Ep 104: How to Flourish with PCOS with Nicole Holness
Fertility Forward Episode 104:
PCOS is a problem faced by many women today. Joining us in conversation is Nicole Holness, a registered dietician nutritionist, and an international board-certified lactation consultant with a focus on PCOS, fertility, pregnancy and postpartum, which has led to her own brand, Holness Nutrition. Join us to hear the story of how Nicole came to focus on fertility and PCOS before we dive into the four categories of PCOS and their related treatments. We explore the role of diet in improving fertility and reducing PCOS symptoms and talk about stress management along with some practical tools that you can implement today. Customization is absolutely necessary for every PCOS patient, and Nicole explains why this is her approach, as well as gives us her perspective on Inositol and where you can find it naturally. Thanks for tuning in to today’s jam-packed episode with another inspiring guest.
Rena: Hi everyone. We are Rena and Dara, and welcome to Fertility Forward. We are part of the wellness team at RMA of New York, a fertility clinic affiliated with Mount Sinai Hospital in New York City. Our Fertility Forward podcast brings together advice for medical professionals, mental health specialists, wellness experts, and patients because knowledge is power and you are your own best advocate.
Dara: So today I am so thrilled to be chatting about a topic that is near and dear to my heart. We're speaking about how to flourish with PCOS, and we have on our podcast Nicole Holness and she is a registered dietician nutritionist and an international board certified lactation consultant with more than a decade of clinical nutrition roles in some of the leading and largest hospitals throughout New York City. She's also been featured in and given expert advice to several leading health websites and publications. Nicole's vast expertise in women's health mainly focuses in on PCOS, fertility, pregnancy, and postpartum which has led her to build her own brand, which is Wholeness Nutrition, with a mission to empower and support women to thrive in their health and hormones with their health and hormones. Her signature program - Fuel Your Fertility - helps women struggling with fertility, regain their periods and conceive naturally or successfully with IVF. Nicole, I am so happy to finally have you on our show. Thanks for being here today.
Nicole: Thanks for inviting me. I'm thrilled to be here.
Dara: I have to tell you, I have been an avid fan of you on Instagram. I have been following you and have really admired your posts and you know, you definitely focus a lot on PCOS, which is what you'll be speaking about today, but how did you come to specialize in this area of women's health?
Nicole: Yes, I'm so excited that you asked that, Dara. My practice is geared towards helping women struggling with all problems and issues under women's reproductive and hormone health. As a woman, I felt the need to help other women thrive at this milestone of womanhood with optimal health and wellbeing by being able to be there for them at this particular stage. PCOS is, as we know, is the most common endocrine disorder amongst women of reproductive age. So it affects approximately six to 18% of women during their reproductive age. So if we're in a room with a group of women, let's say 10 women, we could expect that it could be one or maybe even two women in the room affected by this.
Dara: That's a lot.
Nicole: So it is a lot. So yes, I've been encountering these cases throughout my clinical practice and they do have the likelihood of overlapping in various areas, Dara. So, for example, they're coming from bariatric surgery or having heart disease, diabetes, obesity, subfertility, and other risk factors. And often the women with PCOS, they have this weight stigma and there is lack of health information and lack of support. So by working together I can help them reduce the risk factors and conditions.
Dara: Yeah, that's, that's great. It's something that I see quite frequently in the fertility practice and oftentimes not all, but I would say the majority of the women that I meet with who are diagnosed with PCOS struggle with their weight or struggle with, with losing weight and having a higher propensity of weight gain which is kind of a great segue into, this is something that I don't necessarily think we were educated so much in school, but I feel like over the years being more knowledgeable that there's various types of PCOS. So, have you encountered or are you familiar with multiple types of PCOS that you can maybe share with with our audience?
Nicole: Yeah, so this is a very timely question. So actually there are four types of PCOS and each requires a different treatment. So first there is insulin resistant PCOS, and this is by far the most common type of PCOS. We can say at least 75% of women with PCOS are insulin resistant which is why we often mistake we're mistaken that PCOS is related to insulin resistant, is related to insulin. Yeah. So, but as I mentioned earlier, the excess insulin inhibits ovation and declines with the egg quality. So additionally it increases testosterone levels, which is a hormone, it's a male hormone and interferes with the menstrual cycle. So that's the thing about the insulin resistance PCOS. So the symptoms of this, Dara, are much like prediabetes. We see dark on the skin, excess urination. We see signs of P COS androgen excess, like weight gain, acne, there could be hair loss and any hair undesirable in different places that we don't want it to be like our face and we would want it to be on our, on our head. Right? So unfortunately it, it's, it doesn't work well that way. We lose it from the hair from our head and we may have it on our face or places that we do not want it to be. So that's unfortunate about the insulin resistant PCOS. And as I say, it's by far the most common type of PCOS and the labs may show elevated insulin and androgen levels. So that's something to watch out for with both the most common type. The next type is inflammatory PCOS. Women experience chronic inflammation and this inflammation causes the ovaries to produce excess testosterone as well. So not only in the insulin resistance it happens, but also in the inflammatory. So what again, too much testosterone interferes with ovulation and menstruation. So this is what we see that's happening there. Yep. So that's what the inflammatory type. And the women may have, they may experience headaches, joint pain, unexplained fatigue. They say, why am I so tired? And I'm feeling my joints are hurting me. And they may also have irritable gut. It may obscure some signs of this type of PCOS. As far as the markers, inflammatory markers would give us an idea that this is also happening. The other type for adrenal cause of PCOS, and this is abnormal stress response. So the main stress center, which is the adrenal glands, they are dysfunctional and they release their own variant of androgen, which is a DHEAs. And unfortunately high levels of the DHEAs aren't often tested unless you go through let's say a specialist, endocrinologist, it’s not typically standardly tested. So again, we may notice classic signs of PCOS, the excess androgens, like the weight gain, the acne, the hair loss. We may see these kinds of things happening and of course if stress, mood swings, fatigue, and sleep problems are recurring, then this could be a sign of this. And finally there is post pill PCOS and it occurs in some women after they stop taking the oral contraceptive pill. And this type PCOS symptoms are not present before they start the pill, but it's after.
Dara: OK. I’m familiar with that one!
Nicole: So yes. So we have these different types in the four types that we have to look into to see, okay, which one are we dealing with?
Dara: Yeah. And I wonder also if there is a little bit of overlap perhaps with some of them as well because, and this is something new to me, cuz for me, I'm like, I got all patients with PCOS are prone to insulin resistance or have some form of inflammation or have some form of adrenal fatigue. But perhaps one of these, one of these four is more apparent or is kind of a predominant type of PCOS? Although perhaps one can have a little bit of adrenal fatigue, a little bit of inflammation, but predominantly insulin resistance or perhaps something else is, is a little greater than the other
Nicole: You could have more than one. Yes. As you said, one is more predominant. Yeah. And then you may have a little bit of, okay, there's also inflammation happening here, so we have to look into the cause of both and we have to treat accordingly. That exactly correct.
Dara: That's what I find fascinating. I do think that it's when I'm so happy to see with medicine and wellness in general these days is like we're heading towards kind of really seeing what the markers are, the, the signs and symptoms and then kind of say, okay, which type can this be? And then depending on kind of what is the most apparent, Okay, now from there, what can we do to help lower those signs and symptoms? And I know for you and I, I know for myself, probably one of the most common questions as dieticians that we get when we're working with patients with PCOS is, what is the best diet that I need to do, that I need to start the foods and, and the, and the maybe perhaps the restrictions or the changes that I need to make to really help with my PCOS symptoms and also to help boost fertility. Do you get that a lot?
Nicole: Oh yes. So many people. Yes. What's the best diet for PCOS? How can I boost my fertility? And these are legitimate questions and I do feel the frustration, I understand it. And because these women are going through so much. I'll say that it depends on the type of PCOS that you have. Because each type has a specific hormone imbalance as we discussed earlier, that's affecting the fertility. So let's say if you have insulin resistant PCOS, then your diet must focus on reducing the effect of excess sugar in the bloodstream. For example, high fiber diet. If you have inflammatory PCOS, then we, your diet must be anti-inflammatory. Or we look into other areas, it's not a blanket statement because that's why we have to do a really personalized plan to see what's working for the person. But I'll say a general tip is you should always include, you know, high quality carbs. Of course we are looking at glycemic index, glycemic load, we're looking at protein and, and fats. A nice balance of them. And for snacks try to include at least two or three whether we are looking at healthy fats, definitely a good source of protein there, in fiber. So always we should do mindful eating as well to reduce binge eating behavior so we can build a healthier relationship with food. But I could go off so many different tangents because, because you so many things that we could look at. And I'll say that also, I always eat slowly, eliminate distractions, pay attention to your hunger and fullness cues. So, but if any of the listeners would like a really nice checklist, I, in addition, I do have a very simple checklist of five simple dietary changes to support your fertility. It's a fun quiz that's on my website and after completing the quiz it's called, Is your Diet and Lifestyle Boosting your Fertility? So answer the questions and I'll give you a nice printout with the results and an explanation of the positives and the areas we work on. And I'll give you the checklist. So this is all free.
Dara: I think that's amazing that you offer that cause I do think a lot of people feel like there's often a, a blanket diet with someone with PCOS and usually it starts with cutting out carbs, which I think is a big, biggest misconception. I kind of wanna go back. There's a lot to unpack. You had so much to say. Just even like the notion about, you mentioned the glycemic index and the glycemic load and this is something that as dieticians we learn in school and it's something that we're very familiar with. But I think it's a very interesting thing and it's not something that I always necessarily speak to my patients about in using those terms. But I think it's an interesting thing for people to know about. Glycemic index means something in a different than glycemic load. And correct me if I'm wrong, glycemic index is how much a specific food increases your blood sugar. So you know, if you're eating a banana or if you're eating rice or honey or you're having a smoothie or you're having cookies or cakes or fried food, depending on the, the serving size and and what you're eating, there is a certain number that's given to that food. The higher the glycemic index, the higher it increases your blood sugar levels.
Nicole: Blood sugar. Yes.
Dara: However, the problem is, is we don't eat things oftentimes by itself. We eat things paired with other foods.
Dara: And that's where the glycemic load comes in. And it's a much better determinant of how our, our blood sugars change at that meal. So, you know, if you're eating a a donut, your blood sugar will will be something. But if you're having a donut with some eggs and bacon, your glycemic load may be different and, and your blood sugars may rise differently because there's also fats and other macronutrients that are there that may not get your blood sugars as as high.
Nicole: That's correct. And that's why we do emphasize that having combined meals so that we can definitely not having our blood sugar spike as high as it could if we're eating a particular foods by itself. And I kind of explained to them as well in saying what the average of something is. If you scored, let's say if you scored a hundred percent on the exam, it'll be that's your grade. But if, let's say if you don't do so well and it goes and you're doing an average of something, it brings it down somewhat. So I kinda do that comparison as well when I'm speaking of the effect of how something would raise your blood sugar when you're having combined meals.
Dara: Okay. I think that's great. I think that's great for people to be aware of and that you mentioned it, you know, snacks are very important, especially snacks that include healthy fats and proteins. Not just consuming a snack that's that's just a carbohydrate. So that can help keep your blood sugars a little more stable in between meals. And even just the notion of not going too long between meals because then that can keep your blood sugars dipping too low, which people don't always talk about too high is, is not great, but too low is equally potentially dangerous. Especially for someone with PCOS.
Nicole: Exactly. And then what happens when it goes too low? Then the cravings come in
Nicole: The they grab for something which is not as healthy and then we start having a cycle.
Dara: Well that's the thing. Exactly what I was gonna say is that so many, the women that I speak to with PCOS say like I'm constantly craving carbs. And I do think, you know, I have PCOS so I, I say we, we end up having a higher propensity for carbohydrates. But I it, a big part of that is because a lot of us wait too long in between meals without eating something. Our blood sugar’s dipped too low and at that point it's not necessarily the point of no return. But it makes it that much more challenging to think as mindfully when your blood sugars are low and you're, you're getting hangry, you're getting the shakes
Nicole: And I’ll say it happens to just about anyone. It doesn't have to be someone with PCOS. Right? So of course you wait too long to have your meal, your hunger, the first thing you want to have is okay grab for anything that you can find. And it may be something that's unhealthy.
Dara: That's so true. And I think also, like you mentioned, like there's, there's various diets or meal plans depending on if you have, you know, a lot of inflammation in your body, insulin resistance. If you're suffering from adrenal fatigue. But to be honest with you, this is what I, I tell all my patients whether you have PCOS or not, the general food guides, like I think the general population, it would be great to focus on anti-inflammatory foods which are very rich in vitamins and minerals, a lot of fruits and vegetables and, and whole foods. And also with insulin resistance, whether you have it or not, eating foods that can help keep your blood sugars in this happy healthy zone really can benefit anyone.
Nicole: Yes. that's absolutely correct. And then yes, again, the predominantly there is insulin resistance, but even if you do not have it, it's a healthy way of eating. So why not?
Dara: Exactly. Why not? I also really appreciate that on your Instagram you speak a lot about how diet or what you eat is one area that can help people who are suffering with PCOS. But there are so many other things that can help with our hormone balance and I guess it also ties in with adrenal fatigue, which is often linked with stress. And you mentioned some other things like sleep and mindfulness activities and the importance of being mindful with exercise. So I would love for you to speak about a little bit about some ways that that women aside from food can really help support their PCOS symptoms and and also potentially help with weight loss if, if they're struggling with losing weight.
Nicole: Yes. So apart from diet for stress management is going to be so important. And I know that we're living in a fast world and we want to be on the go and this is happening over here where our hands are everywhere but we just have to do some self care and focus on taking care of ourself for our help and and putting ourselves as women first. I think that thing about us women, we take care of everyone. We take care of the household, we take care of our kids, we take care of so many other areas, but we're neglecting ourselves, right?
Dara: Well, it's like we need to put the oxygen mask on first on ourselves first before we can help someone else on an airplane. But we don't often apply that ending everyday life
Nicole: Yes. So we have to do this, manage our stress whether we want to try doing some yoga, meditation, whether it's journaling cause journaling is just so good to help you reflect on what's helping you, what's not serving you well and changes that we can make. Right? So that's a part of self care. It is something as simple as deep breathing, you know, is so helpful. Like breathing deeply and just relaxing Pause for a moment.
Dara: Remembering to breathe. I think that's something I speak to my patients about. It's, it's so interesting that it's free. We all have it. But we often forget to use it to the best of our ability. That's just
Nicole: Just pause, relax and breathe. So just do whatever works for you but try to practice some form of self care.
Dara: Yeah. And that also I think leads into to sleep and optimizing one's sleep. And it's tough because a lot of times when we're in the silence at night, that's when our mind floats into all the stresses.
Dara: So that's where I do think those breathing techniques can really be helpful or even, you know, there's so many meditation apps that can be used.
Nicole: Yes. And we have to realize as well that yes, the focusing on quality sleep because we may get some sleep, was it quality sleep if was a light on, was it television on, you know, what was happening just before you fell asleep or even during the sleep. So we know chronic sleep deprivation, alters hormones. Especially your hunger and fullness hormones. So after poor sleep ever notice, like you feel hungry all day and you can never quite feel full if you're not sleeping well. So we do underestimate the power of sleep and it's real. We need to try to get enough of it.
Dara: I find it just fascinating how hormones that are not also not necessarily we think are related to fertility or related to hunger can still, something like cortisol, which is a stress hormone, which naturally gets lowered when we're supposed to be lowered when we go to sleep. When we're not getting as good sleep quality and we're not getting that deep restorative REM sleep. How that cortisol level can stay elevated when it's really supposed to to drop overnight. And when that is elevated, not only does it make you more stressed, it also gives you a higher propensity for craving carbohydrates. So that on top of someone with PCOS who may have some insulin resistance and have a higher tendency to crave carbs, it can also be compounded with poor quality sleep.
Nicole: Yes. So this is something that we definitely need to pay attention to. Yes. Everything matters, right? We have to look at our diet, our lifestyle, our environment. So it's holistically, it's not just one area. So we need a complete package to…
Dara: Yeah. To the best of our ability I think. Yeah. And, and making small goals. I would, I also, it was nice to see that you are someone aligned with, with my thoughts on exercise because that's a question that I get all the time is, I work out so much. I have PCOS. I work out all the time, but I'm still not losing the weight. What's going on?
Nicole: Oh yeah. That's also another part of it. Again, stress is a major component. So let's think about the type of PCOS the person has. So, and let's think about what kind of exercise they're also doing. So if it, so some people may need such a high impact exercise, it may be too stressful for them and some may need a more lower intensity again, depending on the type of PCOS that you do have. So it's good that they are proactive in trying to do something too, so I do really congratulate them in trying to take control of the situation. But there are also other things in play here that could be pretty much disrupting their goals.
Dara: Exactly. And I think that's, you know, it goes back to really having a customized approach depending on where you're at at this very moment. And if something works right now but down the road, you know, something feels off the idea of having some openness and some flexibility depending on what is the particular issue at any given moment. And I think this is hard. A lot of times we think I need to work out and I need to sweat. Sweating is great. It definitely releases toxins, but I think a lot of the more gentler workouts sometimes aren't seen as as good of a workout. And really it depends on the person. It also, I think depends on the cycle, depends on how you're feeling that day. I think a lot of times we don't even listen to what we're feeling at the give, you know, anybody moments. Oh yes, exactly. And I, and I also, you know, it's fascinating. I think the, what you posted very recently was all about like the gut. And the gut is like another level of that. We're seeing a lot now that gut-brain connection, that gut-heart connection and how the gut really is a, a determinant of our health.
Nicole: Oh yes. So because studies do indicate that poor gut health increases the risk of estrogen related diseases of course like , you're looking at PCOS, endometriosis, and even breast cancer. So it's also a link with mental health. Right? So we definitely cannot forget the gut.
Dara: Yeah. We can't ignore that for sure. Wow. Lots to think about. I know there are some potentially promising supplements on the market that may be helpful for PCOS and I know one of them is inositol, which is being studied a lot more nowadays in terms of potentially increasing one chances of getting pregnant. Do you think there is potentially some benefit to taking it?
Nicole: Yes, I've gotten these questions as, as well from my clients. And first I'll say inositol is a vitamin like substance that's one of the most commonly recommended supplements right now. And it does have evidence to support its usage for PCOS with the inositols. We can also find it naturally in certain foods like fruits, right? Fiber-rich foods like fruits, beans, grains, nuts and it's very, very rich in buckwheat. So that's a very good source of it. So yeah, so there, as I was saying, there is adequate research to support its function in reducing androgen and supports insulin sensitivity. So your body uses the glucose better. Right? And helps to reduce the hemoglobin a1c as well. So pretty much helps…
Dara: Which often can be elevated. Yeah. With people with PCOS.
Nicole: With PCOS. Exactly. So we see the strong connection there as far as what it does. So, yeah. So it does, it is involved in regulating hormones so such as follicle- stimulating hormone, TSH, insulin. And there are many uses of inositol, as I say, in improving the insulin resistance. Even abnormal lipid levels can lower in androgens. So yes. So I, same studies that's shown that inositol improves ovulation. It helps, as I say, decrease testosterone and we see women starting to get their periods and as little as a month, even within three months of taking inositol. So yes,
Dara: It has the potential.
Nicole: Yes. And I've also experienced that the same with my clients getting their periods back. So a big plus is that it helps to improve equality in women with PCOS. So yes. So women with a PCOS, inositol should definitely be considered and of course should be under the guidance of a healthcare provider.
Dara: Yeah. And also for me, I'm sure you would agree with me, it could be one potential tool that could be helpful along with, you know, nutrition and other lifestyle modifications that you know, should be customized to everyone's specific needs. To each person's specific needs.
Nicole: No one thing is the end all, right? I would say there's not one, Oh, this one thing will solve all your problems. Yeah. And everything. So it's not taking inositol, ignore the other areas and you'll be just fine. It doesn't work like that. So this is a helpful, something that can be very helpful, but we have to take into account that we we’re still following our diet and just being healthy and being mindful about the different pillars we should be focusing on.
Dara: Yeah. I think you can look at it in many ways. You can look at it as wow, that's a lot to work through with, you know, if I'm struggling with PCOS or you could look at it as, wow, there are many different areas that I can look at. And slowly working with slow, actionable, realistic goals. Slowly start to feel better physically and mentally as opposed to having only one thing, you know, looking towards one thing to, to necessarily be the answer. There's, there's a lot of potentials that could be helpful, which is I think nice and it's tough cause I think a lot of us just tell me what I need to do. I wanna be in control and I really do think it should be customized for, for each and every person, which is what you do, which is wonderful that you're there to support each person individually.
Nicole: Yes, definitely. Customization is absolutely needed. We have to do it per person, not just a one size fits all and it has to be relevant for someone's lifestyle, their particular situation, the cause of their PCOS and many different factors, right? This person eats, they eat fish, they don't eat fish or and their likes, dislikes. So there are so many different areas that we do look at when we are definitely assessing a patient and deciding where the route that we would go with managing their PCOS.
Dara: Yeah. I think that's great that you're there to help support each person. What is a couple things, Where can our listeners find you in terms on Instagram and a website and also if there's any last minute words of wisdom that you'd like to share.
Nicole: Yeah, so yes, sure. So you can find me on Instagram at Nicole Holness. Well I'll, it'll give you the other one. You can find me @holnessnutrition. So that's the best place on Instagram to find me. You can also go to my website, it's holnessnutrition.com and you'll, that will be the best way because you'll get everything. You'll get the beautiful checklist. and I do also offer a free three day anti-inflammatory menu guide. Yay.
Dara: Oh wow. And remember, like it's a perfect opportunity to go and take her quiz and see how you do based on that. I find that very interesting and definitely a big draw to your site. I'm so thrilled that you're on and really hopefully helped ease people's concerns regarding PCOS. And I know that, you know, I feel like you've given a lot of hope to our listeners that there are various ways to help manage P C O S, to feel your best to help you ovulate and help you on your health and potentially fertility journey.
Nicole: Yes. And in terms of last minute's hope I'll say that do not feel despaired. I know that the symptoms can be devastating, right? The effects can say affect your mental health. So, please get help and try to build a solid support system in place to, to get the support that you need. So if you are feeling that you need support, you are not alone. Because I will say that in an international survey of close to 1400 women with PCOS found that 12% of the women were satisfied with the information they received. Only 12% and, and about lifestyle management when they were diagnosed with it, so they felt abandoned by the healthcare committee. So I understand that you may feel this way. So there definitely is help that you can get. And 88% of these women, PCOS, report wanting more practical lifestyle management instructions. Know it's easy to get inaccurate information on nutrition as well. There's so much on the internet. As frequently you're looking for answers and you're coming across different kinds of sources. So there definitely is help. And I'll also mention that the international evidence-based guidelines for PCOS and the guidelines, it's based on the work of over 3000 healthcare professionals and consumers internationally and they do to support optimal patient care. And they cite nutrition, exercise, and lifestyle as being beneficial to the management of PCOS. You should definitely consider a registered dietician who specializes in PCOS.
Dara: To help customize and support you in any way possible. Well, Nicole, I feel like you're that for our listeners, Thank you so much. Before we end, I wanted to ask you what we ask all of our guests here on the podcast in terms of gratitude. What are you grateful for today, Nicole?
Nicole: Ok. I would say I am grateful for, and I'm gonna keep it consistent now. I'm grateful for having access to, I'm here in New York City, I have a, I could just go down the street and get my wonderful fresh produce. So easily having access to these kinds of things. And I ordered something last night over the internet. It came just minutes ago. So I'm also grateful for that and I, I thought about it only because I spoke with someone last night who, she lives overseas and when I said I ordered, something is coming tomorrow, she said, Really? So then I realized, oh my goodness, we are so spoiled over here. It's, it makes me grateful
Dara: That, that actually, you know, I was thinking that strangely enough this week I met with a new patient who moved far away and doesn't have a lot of access to fresh produce and the things that we take for granted. We can literally, we have fresh produce all around us in New York and it's things that we often take for granted that, you know, for her, she doesn't have the access to it all the time. So that, that's a beautiful thing to be grateful for. You also spoke about breath work. So I'm gonna say that I'm grateful for my breath work practice. I actually was very fortunate to have a wonderful breathwork session doing deep holotropic breath work this week with some of my dear friends. It felt blissful. It really felt so nice to be in that moment and to feel light and, and at ease. And it really helped clear my mind for the day ahead. So I'm grateful for being able to experience that and have some self care. You know, it's, we, we speak about it all the time with our patients, but it's not something, it's something that we need to remind ourselves to, to do whenever we can.
Nicole: Yeah. So, well, it makes me feel like I wanna do that this evening. I'll get my essential oils running and do some breath work.
Dara: I love that. Everyone listen in. Make it a priority tonight to have some self-care, whatever it may be. Thank you again, Nicole, for…
Nicole: And Dara! I'm sorry, one more thing. Yeah, I can't believe I almost forgot to say it. So I do have a Facebook group called Be the Boss of Your Hormone Health, PCOS and fertility support groups. So if you'll put that in the caption?
Dara: For sure. Everyone listen up, this is great. So many people are looking for a support group, especially, you know, like-minded women who are going through similar experiences and that's great that you are spearheading this. So yes, please everyone check out her Facebook community page. Be the boss of your hormone health PCOS and fertility support group.
Nicole: Yes, it is. We have a challenge that we are running. It's called Flourish for Life, and we have lots of free goodies that we're giving, so, and while you're achieving your optimal health, so it's a win-win.
Dara: Wonderful, Nicole. So happy that I discovered you on Instagram and thrilled that our listeners got a chance to hear about what you do and your passion, and I'm sure everyone gained something new today on that.
Nicole: Thank you. I'm thrilled to be here. Thank you.
Dara: Thanks, Nicole.
Dara: Thank you so much for listening today. And always remember, practice gratitude, give a little love to someone else and yourself, and remember you are not alone. Find us on Instagram @fertility_forward and if you're looking for more support, visit us at www.rmany.com and tune in next week for more Fertility Forward.