shrug and say, “Everyone has PCOS now.” If one in five young women isn’t cycling, that isn’t an inconvenience. It is a societal failure.

Treating this as the new normal means signing a generation up for predictable burdens: decades of fertility struggles, a quadrupled risk of diabetes, increased cardiovascular disease, elevated cancer risks, and a mental health toll that ripples through families and communities. This is not a private gynaecological issue. It is a generational health crisis hiding in plain sight.

And yet, this is also where the revolution begins.

We are no longer in the age where women’s hormonal health can be dismissed as “too complicated.” We are naming what our mothers and grandmothers endured in silence. We are connecting the dots between chemical exposure, stress, disrupted cycles, and fertility struggles. We are demanding transparency from the products we use and accountability from the industries that profit off our bodies. And where systems fail, women are building their own solutions: hormone-safe skincare, adaptogenic infusions, cycle-syncing rituals, communities that turn isolation into collective power.

That is what makes this moment pivotal. PCOS is not just a diagnosis. It is a signal, a red warning light on the dashboard of modern life. Whether we ignore it, or treat it as the urgent alarm it is, will determine not only the health of Gen Z but of every daughter and granddaughter to follow.

We can accept silence, or we can choose noise, loud enough to shake policy, research, and culture awake. Loud enough to shift the future.

HORMONAL & PROUD

Created as a brand to help women navigate the toughest moments in pregnancy, childbirth, postpartum - and practically every stage of life, the SABI aims to change the narrative around our hormones from one of taboo, embarrassment and loneliness, to awareness and even pride. Much more than a wellness brand, SABI offers a carefully crafted line of products to carry you through your hormonal journey; a set of rituals, supportive tools, and ancient herbal remedies that have been tested time and again by women and now, backed by medicine. SABI is a blend of science and nature conceived by women who have experienced the joys and deep implications of bringing a child into the world, the pains of a heavy and difficult period, miscarriage and difficulty conceiving

Here is an invitation to get to know your body and its cycles better and to really understand what is going on inside. Learn to use your hormonal cycle to your advantage no matter your stage of life, and know that you can always support and balance your hormone levels. Look for the right sources of information, know that there is help, and know that you’re supported.

DISCLAIMER

The SABI blog and articles are not meant to instruct or advise on medical or health conditions, but to inform. The information and opinions presented here do not substitute professional medical advice or consultations with healthcare professionals for your unique situation.

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The PCOS Generation: Why So Many Young Women Aren’t Cycling, And Why We Should Be Alarmed