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While menstrual cycles can be an annoying inconvenience for many women, heavy bleeding (menorrhagia) is not normal and can disrupt your life. A few days of heavy flow at the start of your period is usually nothing to worry about. However, if you’re frequently experiencing very heavy periods, you should discuss it with your gynecologist or primary care provider.  Dr. Megan Fish, an OB-GYN with Renown Women’s Health, discusses various reasons, evaluation and treatment methods when it comes to heavy menstrual cycles.  What is classified as heavy menstrual bleeding?  The American College of Obstetricians and Gynecologists considers heavy bleeding to be any of the following signs: Bleeding that lasts more than 7 days. Bleeding that soaks through one or more tampons or pads every hour for several hours in a row. Needing to wear more than one pad at a time to control menstrual flow. Needing to change pads or tampons during the night. Menstrual flow with blood clots that are as big as a quarter or larger. What are the most common reasons for heavier periods?  A variety of reasons why someone might have heavy periods. Fortunately, most of these problems are treatable. Because each woman's period is unique, only a doctor can definitively determine the cause of your heavy periods. Some of the most common issues that cause heavy periods include: Hormone imbalances such as anovulation, thyroid disease and Polycystic Ovary Syndrome (PCOS). Structural abnormalities in your uterus such as polyps or fibroids.  Precancer and cancer such as uterine, cervical, vaginal, ovarian or endometrial hyperplasia.  Infections such as chlamydia, gonorrhea, endometritis or vaginitis. Other medical conditions such as liver disease, kidney disease or Pelvic Inflammatory Disease. Medications such as blood thinners and aspirin, hormone replacement therapy, Intrauterine devices (IUDs), birth control pills and injectables. Pregnancy-related problems such as a miscarriage or ectopic pregnancy.

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Meet and get to know Patty Warren, our featured Sterling Silver Club member this fall. You may recognize her from the latest Senior Care Plus commercial on television, where she joins a coffee chat discussing the many benefits of being a Senior Care Plus member. She’s one of the kindest souls you’ll ever meet – and has a positive outlook on life that we should all strive for. Patty's Story Patty was born and raised in a small Kansas town called Baxter Springs, where she grew up with an older brother, an older sister and two younger sisters. She and her siblings all enjoyed playing sports like softball and basketball, in addition to playing instruments. Patty developed a love and passion for music at a young age that carried into her adulthood. “I wanted to be an opera singer,” said Patty. “I decided to go to college at Pittsburg State University in Kansas where I majored in vocal performance.” After college, Patty moved to Manhattan in New York City to audition to be an opera singer, but she soon realized it wasn’t what she wanted to do after all. She eventually decided to work in the brokerage industry.   After living and working in New York for three years, Patty moved back to Kansas where she later met the love of her life, Michael. “In 1992, I had put a dating ad in the local newspaper,” said Patty. “I received over 30 responses, and I went out on quite a few dates.” Then she had her first date with Michael, and the two of them quickly realized how much they liked each other. He asked her to marry him on Valentine’s Day in 1993, and they went on to get married in front of the Justice of the Peace on May 3, just a few months later. “We had a small wedding so that we could move into our first home together,” said Patty. A few years later in 1999, Patty and Michael moved to Arizona, where they lived for 22 years. Patty worked at Edward Jones Investments for 18 of those 22 years and loved her job and the people that she worked with. She retired in January 2021 during the pandemic, and three days later she and Michael moved to Sparks, Nevada.

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Senior Care Plus is pleased to announce we are now a proud sponsor of Jam On It Pickleball, open to the community seven days a week at the Reno Sparks Convention Center. We’re excited to help promote this fun activity to our members, employees and the public. Pickleball has many wonderful health benefits – particularly for seniors. It’s a low-impact game that raises the heart rate, improves hand-eye coordination and increases mobility. In addition to the obvious physical benefits, pickleball is a great social activity. Getting out of the house and playing a fun, easy-to-learn game with others is a great way to make new friends while improving your physical and mental health!   Ralph Barbato, a Senior Care Plus member from Reno, is a huge fan of pickleball and all it has to offer. “Pickleball has made such a positive impact on my life. I love the physical and mental health benefits along with the social aspect – it’s a great way to meet new people and I’m excited to have it in our community,” said Ralph.

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Type 2 diabetes, formerly known as adult-onset diabetes, is on the rise for adults and children in the United States. Although genetics play a role, you can take steps today to lower your risk of developing this life-altering condition. Michael Raymund Gonzales, MD with Renown Endocrinology answered our questions about Type 2 diabetes and gave us some useful tips for prevention. What effect does diabetes have on the body? And who’s most at risk? First, it’s important to know the difference between the two most common types of diabetes: Type 1 diabetes is the result of the body’s inability to make insulin, which is a hormone your body needs to be able to use sugar, or glucose, for energy. Type 1 is not preventable, and people who have it were either born with it or they developed it later in life due to an autoimmune process that attacked the pancreas that went unrecognized. Type 2 diabetes occurs when the body makes the insulin hormone, but it might not make enough or work well enough for the body to use sugar for energy. This is called insulin resistance. This condition usually develops later in life but is preventable with proper diet, exercise and weight loss. However, due to the obesity epidemic, type 2 diabetes is occurring more often in younger individuals.  Diabetes hurts the body’s ability to break down glucose, so rather than it being used for energy, glucose stays in the bloodstream, which can cause problems. But with early detection and the help of your doctor, diabetes can be managed so that complications are avoided. Left unmanaged, however, diabetes can affect major organs and lead to heart and blood vessel disease, nerve damage, kidney damage, eye damage, skin conditions and more. Type 2 diabetes also results from risk factors that you can’t control, including your family history, race and age. However, there are a few risk factors that you can watch out for, such as being overweight, inactivity, diet choices, having high blood pressure and high cholesterol and triglycerides.

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As the temperatures skyrocket and we return to more outdoor activity, one thing is certain: you must hydrate to stay cool, healthy, and functional. But how much water do you need, and what are some easy ways to ensure you are getting enough? Aurosis Reddy, DO a family medicine provider with Renown Medical Group, shares what you need to know.  How Much Water Is Enough?  Experts agree that recommended daily water intake can vary depending on different factors such as your weight, metabolism, location, diet, physical activity, and health. As a rule of thumb, women should aim for a daily fluid intake of 91 ounces, and men should aim for 125 ounces. It is important to listen to your body and recognize when you might need to increase your water intake. For example, if you’re partaking in strenuous exercise, or spending time outside in the heat, you’ll want to give your body more water and electrolytes to function properly.  How Can I Tell If I Am Dehydrated? Decreased coordination Fatigue Less urination Dizziness Dry, sticky lips and mouth Increased thirst Headache

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Once upon a time … in Incline  This issue’s featured member began writing the latest chapter of her life story by retiring on Lake Tahoe’s north shore in Incline Village, NV.  “I had several criteria when selecting a place to retire,” says MaryBeth. “And a healthy lifestyle was number one. The people who have settled in Incline are very active with both their minds and their bodies. It’s not a stagnant population, it is unusually robust. I’ve made wonderful friendships here and we really watch out for each other, which means the world to me.” “I also wanted four seasons a year,” she continues. “And most importantly, I wanted a place that my son, Addison, would love to visit and share with me – and world-class skiing just minutes away scored extra points with both of us!” Zürich and Beyond  Skiing was something MaryBeth and Addison took to with a passion while living in Zürich, Switzerland. A business move to the land of the Alps (and Swiss chocolate) provided the perfect opportunity for an international education for her son and a culturally eye-opening experience for the family.  “I was unprepared for what it was going to be like living in a foreign place, and I learned a lot about empathy as a non-native and the kindness of strangers, or not. Our seven years there gave us many easily available travel adventures on the other side of the globe, and the friendships I made with people around the world have been lifelong.” “Divas” of the Garden  “Tall and showy” is how MaryBeth lovingly describes the “Divas” of her garden, aka the delphiniums. Located in the sunny part of her yard, the plants explode in a variety of colors that accentuate her home’s landscaping and are a well-earned reward for her mountain gardening challenges. “The very first thing you must do when creating a new garden is amend the soil,” explains MaryBeth. “It’s not sexy, but it’s necessary! And that’s when you learn that every shovelful of “mountain” dirt is loaded with rocks of every size – it’s fantastic exercise!” And her neighbors appreciate the hard work. “I’ve made so many friends of all ages in the neighborhood while working outside in my garden,” shares MaryBeth. “They stop, chat, inquire about the plants and take photos all the time.” Then with a smile, she adds, “You could call it my art.” Aging-In to Life with Medicare At 64 and on the cusp of Medicare eligibility, MaryBeth recently tasked herself with learning what she could about the plans and options that would soon be available to her and was overwhelmed. “I made the mistake of entering my phone number on a Medicare website for “wanting more information” and had no less than 15 calls a day from health insurance brokers – from all over the country!” she exclaims. “What one person would tell me would then be questioned by the next. I eventually quit answering the phone.” However, finding a Medicare plan that meets all of her needs is still a priority. “First and foremost, since I am a traveler (at least before the pandemic) I want to have a healthcare plan that will cover me in any state,” MaryBeth explains. “I would also like a policy that allows for alternative treatments, such as acupuncture – which I’ve had great success with in the past. I know that getting a good Rx plan now will save me money down the line, and I also want to be able to see a specialist without seeing a provider first for a referral.”

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You probably know testosterone (T) plays an important role in how boys physically develop into men. But is that all you know? What happens when a man's T levels are off? Are there symptoms men should look for? And what are the treatment options? Dr. Bobby Kahlon, MD, Renown Medical Group provides answers in a Testosterone Q&A.   What does testosterone do for men?  "Testosterone is known as the 'manly hormone' for a reason," says Dr. Kahlon. "Though women also naturally produce small amounts of it, men produce testosterone at much higher concentration levels. And it affects men in more physical and obvious ways. How much hair a man has on his chest, how deep his voice is, or how muscular he is are all attributable in some way to testosterone. It's also responsible in large part for sex drive and bone strength and affects how men think, learn and experience their surroundings."  Testosterone in men:   Powers virilization (male physical characteristics) and sexual function Builds muscle mass and strength  Supports bone density  Improves cognition  T Trivia: Discover Magazine reveals that “manly” testosterone and other sex hormones evolved long before we did — 500 million years ago — from the ultimate “female” hormone, estrogen. Can you have too much or too little testosterone?  Though high testosterone isn't a concern for most men, low testosterone or low T occurs more frequently and develops for two primary reasons.  Dr. Kuhadiya explains, "Subnormal testosterone concentrations occur either due to pituitary or testicular failure and the causes for each need to be discussed with your physician."  Pituitary failure: Approximately one-third of men with obesity, type 2 diabetes, or metabolic syndrome (which includes increased blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol or triglyceride levels) have low free — or "bioavailable" — testosterone. These health conditions can cause the pituitary gland to "fail" to release follicle stimulating hormone (FSH) and luteinizing hormone (LH) which are essential for triggering testosterone and sperm production. And that can cause low testosterone (hypogonadism). Testicular failure: Though less common than pituitary failure, testicular failure may also be responsible for low T. It's caused by diseases or illnesses affecting the testicles, injury or trauma to the testicles, or certain medicines and treatments such as chemotherapy or opioid pain medication. Providing your complete medical history to your doctor is always the first step toward a proper diagnosis.  What are the symptoms of low T?  The following indicators could be a sign that you have low T, say the doctors.  Lack of motivation and determination, including mild depression  Loss of physical endurance and muscle strength  Loss of or diminished early morning erections  Reduced libido (sex drive)   Erectile dysfunction (ED — difficulty achieving or maintaining an erection)   Gynecomastia (male breasts)  Small testes  T and Time: T levels in men naturally begin to decline by about 1% a year starting at age 30.  How do you test for low T?  "There are different methods for testing testosterone levels," says Dr. Kuhadiya. "Each approach uses a blood sample to evaluate total testosterone, which includes free and attached testosterone that combines with proteins albumin and sex hormone-binding globulin (SHBG). For the most accurate results, testing is based on samples collected in the morning after fasting, and from tests on two different days."  What treatment options are available?  "Well, your best natural option may be YOU," says Dr. Kahlon. "Men with pituitary failure are often able to treat their low T by losing weight to increase levels of the hormone. And even if you don't lose weight, exercise can help boost your testosterone. Unfortunately, if you have testicular failure, weight loss and exercise may not have the same effect."  So, are there other options? "You may want to consider Testosterone Replacement Therapy (TRT)," says Dr. Kuhadiya. "TRT is only available to men who are hypogonadal — with a clinical diagnosis of low T. Injection, gel, skin patch and nasal spray are available TRT options. The best option is the one that works best for the patient. Convenience, insurance coverage and cost are all factors to consider." Dr. Kahlon's TRT preference? Daily gel treatments, which are applied directly to the skin. On the other hand, Dr. Kuhadiya recommends intramuscular injections, which take place once a week or every two weeks.  But both doctors agree on this: physicians and their patients need to weigh the benefits and risks of TRT before proceeding with treatment — especially if your low T condition may require lifelong treatment. "In my clinical practice, I have seen some very good long-term results with an improved quality of life," says Dr. Kuhadiya. "However, in certain situations, TRT may increase the risk of heart disease and is not recommended for men with a history of prostate cancer." Dr. Kahlon adds, "Patients receiving any type of hormone therapy need to be closely monitored throughout the treatment process for any changes in their health."   How do you feel about steroids and T boosters?  "I don't recommend them, certainly not for hypogonadism," advises Dr. Kahlon. "There is no evidence to support anabolic-androgenic steroids or testosterone boosters as a safe or effective treatment for low T in men."  "In fact, there continues to be emerging evidence they may lead to side effects that could potentially harm the liver and the pituitary and endocrine functions of the body," warns Dr. Kuhadiya. "And that damage may be irreversible."

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