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Bird Rock, St Kitts, St Kitts and Nevis, West Indies

info@lakehealthandwellbeing.com

+1 869 765 8702

Category: Women’s Health

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BlogEmpowHerWomen's Health

The Launch of EmpowHer

We are thrilled to announce the successful launch of our EmpowHer project, which aims to empower women living with non-communicable diseases (NCDs) in St. Kitts and Nevis.

The launch event, which took place on Monday 13th February, was a great success and featured a number of inspiring speakers who shared their insights and expertise on gender and NCDs.

The event started with a beautiful opening prayer by Novelia Rawlins-Nwosu, Coordinator of the Chronic Metabolic Disease Programme at the Ministry of Health. This was followed by an introduction by Abi Begho, Programme Director at Lake Health and Wellbeing, who gave an overview of the project and its goals.

His Excellency Michael Chau-Hong Lin, Resident Ambassador for the Republic of China Taiwan, also delivered a speech, expressing his country’s support for the project and its commitment to improving the lives of women living with NCDs.

The Permanent Secretary of the Ministry of Social Development and Gender Affairs, Ms Azilla Clarke, also spoke at the event. Her remarks highlighted the important role that women play in society and the need to address the specific challenges that women living with NCDs face.

Dr Marissa Carty, NCD Programme Coordinator at the Ministry of Health, delivered an informative and inspiring talk on NCDs and women in St. Kitts and Nevis. Terysia Herbert-Browne, Project Officer at Lake Health and Wellbeing, also gave a detailed presentation on the EmpowHer project, its objectives, and its expected outcomes.

The event was brought to a close by Andrew Tseng Kuo, Project Manager for the Women’s Employment, Entrepreneurship and Financial Inclusion Project  (WEEFIP) project, who emphasized the important role that the project will play in empowering women and supporting them in their efforts to overcome the challenges they face.

We are excited about this project and its potential to make a real difference in the lives of women living with NCDs in St. Kitts and Nevis. We believe that by focusing on women who are living with these conditions, we can help to improve their quality of life and promote positive health outcomes.

If you missed the launch event, you can access the full recording on YouTube below.

There is also a short 4-minute summary video of the launch that you can view below.

If you would like to register for the EmpowHer workshops or find out more about the project, please email us at events@lakehealthandwellbeing.com. We would be delighted to hear from you and to share more about this important initiative.

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BlogWomen's Health

We Were A Winner of the WEI Contest!

We are extremely grateful to the Ministry of Social Development & Gender Affairs and the Republic of China (Taiwan) for selecting us as one of the winners of the Women’s Empowerment Initiative Contest and awarding us funding to implement a project to empower women living with non-communicable diseases (NCDs).

This project was birthed out of a research project we conducted last year, with funding from the Commonwealth Foundation. This research project explored the gendered impact of the COVID-19 pandemic on people living with NCDs in St. Kitts and Nevis. One of the key findings of this project was that single mothers on a low income were particularly vulnerable during the pandemic. This was because they were already trying to manage their chronic illness while fulfilling their many roles and responsibilities, (being a mother, working, caring for older parents etc.) with sometimes little or no practical, emotional or financial support. As a result of this, they were exposed to a high level of stress which can exacerbate their NCD and the disaster-related stress caused by the pandemic compounded these issues.

Our project aims to empower women living with NCDs professionally, personally and financially, and we also aim to provide guidance on NCD self-management and self-advocacy to ensure that women can successfully manage their health condition and advocate for themselves. Through this work, we hope that we will enable women living with chronic health conditions to live a full life where they are able to thrive.

We are very much looking forward to starting this project and if you are a woman living with a chronic health condition or know someone who lives with a chronic health condition who may benefit from our project, then please do get in touch with us by emailing info@lakehealthandwellbeing.com  

You can find out more about the Women’s Empowerment Initiative Contest and the other winner, Tab SKN, here and here

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Women's Health

International Women’s Day Webinar

This year, the theme for International Women’s Day was ‘Break the Bias,’ and organisers asked us all to imagine a world that is free of bias, stereotypes and discrimination and built on equity and inclusivity. A world where women have full access to opportunities, information and the freedom to define their own success.

When it comes to women’s health issues like fibroids, endometriosis and PCOS, many biases exist, such as: these conditions are “not that bad”, “not really that painful” and “not a public health priority.”  These biases have left women with subpar treatment options, a lack of information to make informed choices about their health and a lack of appropriate support.  As we neared International Women’s Day, one of this year’s missions reminded us to stand up and address these health-related biases so that women are empowered and can take control of their health. Therefore, in recognition of International Women’s Day, we hosted a virtual womb wellness presentation with guest speaker, Dr Keriise Manchester, an obstetrician and gynaecologist in St. Kitts and Nevis and founder of Manchester Medical.

Our womb wellness session was aimed at women in St. Kitts and Nevis and focused on providing women with information and guidance on what they need to know about their womb health.  Dr Manchester provided a very comprehensive presentation exploring womb wellness throughout a women’s life course from childhood to the post-menopausal stage. The session was accessible in the way it was presented, informative and empowering and we would like to thank Dr Manchester for being a guest speaker for this session and sharing her expertise.

There is still a lot of stigma and sensitivity around the challenges that women may face with their womb health and we hope that this session provided a safe space where women could learn about an important health issue and made them feel more comfortable about talking about these issues so that they are can be addressed and treated promptly.

If you missed this session, you can watch the recording below and if you have any questions, please don’t hesitate to send us an email.

 

Fibroids and Mental Health
FibroidsOH Services

Fibroids and Mental Health Webinar

On Saturday 31st July 2021, we were delighted to host a webinar on fibroids and mental health. This webinar was part of our Fibroids Awareness Month event series which aimed to empower women living with fibroids with information on how to manage the impact of fibroids.  

A very important issue for women living with fibroids is managing the mental and emotional impact of fibroids. Therefore, we invited Olivia Haltman, an accredited counsellor from OH Counselling Services, to help attendees identify, understand and address the many ways that fibroids can affect a woman’s emotions and mental health. 

This session also explored how women can heal and successfully navigate the challenges that living with fibroids may present.

If you missed this session, you can watch the recording below.

Fibroids and Exercise Web
Fibroids

Fibroids and Exercise Webinar

On Saturday 24th July 2021, we hosted a webinar on fibroids and exercise. This webinar was part of our Fibroids Awareness Month event series which aims to empower women living with fibroids with information on the lifestyle changes that may alleviate their symptoms and improve their overall health and wellbeing.

In this session,  we explored the power of exercise in managing fibroids symptoms. We discussed whether exercise can be beneficial in managing fibroids symptoms and we looked at some simple, low-impact exercises that women can easily try at home through fun demonstrations of barre, yoga and other exercises. 

Speakers included: 

  • Abi Begho, Founder, Lake Health and Wellbeing; 
  • Davina Baptiste, Certified Wellness Coach;
  • Jayshree Thokal,  Qualified Yoga Instructor; and
  • Michelle Sutton, Health and Wellness Specialist.

If you missed this webinar, you can watch the recording below.

 

Our next webinar will be held on Saturday 31st July 2021 at 11am AST. This webinar will focus on fibroids and mental health.

In this webinar,  Olivia Haltman, an accredited counsellor, will help women identify, understand and address the many ways that fibroids can affect a woman’s mental health. 

We’ll empower women with the tools they need to improve their emotional wellbeing and successfully navigate the challenges that living with fibroids may present – these include managing and dealing with debilitating symptoms,  fertility issues,  tensions within relationships and the challenges that having fibroids may create in work, home and social settings. 

This is a free webinar.  You can register here

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Fibroids

Fibroids, Diet and Hormones Webinar

July is Fibroids Awareness Month and we’re delighted to be hosting a series of webinars especially for women in St Kitts and Nevis. These events are aimed at informing and empowering women affected by fibroids by providing practical and useful guidance to enable women to take control of their health and wellbeing.

Our series includes three webinars focusing on diet, hormones, exercise and emotional wellbeing.

On 17th July, we were delighted to host a webinar on fibroids, diet and hormones. Led by Davina Baptiste,  a Certified Wellness Coach, this webinar explored the role that hormones play in the development of fibroids and how by making simple changes to their diet, women with fibroids may be able to alleviate their symptoms and thus improve their health and wellbeing.

This was a very comprehensive and informative webinar and if you missed it, you can watch the recording below. 

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Fibroids

Fibrome Info France’s Ongoing Fibroids Campaign

As we begin our work to support women in St Kitts and Nevis who have been affected by fibroids, it has been interesting to explore what is happening on the global scene. When we take a closer look, we see that there are organisations working tirelessly in their jurisdictions to highlight this neglected woman’s health issue.

Today, we’re going to look at Fibrome Info France’s campaign which was launched in March 2021. As part of this campaign, Fibrome Info France partnered with the Women’s Right Ministry in France to raise awareness of menstruation and fibroids. Their campaign aimed to use a variety of communication platforms to empower women with information about fibroids that would empower women to take control of their health. Their campaign focuses on the health and societal challenges associated with fibroids such as the huge burden fibroids place on women’s quality of life and women’s sexual and reproductive health and the action that is required to address these issues.

In April,  their campaign rolled out in hospitals, clinics and medical practices and they utilised printed material including posters and leaflets which were distributed across 550 relay points.  Furthermore, this month (June 2021) their campaign moved into another phase where they will host a series of webinars in partnership with medical experts and these webinars will continue until October 2021.

This is a great campaign that provides much-needed information around fibroids and we’re sure it will make a significant difference by highlighting this important women’s health issue, empowering women with fibroids and providing women with access to the support that they need to manage fibroids.

More Information

To find out more about Fibrome Info France you can visit their website here or follow them on social media:

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Women's Health

Menstrual Health Has a Definition

We were absolutely delighted to learn that the term menstrual health now has an official definition. This is a huge achievement and will be of significant benefit to organisations, like us, working on health issues that impact menstrual health. Specifically, this will enable us to provide more clarity and structure around the work we do on fibroids.

The work to develop a definition for menstrual health was led by the Terminology Action Group of the Global Menstrual Collective.  Using the WHO’s definition of health, the Lancet Guttmacher Commission’s definition of Sexual and Reproductive Health and Rights and past concepts of menstrual hygiene and menstrual health, a multi-stakeholder group developed a comprehensive definition to:

  1. Ensure menstrual health is recognised as a significant global health issue
  2. Highlight the multi-faceted nature of menstrual health
  3. Facilitate a shared language when discussing menstrual health issues

Important points to note about this definition are that it:

  • Considers mental, social and physical wellbeing
  • Highlights the need for age-appropriate education
  • Highlights the right for women to take care of themselves during menstruation and be able to access timely diagnosis, treatment and care for menstrual health-related issues
  • Recognises the need for women to be treated with respect, dignity and sensitivity when it comes to issues related to their menstrual cycle
  • Stresses that women should have a choice as to when and how they participate in all areas of society during the different phases of their menstrual cycle
  • Recognises that menstrual health is not just limited to women’s periods

For us, this definition will be instrumental as we take forward the findings of our fibroids qualitative research project. Now that we have a formal definition for menstrual health, we can apply this to the menstrual health challenges that women with fibroids experience. This will create more structure around our future policy, advocacy, research and public health interventions aimed at improving the health and wellbeing of women living with fibroids.

More Information

For more information, you can read the journal article published by the Global Menstrual Collective here

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Women's Health

Caribbean Region Unites in the War Against Endometriosis

Trudy Christian

President of the Dominica PCOS Association

March is designated as “Endometriosis Awareness Month.” Endometriosis is a serious medical disorder which affects women of any age. It occurs when tissue resembling the lining of the uterus (endometrium) grows outside of the uterus, on organs and structures both in the pelvic region (ex. ovaries)  and outside of the pelvic region (ex. lungs). This tissue behaves just like endometrial tissue would and responds to monthly fluctuations in hormones during the menstrual cycle, building up and attempting to shed but with no exit path. The condition often causes debilitating pain, heavy and painful menstrual periods and mental health distress. Organizations across the Caribbean region who have taken up the mantle in advocating for greater awareness of women’s health issues joined their voices on the evening of March 31st 2021 to shine a much needed light on endometriosis and the current needs of the region in that regard.

The regional collaborative effort manifested itself in the form of a webinar, with presentations on different aspects of endometriosis and its management from each women’s health advocate. The panellists touched on the symptoms of endometriosis and barriers which may exist to diagnosis and treatment. Some of the focus of the discussion was on the mental health implications of endometriosis and how patients can self-advocate and empower themselves when facing the disease. The essential nature of early intervention and the need to approach endometriosis with a multidisciplinary approach was also highlighted. 

Trudy Christian, founder of the Dominica PCOS Association moderated the panel and presentations were made by Abi Begho, founder of Lake Health and Wellbeing in St. Kitts, Julia Mandeville, co-founder of the Barbados Association of Endometriosis and PCOS, Odelia Thomas, founder of She is Lotus of St. Vincent and the Grenadines, Rovin Fevrier, founder of the St. Lucia Endometriosis, PCOS and Adenomyosis Support Group and Abeesha Toussaint, founder of the Trinidad & Tobago Endometriosis Association. Sandrina Davis of Jamaica, who is the Country Director of International Samaritan, shared her lived experience with endometriosis with the audience. She gave the story of her journey with the dreadful disease and ended with a message of hope and empathy. 

The virtual event was an immense success, receiving positive feedback and healthy interaction from those who were in attendance. Several women voiced their concerns over aspects of handling endometriosis such as the availability of specialists for quality interventions, the impact of diet on the condition and the options as it relates to fertility. The panellists hope to continue in their quest of regional communication and collaboration in dealing with women’s health concerns. In minimal resource settings of individual Caribbean islands, it was wholeheartedly agreed upon that collaboration is the best way forward. One region with sisters united in advocacy, awareness and focus. Endometriosis and other female pelvic disorders should be scared. 

If you missed this event, you can watch a recording of the session below. 

Because We CareBlogVolunteer BloggersWomen's Health

My Journey With PCOS

Today’s blog post comes from Andrea Kallumadyil. Andrea is from Ontario, Canada and is a medical student from UMHS. She is currently the president of Because We Care and the vice president of the American Medical Student Association at UMHS. 

In this post, Andrea bravely shares her journey with PCOS and the life lessons it has taught her along the way. 


One of my earliest memories as a child is standing in the hallway with my Grade 3 teacher as I chugged three boxes of apple juice. My Mom picked me up soon after, and I was to have my first ultrasound in a nearby city later that day. The week before, I had my first period. Being of South Asian descent, my family was beyond excited that I had “become a woman” at 8. We spent the afternoon, to my embarrassment, calling up relatives in India announcing the good news. My parents took me out to a nearby convenience store, where I picked out a gift to celebrate the big day. On our way home, we stopped at the walk-in clinic to make sure everything was okay. Practising in a small town with predominantly white patients, my doctor had never had a patient have their period so young. She assumed it could be explained by my South Asian background but decided to run some tests just in case it was something else. The healthcare staff poked and prodded me, only for the tests and ultrasound to come back normal. I was sent home and did not have another period for four years.

I got my period again when I was 12 years old. My periods seemed to have a mind of their own. They would come and go as they please – but they were consistently heavy, caused me a lot of pain, and lasted at least a week. A few months into this unpredictable cycle, I had a period that was more than 30 days long. I was pale, and my hands and feet were freezing in the middle of the summer. They ran some blood tests and referred me to a gynaecologist. I was not only anaemic but also had high levels of free testosterone in my system. Given my lab values and symptoms, the gynaecologist had said it was a straightforward diagnosis: PCOS.

What is PCOS? What are the Symptoms? 

Polycystic Ovarian/Ovary Syndrome is an endocrine (hormonal) disorder that affects the normal functioning of your ovaries. The three main features are

  1. Ovary Dysfunction: Presents as irregular periods, including infrequent periods, prolonged periods, and an absence of periods.
  2. High levels of androgen: Determined either with a blood test or via symptoms of hirsutism (excess body/facial hair) or acne.  Androgens, although referred to as male sex hormones, are naturally occurring hormones at low levels in females.
  3. Cystic Ovaries: The collection of fluid in follicles preventing the release of an egg during your menstrual cycle (ovulation).

A patient usually requires at least two of the three main features to be diagnosed with PCOS. The different combinations give rise to 4 distinct PCOS phenotypes:

  1. Phenotype A: High levels of androgen, ovary dysfunction, and cysts.
  2. Phenotype B: High levels of androgen and ovary dysfunction
  3. Phenotype C: High levels of androgen and cysts.
  4. Phenotype D: Ovary dysfunction and cysts.

In my case, I had irregular periods and high levels of androgen shown both in my blood tests and excessive body and facial hair (hirsutism): Phenotype B. During your diagnostic process, your health care provider may also order an ultrasound and gynaecological exam to rule out other potential causes for your symptoms.

Hirsutism is hard to assess, especially since many populations – Middle Eastern, South Asian and Mediterranean – have more body/facial hair than other ethnic groups, despite having normal androgen levels. Being of South Asian background myself, and the only South Asian family in a then-predominantly white community, my hirsutism was initially overlooked. For many young persons with PCOS, including myself, this continues to be one of the most challenging symptoms to manage.

Outside of the 3 diagnostic features, PCOS has many other symptoms and complications, including:

  • Infertility: PCOS is one of the most common causes of infertility due to less frequent ovulation. It can also increase the risk of pregnancy complications like gestational diabetes and miscarriage.
  • Weight Gain and Trouble with Weight Loss: Almost 80% of persons diagnosed with PCOS are overweight. Additionally, being overweight can make other PCOS symptoms even worse.
  • Metabolic Syndrome: Those overweight and those with PCOS are at risk for insulin resistance leading to diabetes, high blood pressure, and high cholesterol levels. This puts those with PCOS at risk for developing heart disease – as many as 50% of persons with PCOS will have insulin resistance.
  • Androgenic Alopecia: Excess androgen can cause hair loss on the head. Resembles male pattern balding.
  • Acanthosis Nigricans: Dark and thick skin around the neck, breasts, armpits, and groin area
  • Sleep Apnea: The risk is about 5-10 times higher for those with PCOS. This is primarily because those with PCOS are likely to be overweight.
  • Depression, Anxiety & Disorders: Hormonal changes along can increase the likelihood of experiencing depression. Symptoms like hirsutism can increase this risk.
  • Endometrial Cancer: The lining of the uterus (endometrium) is at risk of developing cancer if you are insulin resistant, overweight or have trouble ovulating – all of which are PCOS features.
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Treatment

medications

With each additional symptom, my doctor explained, I felt myself becoming more and more ostracized, imagining all the new ways I’d look even more different from my friends in my hometown. The racing images came to a halt when I heard the word infertility. I was too shocked to process the rest of the information I received and was frankly too embarrassed to ask any questions about what I did hear. I was prescribed an oral contraceptive for my irregular cycles and Vaniqa (a topical hair growth inhibitor) for my hirsutism and left the office. When we got in the car, my Mom asked if I was okay, and in response, I cried the entire 45 minutes home.

I wish I knew that although PCOS is one of the most common causes of infertility, it is also one of the most treatableThere are many options available to manage the symptoms of PCOS.

  • Oral Contraceptive PillsOCPs help regulate hormone levels and foster regular, predictable periods that are shorter in duration with a lighter flow.
  • Metformin: A diabetes drug that improves insulin resistance, can promote weight loss, reduces the rate of miscarriage, and promotes regular menstrual cycles.
  • Spironolactone: An androgen medication that can be used to lower androgen levels in your body. This will improve symptoms of androgenic alopecia, hirsutism, and hormonal acne.
  • Hair Removal: Once hormone levels are managed, many people have success with electrolysis – the only truly permanent hair removal solution. A probe is inserted into each hair follicle to destroy each hair’s growth centre. Other less permanent methods include laser hair removal, epilation, threading, sugaring/waxing, or depilatory creams. A hair growth inhibitor like Vaniqa can also be used, but the hair will resume growth if you cease usage.
  • Weight Loss: Losing up to 5-10% of your body fat can be enough to kick start ovulation. There is also some evidence that a low carb diet may improve your hormone levels and increase fertility. A healthy lifestyle consisting of nutritious foods and exercise will enhance fertility treatment effectiveness regardless of weight loss – remember, it is highly recommended to consult a health care provider before making any significant lifestyle changes.
  • AcupunctureThere is some emerging evidence that acupuncture procedures restore LH and FSH hormone ratios and promote regular menstrual cycles in those with PCOS.
  • Surgery: A laparoscopic procedure that involves destroying a part of the ovary with an electric current. This can stimulate ovulation and decrease androgen levels. The results last for a few months.
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For those trying to get pregnant, additional treatment options include:

  • Fertility DrugsClomid is a fertility drug that triggers ovulation and is often used in combination with metformin. Although some persons can become resistant to the drug, Letrozole (a cancer drug) has shown to be effective in stimulating ovulation in such situations. Injectable gonadotropins are also available under different brand names to stimulate ovulation. However, those with PCOS are at a high risk of developing ovarian hyperstimulation syndrome. Furthermore, you are also at increased risk for multiple pregnancies.
  • Intrauterine Insemination (IUI)A process involving sperm placement in the uterus with a catheter. This process is known to increase the total number of sperm that reach the fallopian tubes.
  • In Vitro Fertilization (IVF): After stimulation of egg production, multiple eggs are removed and inseminated in a lab dish. Multiple embryos are transferred a few days later back into the uterus.

There is also evidence that the following supplements can relieve some symptoms of PCOS. They include:

  • Myo-inositol: Reduces the risk of gestational diabetes
  • Inositol: Increases the number of ovulations, thereby leading to a higher chance of successful conception.
  • Omega-3 Fish Oils: Lowers total cholesterol levels.
  • Co-Supplementation of Magnesium, Zinc, Calcium, and Vitamin D: Provides beneficial effects on hormone levels while reducing inflammation and oxidative stress caused by PCOS.

Living With PCOS

Being diagnosed and starting treatment at a very young age, I was fortunate to not have to deal with the unpredictability of irregular periods. However, I did struggle with managing my hirsutism. I started laser hair removal almost immediately after my diagnosis and embarked on a process that would last several years. I bleached most of my body hair to feel comfortable wearing revealing clothes. I eventually switched to electrolysis, which did reduce the amount of hair grown by 30% but was incredibly painful and time-consuming. I considered myself a very anxious person but was officially diagnosed with anxiety and depression at the beginning of my undergraduate degree. I quickly gained a lot of weight following a high-stress period and my hirsutism got much worse as a result. I went on the keto diet to lose it and obsessively worked out.

However, a restrictive lifestyle like that was not sustainable for me and did not promote good mental health. I was still terrified that I would never have kids and am to this day very set on a specific timeline in my head. I initially set aside my career goals of becoming a physician for something attainable in a shorter period. I bounced from counselling to nursing to speech-language pathology. I did every possible prerequisite during my bachelor’s degree to keep all of my options open. I read countless blogs and videos of what other persons with PCOS did for family planning, careers, and managing their symptoms. I realized that everyone had their own unique story and that the only commonality is that they all did what made them happy. Those that wanted to start a family were able to do so without compromising their career goals. From then on, I began to focus on what I wanted instead of letting my PCOS control every little detail of my life. I stopped being so hard on myself for having symptoms. I started to wear short sleeves without bleaching, I got into the program I wanted to get into, and most importantly, I began to accept myself for who I am. It has been such a freeing experience.

For those currently struggling with PCOS right now:

  1. Try not to compare yourself to anyone else.
  2. Work on what is best for you, given your own story.
  3. Learn to be comfortable in your skin.
  4. Talk to your health care provider to figure out the best way to manage your symptoms.
  5. And most importantly: do not let anyone convince you that your PCOS can stop you from doing whatever you set your mind to.

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We would like to say a big thank you to Andrea for being so open and bravely sharing her PCOS story. If you’d like to ask her a question, please leave it in the comments section below or you can email your question to info@lakehealthandwellbeing.com 


Sources

  1. D’Anna, R., Di Benedetto, V., Rizzo, P., Raffone, E., Interdonato, M. L., Corrado, F., & Di Benedetto, A. (2012). Myo-inositol may prevent gestational diabetes in PCOS women. Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology28(6), 440–442. https://doi.org/10.3109/09513590.2011.633665
  2. Alois, M., & Estores, I. M. (2019). Hormonal Regulation In Pcos Using Acupuncture And Herbal Supplements: A Case Report And Review Of The Literature. Integrative Medicine (Encinitas, Calif.)18(5), 36-39.
  3. Arentz, S., Smith, C. A., Abbott, J., & Bensoussan, A. (2017). Nutritional supplements and herbal medicines for women with polycystic ovary syndrome; a systematic review and meta-analysis. BMC complementary and alternative medicine17(1), 500. https://doi.org/10.1186/s12906-017-2011-x
  4. Lizneva, D., Suturina, L., Walker, W., Brakta, S., Gavrilova-Jordan, L., & Azziz, R. (2016). Criteria, prevalence, and phenotypes of polycystic ovary syndrome. Fertility and sterility106(1), 6–15. https://doi.org/10.1016/j.fertnstert.2016.05.003
  5. Maktabi, M., Jamilian, M., & Asemi, Z. (2018). Magnesium-Zinc-Calcium-Vitamin D co-supplementation improves hormonal profiles, biomarkers of inflammation and oxidative stress in women with polycystic ovary syndrome: a randomized, double-blind, placebo-controlled trial. Biological trace element research182(1), 21–28. https://doi.org/10.1007/s12011-017-1085-0
  6. Polycystic Ovary Syndrome (PCOS). (2020). Retrieved 16 October 2020 from https://www.mayoclinic.org/diseases-conditions/pcos/symptoms-causes/syc-20353439
  7. Polycystic Ovary Syndrome. (2012). Retrieved 16 October 2020 from https://americanpregnancy.org/womens-health/polycystic-ovary-syndrome-70990
  8. Polycystic Ovary Syndrome. (2019). Retrieved 16 October 2020 from https://www.womenshealth.gov/a-z-topics/polycystic-ovary-syndrome
  9. Polycystic Ovary Syndrome. (2019). Retrieved 16 October 2020 from https://www.healthlinkbc.ca/health-topics/tw9103