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Dr. Carilyn Hoffman with Renown's Women's Health explains the symptoms, causes and treatments of Polycystic Ovary Syndrome (PCOS) (also referred to as Polycystic Ovarian Disease (PCOD)), a prevalent condition among women of reproductive age that influences hormonal balance, metabolism and fertility. Make an appointment with Renown Women's Health Click here to schedule Call to schedule: 775-982-5000 PCOS Defined PCOS is a constellation of symptoms characterized by two of the three criteria: multiple small cysts on the ovaries visible via ultrasound, irregular periods and signs of hyperandrogenism. Other symptoms include infertility, insulin resistance, and increased risk of cardiovascular disease. Symptoms of PCOS The symptoms of PCOS can vary from woman to woman, but some of the most common include: Irregular menstrual cycles: This is often one of the first signs of PCOS. Women may experience fewer than nine periods a year, more than 35 days between periods, frequent spotting, and/or abnormally heavy periods. Excess androgen levels: High levels of male hormones may result in physical signs such as excess facial and body hair (hirsutism), severe acne and male-pattern baldness. Polycystic ovaries: Enlarged ovaries containing numerous small cysts can be detected via ultrasound.     Causes and Risk Factors The exact cause of PCOS is unknown, but several factors may play a role: Genetic predisposition: A family history of PCOS increases the risk. Insulin resistance: High insulin levels might increase androgen production, causing difficulty with ovulation. Obesity: Women with elevated BMI’s are more likely to have PCOS, although 20% of women with PCOS are not obese. Diagnosis and Treatment Dr. Hoffman outlines that diagnosing PCOS requires a medical history review, a physical exam, blood work and an ultrasound to evaluate the ovaries. Treatment options can range from lifestyle modifications, like diet and exercise and weight loss, to medications for menstrual regulation, fertility assistance, and rarely surgery. Lifestyle Changes A healthy lifestyle is a cornerstone of managing PCOS. Regular exercise, a nutritious diet, and weight management can help reduce symptoms and the risk of long-term health issues. In overweight patients, weight loss as little as 5% has been shown to improve symptoms of PCOS. Medication Medications may include hormonal contraceptives to regulate menstrual cycles, anti-androgens to reduce hair growth and acne, and Metformin to address insulin resistance. Fertility Treatment For women with PCOS who are trying to conceive, ovulation induction with clomiphene or letrozole is sometimes necessary. Sometimes a referral to a reproductive endocrinologist and infertility specialist is needed for more advanced technologies like IVF. Health Implications PCOS is not just about cystic ovaries or irregular periods; it can have profound implications on a woman's overall health. Women with PCOS are at an increased risk for several conditions, including type 2 diabetes, high blood pressure, heart disease, and endometrial cancer.

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Eating a well-balanced and nutritious diet when pregnant is one of the more essential things you can do for your baby and yourself. The basic principles of what to eat when pregnant are quite similar to how we should be eating all the time. This includes focusing on fruits, vegetables, whole grains, lean protein and healthy fats. Of course, there are a few areas that you should pay close attention to when you’re pregnant and a few foods you should avoid. We consulted Renown Health’s Caitlin Bus, RD, LD, CDE to learn more about pregnancy nutrition. Foods to Eat Regularly: Veggies Vegetables of all kinds -- and in all forms -- are beneficial for you and your baby during pregnancy. Veggies ensure your body is getting the fiber, vitamins and minerals it needs. However, fresh or frozen veggies are considered best, but if you choose to eat canned veggies, make sure you choose a low sodium product. The more greens, the better! If you have an aversion to vegetables, especially in the first trimester, try sneaking them into smoothies. Healthy Proteins Protein-rich foods support your baby's growth while giving your body the nutrients to build and repair tissues, including your muscles, hair, skin and nails. Although protein requirements vary from person to person, a pregnant woman needs additional protein for her baby's growth, especially in the second and third trimesters. Regularly eating high protein foods -- like fish, chicken, turkey, eggs, peanut butter, nuts and beans –– promotes your baby's healthy brain and heart development. Grains Food like brown rice, quinoa, whole-wheat pasta and oatmeal are great to eat while pregnant. They are rich in fiber, iron, B vitamins and folic acid, which are all beneficial to physical development. Grains also help alleviate constipation and hemorrhoids. Fruits Fruit can help satisfy any sugar cravings you have when pregnant while also supplying your baby with nutrients – it's a win-win. Some people advise against fruit consumption while pregnant, but this is a myth. Like with all foods, moderation is key. Fruit can be high in sugar, so it is important to be aware of your intake. Also, make sure you are mindful of your preparation – thoroughly rinse produce under running water for 30 seconds to help avoid foodborne illness. Pasteurized Dairy Dairy products like milk, cheese and yogurt can be great sources of protein and calcium needed for the healthy development of a baby's bones, teeth and muscles. These foods also help with ensuring healthy heart function and nerve transmission. When buying these products, make sure to choose pasteurized products to avoid exposing your body to germs and bacteria. The American College of Obstetrics and Gynecology recommends 1,000mg of calcium per day for pregnant and lactating women. This equates to 4 servings of dairy or calcium-rich foods such as leafy greens, broccoli, tofu, almonds or dried figs. DHA Omega-3 Fats Omega-3s like DHA help support the health of a baby's brain and parts of their eyes. Women who are pregnant or breastfeeding should eat at least 8 ounces and up to 12 ounces of seafood each week. Ideally, food sources that offer DHA omega-3 and that are lower in mercury should be emphasized in your diet, including fish like salmon, sardines and anchovies. If you do not eat fish or omega-3 fortified foods, a DHA omega-3 supplement is recommended. Choline Did you know that 92% of pregnant women fail to meet the daily choline recommendation? Choline is crucial for an infant's brain and central nervous system development. One egg supplies 33% of the recommended daily intake. Although choline is often absent or low in prenatal vitamins, the best food sources include eggs, meats, fish, dairy, navy beans, Brussels sprouts, broccoli and spinach. Iron and Folic Acid Iron is the most common nutrient deficiency during pregnancy. Foods with high and moderate amounts of iron include red meat, chicken, fish, fortified cereals, spinach and beans. Folic acid is used to make the extra blood your body needs during pregnancy. Consuming adequate folic acid early in pregnancy reduces the risk of birth defects that affect the spinal cord. It is recommended to consume 400 micrograms (mcg) per day for pregnant women. This amount is included in your prenatal vitamins. Water Staying hydrated is one of the best things you can do for yourself and your baby when pregnant. In addition to just being good for you, hydration alleviates morning sickness and nausea, while dehydration can lead to contractions and even pre-term labor. Aim for 10 cups of fluids per day, on top of the water naturally occurring in foods. Foods to Avoid: Raw Fish and Fish with High Mercury Content Sorry sushi fans, according to the Center for Disease Control and Prevention, pregnant women are 10 times more likely to get infected by Listeria, a bacteria found in raw or undercooked fish. Also, avoid fish often found to be high in mercury, including swordfish, king mackerel, tuna and marlin. Processed or Raw Meat Similar to eating raw fish, eating undercooked or raw meat increases your risk of infection while pregnant. Hot dogs and lunch meats should also be avoided, unless they have been reheated to be steaming hot (for example, in a microwave). Alcohol Drinking alcohol when pregnant can impact your baby’s brain development and increases your risk of premature birth, low birth weight or miscarriage. Just don’t do it! Minimize Caffeine High caffeine intake during pregnancy can restrict your baby’s growth; therefore, it is recommended that pregnant people limit their caffeine intake to less than 200 mg per day – that’s roughly two cups (16 fl oz) of coffee per day. Runny Eggs Eating raw or runny eggs when pregnant increases your risk of Salmonella, which can cause fever, nausea, vomiting, stomach cramps and diarrhea. Always make sure your eggs are cooked through or use pasteurized eggs.

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Need fresh hiking trails? These hiking trails offer new views, a different route or the motivation you need to get outside. Of course, whatever you’re looking for this summer, these trails were made for sunshine in Reno-Tahoe. Easy Hiking Trails Oxbow Nature Study Area Nature Trail Location: 3100 Dickerson Road, at the Truckee River. Parking: There is a parking lot onsite. Time Out and Back: 30 minutes Items to Bring: Water, sunscreen and a hat. Although this loop is just under one mile, it’s the perfect escape in the heart of Reno. And this riverside trail is accessible for all skill levels. Bird watcher? Certainly, keep an eye out for black-crowned night herons, red-shouldered hawks, mule deer, beavers and more wildlife in the area. Tahoe-Pyramid Bikeway – Sections 2 to 4 Location: West Reno to Sparks Parking: Woodland Drive, Crissie Caughlin Park, Idlewild Park, 1st Street, Rock Park and Spice Island Drive. Time Out and Back: 2-4 hours (each section, out and back) Items to Bring: Water, sunscreen and a hat. From west Reno to Sparks, this paved portion of the trail stretches more than 8 miles. And it is easy to find as it runs along the Truckee River. As one of the easiest hiking trails in the region, it includes numerous parking access points and you can walk as long or short as you desire. In particular, one great route is from Rock Park on S. Rock Boulevard to Cottonwood Park on Spice Island Drive in Sparks. It’s an easy walk for all hiking levels. Notably many evening hikers explore this area to view the bats living under the McCarran Bridge. Additionally, an array of birds and river views can also be found along this enjoyable path. For maps for sections of this path, visit Tahoe-Pyramid Bikeway’s website. Cave Rock Hiking Trail Location: South Lake Tahoe; turn right on Cave Rock Drive from Highway 50, just prior to the tunnel. Parking: Park on Cave Rock Drive. Time Out and Back: 30 minutes Items to Bring: Water and sunscreen. Not only does this short trail have breathtaking views of Lake Tahoe, but it is also meaningful. Chiefly the rock was created more than three million years ago. Equally important, it is still considered sacred to the Washoe Native Americans. Also, leashed dogs are welcome on the trail. Moderate Hiking Trails Steamboat Ditch Trail Location: To get to the trailhead, take Mayberry Drive in west Reno. Then turn south on Plateau Road and right onto Woodchuck Circle. Parking: There is a dirt area for limited parking. Time Out and Back: 3-5 hours Items to Bring: Water, layers, sunscreen and a hat. Of all the hiking trails listed, this one offers some of the best views of downtown Reno and the surrounding hillsides. Built by Chinese laborers in the late 1870s, the Steamboat Ditch is the longest ditch in the Truckee Meadows region. In fact, the water serves as a vital source for ranchers and farmers south of Reno. First, start behind the Patagonia in northwest Reno at the Tom Cooke Trail or park off of Woodchuck Circle. Next head west to find the “Hole in the Wall.” Surprisingly this is a tunnel engineered through the hill, so the ditch could supply water to the Truckee Meadows. This hike is a little over 8 miles with the halfway point just under 4½ miles. With this in mind, if you’re thinking of hiking with your four-legged friend, remember to bring your leash because rattlesnakes can be spotted. Usually there’s also little shade, so plan accordingly by bringing a hat and dressing in layers. Thomas Creek Trail Location: Head out on Mt. Rose Highway going west to Timberline Road. Then drive 1.3 miles past the end of the pavement, stay on Timberline and you will see the trail head on your left shortly after you cross the bridge. Parking: There is a paved parking area on Timberline Drive. Time Out to Back: 2-6 hours Items to Bring: Water, layers, food and a phone with GPS or map. Definitely put he Thomas Creek Trail on your hiking trails list. Located off of Mt. Rose Highway, it is a very scenic hike winding along Thomas Creek into a Jeffrey pine forest. You may choose to hike to what appears to be the end of the trail (where it meets the road) or continue further up for 1/8 of a mile into the Mt. Rose Wilderness. Hiking up the trail to the creek crossing, and then taking the dirt road back down is a great way to see the entire canyon. While this hiking trail is closer to 5 miles, it can be shortened by turning around at any point. Another option is to look for signs to turn off the Thomas Creek Trail at the junction for Dry Pond Loop. Dry Pond is a 4½-mile, out and back hiking trail from the Timberline parking lot. Ultimately you may see a pond or hilltop meadow, depending on the season and weather. Overall it is possible to go anywhere from 2 to 6 miles (or more), based on what you choose to hike. The gain along the creek is minimal, with an 800-foot gain at the top part of the trail. In particular, watch for mountain bikers, as this is also a very popular biking trail. Hunter Creek Trail Location: Go west on Mayberry Drive to Plateau Road. Then turn left and go up the hill to Woodchuck Drive. Lastly, turn right and follow Woodchuck to the hiking trail head. Parking: Paved parking on Woodchuck Drive with a bathroom and benches. Time Out and Back: 2-5 hours Items to Bring: Water, layers, a snack, sturdy shoes and sunscreen. The Hunter Creek trail is about a 7-mile day hike with a little over 1,000 feet of overall gain leading to a waterfall. Ultimately it’s totally worth the trip! This hiking trail winds up Hunter Canyon through sagebrush, Jeffrey pines and interesting rock formations. The waterfall is a great place to sit on shaded logs and enjoy lunch. This trek is very rocky and narrow at times, so good trail shoes are recommended. Furry friends should also be leashed, as rattlesnakes and wildlife are common along the trail. Difficult Hiking Trails Hidden Valley Loop Location: Hidden Valley Regional Park; drive east on Pembroke Drive and turn left on Parkway Drive. The park is at the end of the road. Parking: Park on the east side of the park, closest to the hills. Time Out and Back: 3-6 hours Items to Bring: Water, sunscreen, shoes with good traction and a lunch or snack. Overall this 6-mile loop has about 1,800 feet of gain and is located east of Hidden Valley. We recommend starting the hike from Hidden Valley Regional Park. First, head southeast on a dirt road and then turn east onto a very steep trail that winds over red dirt for about a half mile. In fact, this is the steepest part and it’s a leg burner. Once you get past the climb, the trail gradient decreases. Then you wind along the south side of a big bowl lined with pinyon pine and juniper trees. The hiking trail continues up to the ridge line where there are incredible views of the Truckee Meadows and Mt. Rose. You can hike back down from this point, but it is best to continue on the trail along the ridge line to where it isn’t as steep with incredible views. Frequently you may see wild horses while hiking in this area. Mount Tallac Location: Southwestern side of Lake Tahoe, between Emerald Bay and Camp Richardson. Turn south on Mt. Tallac Road from Highway 89. Parking: Follow Mt. Tallac Road to the parking lot. Time Out and Back: 6 hours Items to Bring: Water, layers, lunch or snacks, sunglasses, hat, sturdy shoes and sunscreen. Definitely a big hike with an even bigger reward — an incredible view of the Desolation Wilderness and Lake Tahoe. This hiking trail is 10.5 miles out and back with a 3,500-foot elevation gain. If you’d like to explore the area without the 6-hour commitment, hike 1.7 miles out to Floating Island Lake or 2.3 miles out to Cathedral Lake. Day use permits are required and you can fill one out for free at the trailhead.

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Fishing can be great for relaxation, and it’s a great family activity. Here are five suggestions for great local fishing spots, plus a recipe for trout if you wind up catching one! There are many ways to unwind in the great outdoors in our beautiful region, and fishing can be easily added to that list. The benefits of casting a line are many. According to a study by Harvard Medical School, fishing was compared to yoga for its links to stress relief. The study notes that fishing brings out the relaxation response that slows down breathing, reduces blood pressure and relaxes the muscles. So, get out there and find some fish. There are many lakes of many styles to practice this ancient art, but here are the five that keep coming up in local conversation, virtual or otherwise. If you want to explore more options, the Nevada Department of Wildlife’s fishing guide can fill you in (and then some!). One thing to note about two of the areas we’ve chosen, Pyramid Lake and the Truckee River. Winter flooding has led regional officials to make necessary repairs to both areas, and there may be restrictions to access, including roads that lead to some of the fishing areas in both of these large bodies of water. Be sure to check first at the sites below before heading out, and you can also go to the flood advisory page for our region on water.weather.gov to check on flooding advisories throughout the summer as snowmelt continues. Five Great Regional Fishing Spots Boca Reservoir Location: Stampede Dam Road, 2 miles north of the Boca exit on Interstate 80 Two types of fish: rainbow trout, kokanee salmon More details: One of the more reliable year-round spots, Boca Reservoir even hosts ice fishing once (or if) the body of water freezes over. It’s located in the beautiful Tahoe National Forest. Donner Lake Location: Take the Donner Pass Road exit from Interstate 80, turn onto South Shore Drive Two types of fish: brown trout, mackinaw trout More details: A great scenic lake at the edge of Donner Memorial State Park, this fishing spot includes a public pier, while its China Cove on its southeast end is also a good place for mackinaw in the fall. Paradise Park Ponds Location: Take US Highway 395 to the Oddie Boulevard exit, follow it about a mile to the corner of Oddie and Silverada boulevards Two types of fish: rainbow trout, channel catfish More details: The Reno-Tahoe area has several urban lakes ripe for fishing, including this longtime spot for anglers. There are two large and two small ponds for a fun experience no matter your skill level. It’s also open year-round. Pyramid Lake Location: Interstate 80 to the Fernley exit, then take the Wadsworth/Pyramid Lake ramp to State Highway 447 Two types of fish: cutthroat trout, Sacramento perch More details: This is one place everyone talks about for fall fishing, as the season, which opens on Oct. 1, is very popular. The lake is run by the government of the Paiute Tribes and has distinctive rules for those who choose to fish here. Truckee River Location: Along Highway 89 and Interstate 80, between Tahoe City limits and Reno city limits Two types of fish: rainbow trout, mountain whitefish More details: This portion of the Truckee is where most of the fishing takes place, although the Reno-Sparks Recreation and Visitors Bureau notes that “this is not a river to fish to death in one spot. There is plenty of room and one should keep moving until one finds some agreeable fish.”

Read More About Get Reel: Top 5 Fishing Spots in the Truckee Meadows