Dear Sister: PCOS, PMS & Female Reproductive Health

In this conversation I sit down with my sister Usra to talk about something that touches every woman, but we rarely say out loud: our reproductive health. Usra was diagnosed with PCOS, and she’s been on a rough ride with symptoms, medications, and the mental chaos that comes with hormonal storms. We talk about PMS, the shame of buying sanitary pads, and what happens to a woman’s mind after childbirth. This one is raw, sisterly, and long overdue.

The slow burn of a PCOS diagnosis

Usra got her first period at 14, and from the start her cycle was irregular. But like so many young girls, she was told it would take time to settle. She went to doctors, tried treatments, and the pattern continued: periods would disappear for three months, then come back. One doctor finally said, “It’s okay, you don’t need medicine right now. When you get married and face problems, then we’ll treat it.” So she let it go.

For years, no one connected the dots. Weight would suddenly spike and drop. Acne flared. Mood swings became a constant. It wasn’t until three years ago, when her symptoms worsened, that a full workup revealed PCOS. The real shock, Usra says, was learning that PCOS is not just about cysts. It’s a whole-body hormonal storm. “It’s not only cysts on ovaries. It’s the ratio of two hormones being out of balance, and that was throwing everything off.”

A pill that stole my self

To regulate her cycle, Usra was put on Diane 35, a birth control pill commonly prescribed for PCOS. What followed were three of the hardest months of her life. “For those three months, I was not living in my body,” she tells me. “I didn’t know what to feel, what to think, what to say. Every emotion was multiplied by ten times, a hundred times.” She withdrew from friends, from conversation, from herself. Her social life became zero, and at home, the worst reactions surfaced.

The medication gave her severe brain fog. “I couldn’t form sentences. I would forget things unless I put them on a to-do list. I’d sit in meetings and not be able to speak properly.” Her self-esteem plummeted. One evening, a scary thought crossed her mind: “There is no point in living if this is how I have to feel forever.” She immediately recognized it wasn’t her. “I knew this is because of the medicine. It’s not me.” She stopped the pills, and within days, she says, “I felt like I met myself again after three months.”

Brain fog, anxiety, and meeting herself again

Usra’s anxiety had become so intense that at one point she was given anti-anxiety medication. After four days, something shifted. “I was laughing and I felt a happiness I hadn’t felt in a whole year, literal tears started falling because I realized, this is me. Anxiety had completely taken over my personality.” That moment of recognition is heartbreaking and universal. How many women are walking around with anxiety so deep they forget who they are?

The physical symptoms kept piling on. Calcium and vitamin levels dropped. Her hair started falling out. She was put on a diabetes medication to balance insulin, and she had to learn to balance her sugar intake so she wouldn’t crash during workouts. With a personal trainer, a supportive doctor, and a lot of trial and error, she slowly rebuilt. “Now I am living inside my body again,” she says. That sentence felt like a victory.

PMS: the mood swings no one prepares you for

We both have our share of PMS stories. I share a moment from my own life: one day, my brother slammed the car door a little too hard, and I burst into tears. His response? “When your wife comes, she’ll be just like this.” That casual invalidation lives in so many of our homes. “Just because I’m PMSing doesn’t mean my feelings aren’t real,” I told him.

The truth is, PMS can be a magnifying glass for things we’ve been suppressing. “Sometimes during PMS, you finally feel things you’ve been pushing aside. You realize, I need to stand up for this. This isn’t right.” It’s not just irrational moodiness; it’s a body forcing you to pay attention. And when the cramps hit, for Usra, it was belt-tightening pressure on her belly in the middle of summer, you learn that period pain is rarely taken seriously.

The brown bag and the silence we inherit

I remember going to the supermarket as a teenager and having the sanitary napkins placed in a brown paper bag, as if they were something to hide. No matter which store I went to, there was always a woman stationed near the counter to wrap them in that brown bag. My teacher once said to me, “This is a part of your body. Why the brown bag?” That question stayed with me. From that day, I refused it. “I’d walk to the counter, and if they tried to hand me a brown bag, I’d just say no.”

The sharam, the shame, around our own bodies is not something we’re born with; it’s something we’re taught. And it keeps us from talking about PCOS, about painful periods, about the realness of postpartum depression. The brown bag might be gone in some places, but the instinct to hide is still very much alive.

After the baby: the loss of self

We talked a lot about what happens to a woman’s body and brain after giving birth. The hormonal dive after delivery can mimic severe depression. The brain actually changes its wiring to hyper-focus on the baby, which is why new mothers experience brain fog, memory lapses, and a kind of identity erasure. “I used to be able to do so many things, and suddenly I felt like I couldn’t do anything else except care for the baby. It felt like I had become stupid.” That loss of self, combined with sleep deprivation and the sheer intensity of mothering, can push a woman into postpartum depression.

And the scary part is, there’s no time to process it. “Using the bathroom feels like a luxury when you have a newborn,” I remember saying. Women are expected to show up, be grateful, and never complain. But some feel such overwhelming despair that they resent the baby, and that guilt spiral can be dangerous. Usra and I want every woman to know: postpartum depression is not a weakness, it’s a medical condition. If you’re feeling it, reach out. You’re not a bad mother. You’re a human being navigating an enormous change.

Why this conversation matters

This episode is for every woman who has ever been told her symptoms are normal, who has felt crazy on a pill she didn’t question, who has cried in the brown bag aisle or sobbed behind a closed bathroom door after having a baby. We are not alone in this. Our bodies are not a source of shame. The more we talk, with our sisters, our friends, our doctors, the more we realize that so many of us are carrying the same invisible load. Let’s put the brown bags away for good.