PMS- Why You Get It and What to Do [Podcast]
Nicole Jardim is one of my favorite menstruation experts and co-host of The Period Party, a podcast that actually makes this sometimes-tough topic fun! Nicole joined the podcast today to break down Premenstrual Syndrome (PMS) for us and answer the question, “Are Women with PCOS more likely to have PMS?” Listen in (or read the transcript) as we discuss this plus:
- the root causes of PMS
- the impact of stress, diet, nutrient deficiency, and environmental toxins
- relationship to blood sugar instability, hypoglycemia, and hyperglycemia
- how to lessen symptoms
- possible triggers
- fixes including what to eat and HOW to eat it
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Amy: Today we’re gonna be talking about a very popular subject I hear from a lot of women with PCOS who are suffering with PMS, or what they think is PMS. I’ve been really curious to find out whether women with PCOS are more likely to have PMS, and so I reached out to one of my favorite period experts, Nicole Jardim.
She is a certified women’s health coach. She’s the creator of Fix Your Period. It’s a series of programs that empower women to reclaim their hormone health using a method that combines simplicity and sass. She’s also the cohost of The Period Party, which is one of my favorite podcasts on iTunes. So be sure to check out here podcast if you want to learn more how to fix your periods. Nicole, thanks so much for joining us today.
Nicole: Hi Amy. Thank you for having me. I’m so excited.
Amy: Yeah. I’m really excited to talk about this subject. I don’t think I’ve tackled it on the PCOS Diva podcast yet.
Nicole: Get ready.
Amy: Yeah. I know, get ready. Lot’s to talk about. We’re gonna try and fit as much as we can in the 30 minutes or so that we have. Let’s just maybe start out with defining what is PMS? I know there’s another acronym that’s tossed around PMDD. Maybe you could just give us the skinny on that.
Nicole: Oh, yes. Okay. I’ve got so much. All right. I’ll break this down easily. PMS refers to a collection of physical and emotional symptoms … also mental symptoms. They arise in a cyclical pattern. Usually they coincide with the latter half of the menstrual cycle or the luteal phase. That’s where pretty much everyone experiences symptoms.
Some women experience some symptoms right after their period. That’s sort of taken on a new name. They call it post-menstrual syndrome. I feel like that’s a whole other can of worms and possibly another podcast episode. Just so you know, there’s something going on there too, if you experience symptoms during that time right after your period. That could be what’s going on for you.
These symptoms usually resolve when your period starts. So, it’s this lead up, usually the seven to ten days leading up to your period.
A lot of people find, or a lot of people say that PMS is a joke, right. It’s not even a legitimate condition. In our culture, I feel like it’s just a part of the experience of being a woman with all the lame PMS jokes to go with it. I just think it’s so interesting because we’ve made it into something that is not serious. In fact, I think it is something that we should be taking seriously because it is a legitimate condition that women experience.
Then, of course, there’s premenstrual dysphoric disorder, or PMDD. PMS is just sort of a normal inconvenience of menstruation for most women. There’s about … it’s probably about 3 to 8% of women, they experience something much more severe and that’s called PMDD.
For regular PMS symptoms, we’re talking about things like bloating and cramping leading up to your period, and acne sprouting on your face, or on other parts of your body. Then food cravings and potentially stomach issues, like stomach upset or feeling nauseous. Having issues sleeping, as well, falling asleep or staying asleep throughout the night.
A lot of women experience headaches or menstrual migraines, breast tenderness, or breast pain. Just this sort of fatigue that hangs over you and won’t go away. Then a lot of women experience some of these emotional symptoms like anxiety, and irritability, and just this feeling of fullness, and really wanting to release it, which, again, metaphorically, means your period is filling up and will be released soon.
A lot of women then feel more severe symptoms related to PMDD like actual depression, where they actually feel sadness and hopelessness and feelings of worthlessness. The insomnia is far worse than just one or two sleepless nights, or one or two nights where you have trouble falling asleep.
The other symptoms related to PMDD are just a decreased interest in your usual activities, which isn’t totally abnormal for this time of the month. If you’re really stuck, you actually go through a mini-depression every month and you’re lashing out at people in your life, and you feel constant tension, and really extreme anxiety, and it’s actually creating conflict in your relationships, or preventing you from maybe even going to work, or doing other daily activities, and you’re feeling out of control, that’s really where I would be talking more about PMDD.
Women with PMDD will often say that their menstrual cycles are negatively impacting their relationships, their career, their mental well-being. It’s not just a matter of some uncomfortable symptoms, like PMS, each month, but it’s more comparable to debilitating and sometimes even traumatic symptoms.
Amy: Do you think that most doctors recognize PMDD, or is that when you go to the doctor and they say, “Well, it’s just PMS and whatever you’re dealing with is kind of in your head.”
Nicole: Funny you should ask that because, unfortunately, the most common treatment for PMDD are SSRI’s, or anti-depressants. Oral contraceptives are also popular because they disrupt ovulation and the production of our estrogen and progesterone, and all those evil PMS symptoms start to dissipate when we are no longer ovulating and we’re just flat lining our hormones. Yeah, we are using anti-depressants.
Interestingly, our friend, Dr. Lara Briden, actually had pointed me in the direction of an article maybe last year on the invention of PMDD and the invention of this condition, essentially, by big pharma. I know this sounds so conspiracy theory like.
It was actually on MedPage Today so I know it’s legit, somewhat. They were talking about pharmaceutical reps coming together, pharmaceutical people who came together to devise a solution for women with this condition that they essentially invented.
I’m always very weary of, again, someone being diagnosed with PMDD, or PMS even, because I feel like we tend to pathologize these symptoms that we experience. In many cases, what we should be doing is just looking at a root cause for what’s causing the hormonal imbalance in the first place.
Coming back to what you were saying, yes, I actually think a lot of doctors will recognize something like PMDD because there’s a solution for it. There are anti-depressants that they can recommend.
Amy: I think that happens with a lot of women with PCOS too. You look at our symptoms, and the response is treating the ill with the pill. So, you have acne and let’s put you on Accutane, or you’ve got depression … some women that have depression do need to be medicated. Sometimes it can just be you’re low in a specific nutrient.
Doctors aren’t really looking at, or sometimes aren’t really looking at getting to the root cause. I think that brings us to, what are the root causes of PMS and, potentially, PMDD?
Nicole: Oh, yeah. There’s a number of different issues happening or at play, especially for women with PCOS. I’ll just go into an overall view for most women because I think that it’s really important for women to understand that this can really happen to any of us. It’s not just women who potentially have PCOS.
More than anything, just to build on what you said about there’s a pill for every ill. We need to be really paying attention to our bodies and paying attention to what’s going on and taking those cues, rather than looking to external sources to help us figure out what’s going on. It’s helpful, of course.
I think it’s so important for us to really get in the-know and understand, because anti-depressants to deal with your PMDD, they come with their own side effects. So we have to be very in the-know about that. I just don’t think that there’s anything normal about what women endure each month when it comes to these conditions.
These are now being categorized as female psychological disorders, and I think there’s something wrong with that. It’s almost like saying to women, “Well, your bodies are just not meant to work without the help of some kind of pharmaceutical.” I think that, that’s a potentially dangerous message to spread.
Coming back to the causes, we have a couple of different things going on. It’s usually a combination approach. Psychological stress is a big part of this, obviously. We all know this by now. I feel like we’re all broken records talking about stress in our lives, but that is a big part of it. I’ll explain how that connects to our female sex hormones, as well as diet, you mentioned, and nutrient deficiency. There’s definitely a specific nutrient deficiencies that contribute to these hormones going a little bit out of whack and then causing these problems.
Then environmental toxins, so ones that they make estrogen, in particular. That, of course, is very applicable to women with PCOS. Then, of course, one of my other ones I consider to be a big issue too is pore detoxification. So we’re not either detoxing certain chemicals and toxins from our bodies, but we’re also not detoxing estrogen correctly either. That, again, comes back to a number of different factors.
One of them is we’re overloading our bodies. The second thing is there’s a genetic component. There’s also a good health component. The other thing, too, is that coming back to your diet, which I think is, again, the really root cause of everything, as well as the stress, but the diet in particular, is that we’re living in a time where our dependence on refined carbohydrates, and sugar, and living in our stress filled world is just an ever present problem.
I think it’s massively important that we’re looking at this and especially for women who have polycystic ovarian syndrome because we’re basically set up almost genetically for chronic blood sugar spikes and crashes. So we have to be especially diligent about that.
I say we, I don’t have PCOS. I don’t know why I’m saying that. You guys have to be. I’m just saying that because back in the day, I wasn’t getting my period for months at a time, and I was eventually put on the pill. I was never diagnosed with PCOS formally, but I had a lot of the tell-tale symptoms. I definitely relate to a lot of what women experience with this condition.
Coming back to PMS and this root cause when it is linked to our diet, I really think that these blood sugar imbalances play a really big role. I joke about this, about PMS being the same as just being hangry all the time, and it actually kind of is that in a way, when you think about in terms of blood sugar instability and hypoglycemia and then hyperglycemia.
The symptoms of that and PMS are actually very similar. When you think about just getting annoyed and frustrated and having a little bit of a tantrum or just having these headaches or these bouts of fatigue, all of it is very similar. What’s really interesting is that insulin sensitivity is actually higher in our follicular phase, so that’s that first phase of our cycle, and drops in our luteal phase in the second half of our cycle, which is very interesting to me.
This makes our bodies more prone to blood sugar and insulin imbalances in that second half of our cycle. Whereas, in the first half, we tend to not have those issues so much. So the PMS cravings, and the mood swings, and the brain fog, and the bouts of the fatigue, those are all, typically, what happened in the second half.
I’m always convinced that it’s because progesterone has a blood sugar lowering effect on our bodies. So when progesterone is higher in that second half of our cycle or after we’ve ovulated, we tend to have more of these symptoms. Whereas, estrogen actually enhances the efficiency of insulin. So in that first half of our cycle leading up to ovulation, we typically have higher estrogen and our blood sugar tends to stay more stable.
Amy: I love how you explain that. I could really relate to the similarity of blood sugar imbalances with how I feel right before my period. Just the fatigue is like I’ve been hit by a truck some days. I’ve got to take a nap and it’s very similar to how I feel if I’ve eaten a high carbohydrate meal.
Amy: I just get hit with that low blood sugar dip afterwards, like that hypoglycemic plunge. Yeah, and the cravings. I mean, that makes a lot of sense.
Amy: ‘Cause I’m looking for … I don’t understand why I’m so hungry.
Nicole: What’s really great is that progesterone, obviously, the more dominant hormone while you’re pregnant, that pro-gestation hormone, as it’s called. It actually does something with insulin while we’re pregnant. It actually puts us in a state almost of insulin resistance so that we can grow our baby faster, which I’m always so fascinated by this.
It wouldn’t be crazy to think that progesterone does that to us in the second half of our cycle, as well. I think women, they constantly say to me, “Well, how do I even know, you know, my blood sugar’s dysregulated or that I have insulin resistance?” I image you’ve talked about this ad nauseam on the podcast, and on your blog, and in your book.
I find that just telling women, just a few things like, the brain fog, or this fatigue that you just described, that’s good sign that there’s an imbalance probably temporary, more than likely. But, an imbalance in your blood sugar, and then that mid-morning or the mid-afternoon energy dip or the crash, or feeling sleepy after you’ve eaten a meal, and then sugar cravings right after a meal.
Usually if you see any of those, it’s likely that something happened in your meal or the food that you ate or whatever you just drank, maybe it was a coffee, that caused some blood sugar, maybe a blood sugar spike and crash. I think that’s helpful for people to just have an idea of what that looks like.
Amy: Yeah. No, very, very helpful. For somebody like me who, I do get irritability. I do have the cravings. Then I do get the fatigue. It’s usually one or two days before my period starts. Is there anything I could do? Or is there anything to fix, maybe not alleviate, but lessen those symptoms?
Nicole: Yeah. Absolutely. I think that for many of us too, I take a sort of nuanced approach to PMS. The reason I say that is because, or PMS symptoms in general. Because we have turned premenstrual syndrome into this kind of jokey thing, we view it as being something bad.
I really feel like we need to flip the script on it a little bit, because I don’t really consider any of the symptoms to be bad necessarily. I just consider to them to be your body speaking to you in her own language, which we are always working to decipher. She’s essentially saying, “Amy, you might need to take a break. You might not need to be doing whatever it is you’re doing today and just chill out.”
I get those messages all the time. I always encourage women to really tune into what it is that their body is actually trying to tell them and start to pay attention to that and listen to it. When you said irritability, or you’re just exhausted, it really is that, right. Our bodies were fundamentally designed to expend energy at certain times of our cycle, and then conserve it at other times. That really is the time.
I kinda joke. I call progesterone truth serum because all kinds of stuff comes out during that premenstrual time. I’m sure women who are listening can relate to this. I bet you can too.
I was just having a conversation with my partner. We were talking about some hard stuff. I was like, “Well, maybe I shouldn’t be talking about this at this time of my cycle, ’cause I’m about to get my period.” Then I was like, “Well, you know, it’s good,” because obviously what you’ll find is, what’s amazing at this time of your cycle is that you get so many intuitive hits.
If you just slow down a little bit, you’re able to really tune into what’s going in your life, and what you might need to shift or change. It’s really hard, I think, to do that when we continue to go, go, go, like we were doing around ovulation time, for instance. As a result, we miss all of those cues.
I think our bodies, they’re like, “Okay, fine. I’m gonna just rebel against you.” Or something. Then you start to feel all of these symptoms. I think more than anything, it’s so important for us to figure out how we can …
There’s obviously a lot of solutions we can do to address. I’ll talk about those. But, I think it’s so important for us to really take it down a notch and figure out what our bodies are saying to us so that we can then live more in sync with them versus constantly feeling like we’re butting up against them. Could you agree with that?
Amy: Oh, yeah. Now that I am cycling, I mean, early when I was really struggling with PCOS, I would have this non-existent cycle-
Amy: Women listening can probably relate, like why I don’t have PMS ’cause I don’t even have a cycle, or I was on the pill and it suppressed a lot of that. Now that I am still every 28-30 days like clockwork, which is a miracle ’cause it wasn’t like that when I was young, I’ve come to honor that cycle.
I think that’s what you’re talking about and what a lot of woman’s hormones bloggers, I think, and experts are alluding to now, is that we need to go with the flow, right, and honor our cycle. I look at my calendar now and know that at that time of month, I’m really usually pretty tired. I may not be able to run a 5K.
Nicole: Yes. Exactly.
Amy: But, earlier mid-cycle, I feel really energetic and I probably could do that. I do think that, that’s really to honor your body cycles. I’m jumping around a little bit, but because I alluded to the fact that women with PCOS struggle with ovulation and regular menstrual cycles. I mean, are we more likely to have PMS?
Nicole: Yeah. This is so fascinating to me. In all of my research, and in just in prepping for chatting with you today, I was finding some really great information that I wanted to share. I talk about this on my blog and it’s just the relation between our gut health, and our mental and emotional health, of course.
Estrogen and progesterone, they impact our neurotransmitters, which is why when a woman is struggling with PMS or even PCOS, it’s like a full body experience, right. It’s not just a little bit of cramping and some acne. It’s usually more than that. It’s pretty multifaceted.
Obviously, our gut health is connected to everything. What a lot of women don’t realize though, is that histamine, which is produced by bacteria in fermented foods and other foods as well, which I’ll get into a second. There’s some interesting research that shows that that can trigger PMS symptoms, whether it’s before your actual period or around ovulation or just if you’re estrogen dominant.
I think it relates to women with PCOS, in particular, because they tend to not ovulate often so they tend to have more estrogen in relation to progesterone. Progesterone typically will down play the effect of histamine on our bodies. Whereas, estrogen actually triggers it and causes it to rise.
For anyone who really doesn’t know what that is, histamines are chemicals that are stored in immune cells called mast cells. They’re involved in a whole bunch of things like, immune response, and nerve transmission, all kinds of things. What happens is these mast cells get triggered and they release histamines.
I was talking about this on my blog, especially because it relates to endometriosis, but it definitely relates to PCOS too. If you think of histamines, you think of an antihistamine, right. So you think of sneezing, and itching, and hives, and wheezing, and things like that, and getting all red and swollen.
Interestingly, women with PCOS, like I said, they actually tend to have more histamines, or histamine issues. The reason for that is a lot of the time women with PCOS have a less diverse microbiome, which is so interesting. Although, I think that that tends to be the case for most humans in the developed world now.
They’ve made the connection between PCOS and this less diverse microbiome. Then there are not only these mast cells producing histamine, but they’re actual gut microbes that are also producing histamine as well. They regulate it. They produce it. They deregulate it, that kind of thing.
I was thinking along the lines of this connection between a woman who has PCOS who has this potential compromised gut health and that her histamine production is potentially triggering these PMS symptoms. Ladies, if you’re having issues where you’re not really ovulating, and you’re in an estrogen dominant state, and you feel like you experience a lot of these PSM like symptoms that I described, that’s what this could be.
If you do ovulate and maybe not often, but you ovulate when estrogen rises significantly and you experience this around ovulation, almost like a PMS, an ovulatory PMS, or you experience it towards the end of your cycle, know that this could potentially be what’s going on.
I think with histamine, it’s a little tough in that there’s no super easy way. I think what’s great is that women, if you do feel these symptoms and maybe think that this could be what’s going on, because the symptoms that you experience too, are not only the PMS like symptoms.
If you get skin rashes or you have, like I said, sneezing, or itchy eyes, or red nose, or itchy skin, or swelling, or anything like that, that’s definitely a sign too that there’s a histamine intolerance. Histamines are typically found in, like I said, in sauerkraut, so fermented foods, yogurt, pickles, sour cream, aged cheeses, like cheddar, goat cheese, or something like that. Then things like alcohol, sadly wine and beer, in particular, and avocados, unfortunately, and chocolate, and other dairy products.
Again, you could find a list online, and maybe consider cutting those out for one to two weeks, and see what happens, because I’ve seen great results for women where they do that and it really helps to stabilize the effect of histamines on their health.
Amy: Yeah. That’s really interesting. I mean, certainly I think a lot of women listening probably don’t do dairy already.
Nicole: Yes, yes.
Amy: But, fermented foods is something that is considered to be really healthy in rebuilding gut. I can tell you so many women with PCOS now have turned their soda habit to Kombucha habit.
Nicole: Ah, yes. I know.
Amy: Yeah. That I think could be affecting, not only histamine, but things like candida as well.
Nicole: Oh, yeah.
Amy: I think that, that’s really fascinating. I haven’t read about the histamine PCOS connection. I’m fascinated. Did you say that you wrote a blog article about it?
Nicole: I have some information on it. I haven’t quite written a blog article specifically about it yet, but I wanted to do that just because I think it’s so important for us to be paying attention to these things that you never even really know about.
Amy: I wanna circle back to the fixes.
Amy: I think that’s a great point about possible histamine intolerance. Then earlier you were talking about your diet and detoxification and stress. You talked about your gut health as well. I’m wondering if you could give us a few concrete tips that we could walk away with and put into action?
Nicole: Yes, I would love to. I think that more than anything … I know you’ve probably talked a lot about this too. When we eat a breakfast with protein and fat in it, it really changes the game for us. It changes everything throughout the day.
A friend of mine created something called the Superhuman breakfast a long time ago. I’ve really stuck with it. It’s just one of my favorites. It’s essentially eggs, poached, soft boiled, something like that, some kind of greens, steamed or sautéed. Whether that’s kale or collards or some other kind of leafy green or broccoli or something.
Then sweet potato and avocado and maybe any other veggies you’d like, or some kind of meat, whether that’s sausage or bacon or something that you can put with this breakfast. I even sometimes have it for dinner because it’s so great. Again, it keeps you full for so long. It’s got all the things that you would really need. I’m a big fan of figuring out what’s happening for breakfast. That’s huge.
I think when we think about eating, it’s so … This ties into the stress component too and just the doing of all the things that all the time. When we eat, it’s so important to notice what we are doing or not doing. I find that so many of us just constantly walking or rushing to work. We’re standing at the kitchen counter, or at our desk. We’re doing a million things while we eat. All of this actually raises our blood sugar because we’re eating in what your body considers to be a stressed environment.
Amy: I have to interject about doing things while you’re eating. I mean, social media scrolling through Instagram and Facebook. How many of us cannot put our phone down? Me included sometime.
Nicole: Yes, same.
Amy: Looking at all of the political stuff that comes through on your feed. Looking at maybe what your friends are doing and then it brings up feelings of jealousy or envy ’cause they’re on some fabulous vacation and you’re trying to eat while you’re trying to process all of that. Social media’s not great either. You’ve gonna need a break.
Nicole: No, I could not agree more. I was actually just talking about that in the last couple of days. My really coming to terms with my addiction to wanting to see those things and get that dopamine hit every single time I open one of those apps.
Yeah, we really have to be cognizant of that. So going outside and eating, or literally leaving your phone in the office or at home, and going outside and eating, and aiming to chew your food 20 to 30 times per mouth full. I mean, who really does that? I do because I’m a freak. You notice when you chew your food and other people don’t.
Just really thinking about how you can be more mindful when you’re actually eating your food is so crucial. Then there are a couple of other things too that I think are so important. One of them is vitamin D. I know that you talked about this. I talk about this too a lot. Just the connection between low vitamin D and diabetes, low vitamin D and polycystic ovarian syndrome.
It’s really crazy. Every unit increase in vitamin D levels, there is an 8% decrease in the risk of getting diabetes. That’s just really interesting because it’s very clear the correlation. I’m always on women to make sure that they get their vitamin D tested. Of course, make sure that it’s over 35, at a minimum. 35 to 70 is really where you’d like it to be. It’s a big range, but it depends on how you feel, right. So check in with yourself.
If you’re not feeling great at 35, it likely needs to be higher. Getting in the sun, if you live in a sunny environment, every single day, also supplementing if that’s necessary. Just knowing that you need to be testing relatively consistently, one to two times a year just to see where your vitamin D is, especially if you have PCOS just to make sure that you’re taking care of the basics that your body needs to stay within the range of stable blood sugar.
Another thing that I also recommend too for blood sugar stability and just addressing PMS symptoms in general is Omega-3 Fatty Acids. I’ve seen so many amazing studies about Omega-3s, and inflammation, and physical pain, which are, or course, all going to trigger these symptoms that we experience whether that’s at ovulation time or at PMS, premenstrual time.
So, Omega-3 Fatty Acids, whether you’re consuming cold water fatty fish and or taking two capsules, one to two capsules of Omega-3 Fish Oil a day, something around 2000 mg a day, I highly recommend this just for all of the, again, brain inflammation and physical inflammation.
Again, coming back to the histamine limiting, or limiting the histamine releasing foods, that too, I think, just even for a week or two just to see if that helps to improve your symptoms.
Amy: Yeah, that’s great advice. That’s one of the reasons that my essentials bundle that I offer has Omega 3s and vitamin D. I just think it’s so important that women … like you said, you have to find out where your vitamin D level is. Some women need mega amounts for a while to get it optimized.
Amy: At end, while you’re recording this in October, I think you podcast coming out in November though. It is breast cancer awareness month. There’s a correlation between low vitamin D and breast cancer too.
Nicole: Yes. Absolutely. I know. I was just reading that somewhere. I think on Dr. Ben Lynch’s website. He was just talking about that, about breast cancer, the pink washing of breast cancer. That’s, again, a whole other podcast. The fact that, actually we should really just be looking at some nutrient deficiencies versus talking about making everything pink with fake food coloring. That’s potentially going to be problematic for us. So, yes. Yeah, vitamin D is huge for that too.
Amy: Yeah, so really great tips. If you’ve been following the PCOS podcast for a while, hopefully, you’ve been doing some of those things already and you’re ahead of the game. Can you give us some thoughts on maybe resources for looking into histamine intolerance? Is there any sites that you like?
Nicole: I suppose I could just write this blog post. I could share that with you. It wasn’t anything that I found on anyone’s site per se. It was just some studies that I was looking at. I’ll definitely have to provide that, give that to you so that you can put in the show notes.
Amy: Okay. I think we’re about out of time, but I wanna make sure that women can find out more about the work that you do Nicole and where can they find out more about you and what you … I know you offer so much for women who are trying to fix their periods.
Nicole: Thank you. Yeah. You can just find me on my website. It’s nicolejardim.com. My blog has a ton of information. I’ll make sure to get that histamine blog post up. You can also take my quiz to figure out what’s going on with your period. I have a free seven-day course for women are interested in fixing their periods once you take the quiz.
I’m also the cohost of the Period Party, which Amy I know you’d mentioned. You can find that on iTunes and pretty much anywhere podcasts are these days. I do that with my friend Dr. Nat Kringoudis. It’s actually a party. It’s pretty hilarious. We had Amy on a couple of weeks ago.
Amy: It was fun.
Nicole: It was. It was so fun talking with you. Yes, those are the main places that you can find me.
Amy: Excellent. I so appreciate you taking the time to come and talk to us about PMS and PMDD. I look forward to having you on soon. I know you have some projects that you’re working on that I know that women with PCOS would be interested in. So, we will have you back on the PCOS diva podcast soon.
Nicole: Thanks, Amy. Thank you so much for having me.
Amy: Thank you everyone for listening. I look forward to being with you again soon.