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Women undergo multiple hormonal changes throughout their lives, leading to different physical and emotional experiences. Dr. Carilyn Hoffman, at Renown Women's Health, explains these confusing life stages and helps decode menopause. Perimenopause: Transitioning Towards Menopause Defined as the time "around menopause," perimenopausal symptoms are caused by hormonal fluctuations that occur as the ovarian function declines. Levels of estrogen and progesterone decrease, and follicle stimulating hormone increases. These hormonal fluctuations may cause a range of symptoms including: Irregular or abnormal periods: Initially cycles intervals vary in length by greater than 7 days, then in later stages the interval increases to greater than 60 days between cycles Hot flashes and night sweats: This is the most common symptom and 50-82% of women will have vasomotor symptoms Mood swings and memory problems Anxiety or insomnia Heart palpitations Decreased libido and vaginal dryness Weight gain and thinning hair Increased risk of urinary tract infections Decreased bone density Menopause Menopause is defined as year without a menstrual cycle and marks the timeframe when the ovaries stop making estrogen. This signifies the end of the reproductive years. The average age of menopause is 51; however, the menopausal transition can last about 8 years. This means that women in their late 30’s and 40’s may start to have symptoms of perimenopause. The worst vasomotor symptoms are typically experienced at the one-year mark since the last period. Unfortunately, some women experience symptoms throughout the entire menopausal transition. Postmenopausal After 12 months without a menstrual cycle, a woman is confirmed to be postmenopausal. This is sometimes difficult to define, as women may have had procedures that cause menstrual suppression such as a uterine ablation or hysterectomy or they may still be on contraception. Sometimes, lab work may be recommended to help determine menopausal status. However, due to the broad time period that the menopausal transition occurs and the variations in normal hormone levels throughout a cycle, lab work is not always helpful. Dr. Hoffman explains the importance of thorough counseling for patients seeking to "check their hormone levels." She emphasizes that menopause is diagnosed clinically, focusing more on the individual's symptoms rather than lab values. This approach ensures that patients understand the implications of the test results and the treatment strategy. Menopause Medical Management Medical management of symptoms should be tailored to the individual’s concerns. Abnormal Bleeding: There are a range of medications, IUDs and procedures available if the main concern is irregular or prolonged menstrual bleeding during perimenopause.  Hot Flashes and Night Sweats: Hormone Replacement Therapy (HRT): HRT is currently the most effective method for relieving vasomotor symptoms. However, it's important to discuss potential risks with a healthcare provider, as HRT can increase your risk of blood clots and breast cancer. If improperly prescribed, it can also increase the risk of uterine cancer. The American College of Obstetricians and Gynecologists recommends the lowest dose for the shortest duration. Low-dose antidepressants: SSRIs/SSNIs may mitigate hot flashes and mood disorders for those who are not candidates or prefer to avoid HRT. Currently, only Paroxetine is FDA-approved for this use.  Fezolinetant: This is a newly FDA-approved non-hormonal medication that works at the brain's level to treat vasomotor symptoms. Gabapentin: This is an anticonvulsant medication that has been shown in several studies to be helpful for vasomotor symptoms, but it is not currently FDA-approved. Genitourinary Symptoms of Menopause:  Vaginal estrogen: Vaginal dryness and pain with intercourse due to thinning vaginal tissue is a common symptom of menopause. Vaginal estrogen is highly effective at decreasing these symptoms and has fewer side effects than systemic HRT. Ospemifene: This is a selective estrogen receptor modulator that is a non-hormonal FDA-approved medication for severe vaginal dryness. Natural Symptom Relief Strategies: Nutrition: Incorporate calcium, vitamin D, and high-quality protein to support bone health and muscle maintenance. There are limited studies on phytoestrogens (found in soy and tofu) and vasomotor symptoms. While the data doesn’t necessarily support that these phytoestrogens relieve symptoms, no detrimental effects were found and these tend to be high quality and healthy proteins. Exercise: Regular physical activity can ease menopausal symptoms and support weight management. Data doesn’t support that this reduces vasomotor symptoms, but it can be helpful in weight management and sleep quality. Beverage choices: Limiting alcohol and caffeine can help decrease the frequency of vasomotor symptoms and may also improve sleep quality. Alternative remedies: One study shows that Chinese herbal medicine and acupuncture are effective at relieving vasomotor symptoms. There is not enough evidence to recommend Black Cohosh, and it is associated with liver toxicity in high doses. Studies don’t show that St. John’s Wart or Gingko Balboa are any better than placebo.  Always mention your alternative medical therapies to your provider as some do interact with other prescribed medications. By understanding and recognizing that the symptoms of menopause are real and treatable, women are empowered to manage this transition better and can maintain their well-being and quality of life. Please schedule an appointment with Renown Women’s Health if you’d like to discuss your menopause symptoms with a provider.

Read More About Dr. Carilyn Hoffman's Guide to Menopause Medication & Relief

Abdominal pain is one of the most common reasons for an Emergency Room visit. The abdomen is an area that encompasses multiple organs and functions. So how would you know when the pain you are feeling is an ovarian cyst or something else, and when should you seek medical attention? Dr. Carilyn Hoffman, at Renown Women's Health, explains. Ovarian Function Defined Located on each side of the uterus, the ovaries are part of the female reproductive organs and produce eggs (ova), released during the menstrual cycle, allowing for fertilization and pregnancy. They also produce hormones such as estrogen and progesterone, which play an important role in female traits, bone health, cardiovascular health and pregnancy. Symptoms of an Ovarian Cyst Cysts are solid or fluid-filled masses. Ovarian cysts can be in the ovary or on its surface. When cysts are enlarged or rupture, they can create a dull ache or sharp pain below the belly button. Besides discomfort and pain, other symptoms of ovarian cysts may include bloating, fullness, pressure or heaviness. "Ovarian cysts are common; most are physiologic and will go away on their own. They are frequently found incidentally on ultrasound and are present in the middle of the menstrual cycle," says Dr. Hoffman. "However, if a woman experiences sudden and severe pelvic pain they should seek immediate medical attention. Sometimes ovarian cysts can become large and twist on themselves. This is called ovarian torsion and is a surgical emergency. Other times, cysts can rupture and bleed. This is called a hemorrhagic cyst and can also be a surgical emergency." Diagnosis and Treatment If an ovarian cyst is suspected, your doctor will perform a pelvic exam and order an ultrasound. There are certain ultrasound findings that suggest that the cyst is benign. There are other ultrasound findings that are concerning for cancer. Small simple cysts often resolve on their own, whereas solid or very large cysts may require surgery.

Read More About What is an Ovarian Cyst, and How is it Treated?

Obstetrician-gynecologists (OBGYNs) see patients from menses (the monthly menstrual cycle that occurs as a part of the female reproductive system), pregnancy and childbirth through menopause and play a pivotal role in managing reproductive health and overall wellness. Dr. James Alexander with Renown Women's Health explains. "As experts in women's health, we are uniquely positioned to recognize subtle changes or symptoms that might indicate broader health issues. This comprehensive approach allows us to serve as a valuable first touchpoint for various health concerns." Preventive Screenings: A Proactive Approach One key aspect is an OBGYN's ability to recommend preventive screenings based on your symptoms, age, lifestyle and medical history. For instance, lipid screenings are critical for monitoring cholesterol levels, which can be a significant factor in women’s heart disease. An OBGYN keeps up with the current guidelines for routine screening as well as in women with risk factors such as high blood pressure, diabetes, or a family history of heart disease during your visit. By identifying risks and abnormal screening early, they can collaborate with you to implement lifestyle changes or treatments to reduce your risk of heart conditions. Schedule Your Screening Appointment Make an Appointment by Phone: 775-982-5000

Read More About The Expanded Role of OBGYNs in Women's Healthcare

Raquel was 33 when she was diagnosed with breast cancer. It was April 2023, when she found a lump in her breast and was referred to the William N. Pennington Cancer Institute. After comprehensive imaging, she was diagnosed with invasive lobular carcinoma, which is a type of breast cancer that begins in the milk-producing glands of the breast. Between June 2023 and January 2024, she received a total mastectomy, chemotherapy and radiation at Renown Health. “Breast cancer is uncommon in women under 40, but any woman with a mass or lump in her breast should have an exam by a physician and imaging at any age,” said Dr. Lee Schwartzberg. In fact, according to the Centers for Disease Control and Prevention (CDC), only 9% of all new cases of breast cancer in the U.S. are found in women younger than 45. “It was a pretty scary diagnosis, but I’ve been led by great people through the process,” she said. “They were so helpful and there for me throughout the chemo and radiation.” Raquel's journey through breast cancer treatment at the William N. Pennington Cancer Institute was marked by the exceptional care provided by the Renown Health team, including nurses, nurse navigators, therapists, support teams and providers. Among the dedicated professionals, Dr. Michelle Chu and Dr. Lee Schwartzberg played pivotal roles in Raquel's diagnosis and subsequent treatment plan. Their expertise, compassion and commitment to patient care left an indelible impact on Raquel's experience. Their thorough examination and comprehensive approach ensured that Racquel received the best possible care for her invasive lobular carcinoma. In addition to the care provided at Renown, Raquel greatly benefitted from being connected with a mentor by Dr. Chu. This mentor, Kayla, had undergone a similar diagnosis and treatment plan, and at the same age Raquel. They texted and called each other throughout Raquel’s treatment, providing additional support through a challenging time. As of January 2024, Raquel is done with her treatment and continues to see her care team for follow-up appointments. “I’m through the worst and ready to rebuild my life,” Raquel said. To help celebrate this milestone, Nevada Athletics invited Raquel to receive the game ball at a Nevada Men’s Basketball game. She was joined on the basketball court for this special recognition by her husband, Raul; mother, Arlene; and two daughters, Ryleigh and Rhiannon. Racquel's journey is not only a testament to her resilience but also a tribute to the invaluable contributions of Dr. Chu and Dr. Schwartzberg in guiding her towards triumph over breast cancer.

Read More About Celebrating Resilience: Raquel's Remarkable Journey Through Breast Cancer Treatment

If you or someone you know is experiencing a medical emergency, it's essential to seek immediate attention by calling 9-1-1 or visiting the ER for a thorough evaluation by a trained medical professional and timely intervention. Access to a convenient and trusted emergency room (ER) is critical to any person’s healthcare needs, including medical emergencies related to women’s health. We explored some common scenarios and warning signs prompting women to seek immediate medical attention with Aiden Gould, Board-Certified Emergency Physician at Renown Health. When your medical emergency can’t wait, Renown ER is here to provide you with the region’s leading emergency care to diagnose and treat your condition or illness.  Understanding Common Reasons Women Visit the Emergency Room Gynecological Emergencies: One of the most common reasons women may seek emergency care is due to gynecological emergencies such as severe pelvic pain, abnormal bleeding or complications related to pregnancy. These issues can be alarming and warrant immediate medical attention if the issue persists or is out of the ordinary for you.  Emotional and Physical Well-Being: For those facing diverse medical or mental health emergencies, seeking prompt assistance is crucial for a thorough assessment and safe, timely intervention. Renown ER teams are equipped with trained professionals who provide compassionate care for individuals seeking help in the following situations: Suicide risk assessment and intervention Substance abuse assessment Assault and trauma care Crisis support and intervention Resources for ongoing care and well-being support Severe Abdominal Pain: Unexplained and severe abdominal pain that is substantially different than what is normal for you is a symptom you should never ignore as it can indicate underlying issues. Warning signs of an acute medical situation include fever, vomiting or a rapid change in motor function and inability to move due to pain. Respiratory Distress: Difficulty breathing, persistent coughing and other respiratory issues can be especially concerning. Women with pre-existing respiratory conditions like asthma or those experiencing sudden respiratory distress should seek immediate care from a medical professional. Warning signs of respiratory distress may include a significant change in one’s breathing rate, changing of the skin color to blue, gray or paleness due to lack of oxygen, nose flaring and chest retractions. Cardiovascular Emergencies: Heart-related issues are not exclusive to men. Women can also experience cardiovascular emergencies that often go undiagnosed because symptoms differ from men. Symptoms like chest pain, extreme fatigue, vomiting or pain in the abdomen, shortness of breath or palpitations should be evaluated by an emergency medical professional as timely intervention is critical in such cases. Renown leads the region in cardiology care with our technological expertise and patient-centered approach. Our comprehensive team diagnoses heart disease and other cardiac conditions, offering personalized treatment plans.  Neurological Symptoms: Sudden and severe headaches, seizures or other neurological symptoms may prompt women to visit the ER if symptoms are extremely disorientating or debilitating. These symptoms could be indicative of various conditions from mild to severe, including strokes or neurological disorders that require prompt evaluation.  Renown Regional Medical Center is a Comprehensive Stroke Center, providing primary stroke care including evaluation, treatment and education to patients who arrive at a Renown facility with the signs and symptoms of a stroke. Compassionate Care in Times of Need At Renown Health, we understand that your time is valuable, especially in emergency situations. That's why we strive to provide patients with exceptional care, compassion and respect. Plan ahead and make informed decisions about seeking medical care by viewing your estimated triage wait time at a Renown ER.

Read More About Most Common Reasons Women Visit the ER

For the average person, wounds aren’t an everyday worry. However, for at least eight million Americans, chronic wounds can pose a serious threat to health and well-being. From a person with diabetes experiencing painful neuropathy to a patient healing from a significant burn, caring for advanced wounds is a major part of their healthcare journey. Who do they go to get the care and guidance they need? The answer: Renown Wound Care. Serving patients in both the inpatient and outpatient settings, this department provides comprehensive, best-in-class treatments for severe and chronic wound healing and ostomy care. Our Wound Care team members have mastered the art of harnessing cutting-edge technologies and a patient-centric approach to redefine the standards of healing.  Advanced Care for the Best Repair  At Renown Health, we are fortunate to have a team full of nurses, physicians and more caring for patients with wounds caused by a wide variety of conditions. Those include:  Burns Trauma Vascular diseases Radiation therapy Pressure ulcers Diabetes and diabetic neuropathy Adding to the expert-level continuum of care, Renown is the only health system offering complete ostomy services in the entire region. The Wound Care team helps ostomy patients with the fitting of their medical bags, treatment of any skin conditions that may arise after ostomy bag placement, care coordination and much more.  With a multidisciplinary network of experts tailoring personalized treatment plans, there is never a dull moment on the floor. On the outpatient side, the team expects 50-60 patients in one day alone.  “As a clinician, wound care is a lot of ‘arts and crafts,’ so we get to use our creative and critical thinking skills to provide the best possible care,” said Samantha Moore, Advanced Wound Care Specialist RN for Outpatient Wound Care. “Each patient has an individualized plan of care – we greet them as they come into the clinic, escort them back to their treatment rooms and get their latest health updates and life situations before providing wound or ostomy care. We prepare each morning doing chart reviews to determine patient needs, wound progression and referral needs.”  “We are a highly specialized, dedicated group of professionals with a passion to treat and heal our patients’ wounds,” added Lori Conner, Advanced Wound Care Specialist RN for Outpatient Wound Care. “When a patient comes to our clinic for evaluation, they are given a dedicated appointment to thoroughly go over their medical and surgical history, medications and nature of the wound.”  Switching over to the inpatient care team, they operate like a well-oiled assembly line, navigating different daily assignments with precision and flexibility.  “On the inpatient side, our day starts in our office with triaging our consult list; after the triage process is completed, we get our assignments, which can consist of wound vacuum-assisted closure (VAC) patients, follow-up patients, ostomy education patients and new wound consults,” said Megan Uy, Advanced Wound Care Specialist RN for Inpatient Wound Care. “In the case of patients requiring wound VAC changes, we consider what kind of pre-medication for pain that they need. Although some patients may be seen on a time schedule, the day ends up flexible as patients are being seen by other specialties. This flexibility also benefits the patients, making them feel more empowered with their care.”  “Each day in the inpatient setting, we get to our office and sort through all the new consults that came in overnight, and the charge nurse makes the assignment for the day,” added Madison Arlin, Advanced Wound Care Specialist RN for Inpatient Wound Care. “After the assignment is completed, each nurse is responsible for researching their patients and organizing their day, typically by priority – wound VACs and ostomies usually take top priority.”  Now, how do these treatments actually work? This specialized field handles advanced methods of treating each condition, including:  Biological skin substitutes Surgical debridement Advanced wound dressings Negative pressure therapy Pre-ostomy markings and education Offloading techniques, such as padding or dressing “Before starting treatments, we communicate with our nurses and providers to make sure that the patient is comfortable prior to wound care,” said Dianna Seo, Advanced Wound Care Specialist RN for Inpatient Wound Care. “After we see the patient, if there is a need for escalated care, we contact the provider for additional testing or consults. We continue to follow-up on patients that have severe wounds, wound VACs and ostomies.”  In the hands of the Wound Care team, patients exit our hospital walls not only restored but also empowered, set on a trajectory for long-term healing. Your Expert Care Guides  No matter the case or the severity of the wound or condition, patient care, comfort and communication always come first – before, during and after treatment.   “Many of our patients have chronic needs, so we end up seeing them for several months, if not years in some cases; we stay up to date with their specific psychosocial needs and help remove barriers that would prevent their wounds from healing,” said Samantha Moore.  “I enjoy knowing that my positive attitude can improve our patients’ days,” added Maddie Pauley, Patient Access Representative for Outpatient Wound Care. “When they’re routinely coming to appointments they might not enjoy, hearing them praise our team and give their thanks is one of the most rewarding feelings.”  As a wound care patient, there can be a lot of unknowns when beginning their care journey. However, these team members carefully walk each patient through every step from beginning to end.  “When we go to see a wound care patient, our team is very consistent about explaining to the patients what our role is and what we plan to do with their wound, and then we continue to actively communicate throughout wound care each step that we are doing as we are doing it,” said Madison Arlin. “We also encourage some of our patients to listen to music that they enjoy during the wound care, or we will cover their eyes with a cloth if they request so that they don't have to see their wound. Sometimes, we will ask the family to stay at the bedside to hold their family member's hand.”  Education is crucial to ensuring each patient knows what to expect in order to care for their wound and understanding the stages of healing. Fortunately, this team is well-versed in the world of wound wisdom.  “A lot of education is provided on the type of dressing we are applying, and if the patient is going to be performing their own dressing changes, we will go over the entire change with them and provide supplies for discharge,” said Megan Uy. “Additionally, there will be written instructions in their discharge paperwork. In the cases of wound VAC dressing changes, each step is explained to the patient before doing it, and we also go over discharge options and expectations.”  “As a clinician who sees a lot of patients prior to having their ostomy placed (pre-surgical marking), one of the most important things we do is first sit with the patient and/or caregivers and talk about their fears, concerns, questions and goals,” said Samantha Moore. “We provide a lot of emotional support and education, helping identify community resources. For our wound patients, we spend a lot of time educating our patients/caregivers about how and why their wounds occurred. We try to connect with them on a personal level and help them identify ways to help their wounds heal.”  To see a patient’s care journey from the second they enter through our doors to the moment they return home is one of the most rewarding feelings for the Wound Care teams. In fact, they’ve had the pleasure of treating patients for years and seeing their wounds almost completely heal. The team collectively values the successful healing journeys of their patients as their proudest achievement.  “One of our team's greatest accomplishments was being able to see one of our long-term patients discharged with nearly resolved wounds,” said Megan Uy. “This patient had been in our care on-and-off for the past year with many hospitalizations and had complicated high-output enterocutaneous fistulas within his wound bed. These were incredibly hard to keep a dressing on successfully, and he often had issues with the dressing leaking. Eventually, we got a dressing that could remain intact until his next scheduled dressing change, and he was able to get surgery that fixed his fistulas. Being able to see him recover and heal his wounds was a very large accomplishment for us.”  The admiration and compassion this team has for their patients also extends to each other. The cohesive way they work together only further benefits their patients, offering the best-possible collaborative care.  “We have extremely skilled clinicians in our group that are not only incredible in the work that they do and the patient care that they provide but are also enjoyable to work with as well,” said Geane Weaver, Advanced Wound Care Specialist RN for Inpatient Wound Care. “There is something to be admired in each and every one of my coworkers.”  “Our team is very close and supportive of each other at all times,” added Madison Arlin. “I feel very lucky to work with such an amazing group of people. Our team is very proud of the work we do.” Fervently Fighting the Good Fight So, with the highly specialized nature of advanced wound care, how did these team members get inspired to join the Wound Care team in the first place?  Well, for many of these devoted employees, their first exposure to caring for wounds took place on different units – sparking their interest in making wound care their full-time career.  “Renown was the most welcoming towards me as a student nurse, and I liked that it was a teaching hospital,” said Madison Arlin. “I started in the General Surgical Unit (GSU) immediately after graduating nursing school and worked there for two years before transferring to wound care. I decided to apply to the wound team after watching the wound nurses do wound VACs and ostomy changes on the floor. I would ask them if I could watch, and I was always very fascinated by the wound healing process.”  “Prior to joining the inpatient wound team, like Madison, I was also a bedside nurse in GSU,” added Geane Weaver. “Working on that floor, I was already exposed to a lot of patients that were requiring some kind of advanced wound care in one way or another. Working in the GSU, I also cared for a lot of patients that had wound VACs and ostomies. These patients make up a huge group of the individuals that our team sees on a regular basis, and they've always been intriguing for me, so naturally, wound care has always been on my radar.”  For other team members, wound care has always been a point of curiosity throughout their education and career. From their very first exposure to this care area, they were hooked.  “I was always curious about wound care even through my nursing school experience,” said Dianna Seo. “When I was working on the floor, I would trade to do wound care for patients. When I had time, I would follow wound care and help when I could. I joined the skin team which drove me to be increasingly involved with wound care. As soon as there was a job opening, I applied for the position. I worked in outpatient wound care for approximately four years and now inpatient for another four years. I have enjoyed all aspects of wound care and patient care.”    “I had great clinical experience at Renown when I was in nursing school; I also was very interested in caring for trauma patients, and Renown being a Level II trauma center aligned with my interests,” added Megan Uy. “I began my nursing career in the GSU, but my dream job was always Wound Care. During my nursing school clinicals, I had the opportunity to watch some members of the wound team do wound VAC changes and thought it was incredibly intriguing and a great combination of utilizing the knowledge of anatomy and physiology while being creative with handicraft. A position opened on the team around the time I met the prerequisites to be eligible for the position, and luckily, I got it.”  Our Wound Care team has achieved significant employee and departmental milestones over the past year, reflecting their dedication to enhancing patient care and overall process improvement.  “We have had many accomplishments within the last year and are currently working on more to improve the hospital,” said Dianna Seo. “Madison Arlin won the DAISY Award for her great work with our patients. Megan Uy won Top Talent of the Quarter for helping a stranger. Ande Ferriera has worked tirelessly to improve our process improvement. Allie Saunders, as our leader, has worked to improve patient skin by getting new beds for Renown Regional. All our patients that have healed or are on their way to healing under our care is our greatest achievement that we as wound team is most proud of.”  “We are constantly updating protocols, notes and orders for bedside nursing so that it is a more straightforward and seamless charting process,” added Madison Arlin. “We have representatives of different supply companies come and present new products that we think may benefit our patients better. Our wonderful tech has even updated our department site on Inside Renown so that the nurses always have references available.”  Renown’s strong influence in the region – and the opportunity to give back to their community – was, and continues to be, a major draw for this team.  “Since I can remember, Renown has always been the most prevalent healthcare name for my family and has always taken the most amazing, thorough care of my loved ones,” said Maddie Pauley. “I have always wanted to work somewhere I could help people, and starting at Renown has really opened my eyes into how much of a difference each one of us can make.”  Our Wound Care department’s success stories and proactive approach not only reflect their passion for healing but also inspire a ripple effect of positive change throughout our health system. They proudly exemplify a shared commitment to enhancing the well-being of all patients under their care.  “Being part of Renown and part of this team has been my blessing; I get to do a job I love with people that love it too,” closed Dianna Seo.

Read More About Department Spotlight: Wound Care

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.

Read More About Understanding the Reasons Behind Heavy Menstrual Cycles

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.

Read More About What is Polycystic Ovary Syndrome (PCOS)?

Above: Brian Cushard (left), Renown Health Foundation Board Chair, with his family At Renown Health Foundation, our mission is simple yet powerful – to raise funds that support Renown Health, the largest not-for-profit health system in northern Nevada. We are the driving force behind initiatives that bring state-of-the-art equipment, conduct groundbreaking research, enhance healthcare services, improve patient outcomes and contribute to the overall well-being of our community.  Our Dedicated Board of Directors  Our impactful work would not be possible without our Board of Directors – a fantastic team of 27 local volunteers. They bring diverse skills to the table, working together to create positive changes in healthcare for northern Nevada. Our board is at the core of our Foundation's success by guiding important decisions, sharing valuable insights and actively engaging in community relationships.  Meet Brian Cushard – Renown Health Foundation’s Chair  Brian Cushard took on the role of Foundation Board Chair at the beginning of 2024. Brian, who is the President of LP Insurance Services in Reno, will lead us for the next two years, bringing a wealth of experience and a deep commitment to community well-being. Since joining Renown Health Foundation’s Board in 2018, Brian has been instrumental in shaping our strategic direction.  Brian’s Vision: Advocating for Renown Health’s Mission and Making a Difference  We had the opportunity to sit down with Brian and explore his passion for healthcare philanthropy and the positive changes he envisions. Brian's 'why' is firmly rooted in the belief that a robust health system serves as the backbone of the community. His vision extends beyond fundraising; it's about inspiring the community by sharing remarkable stories of care and championing Renown's impactful contributions.  Q: Why does Renown's mission matter to you, and how do you see your role making a difference?  A: Renown's mission matters deeply to me because, without a highly functioning healthcare system, the economic structure of the community can be impacted. At LP Insurance, where I work, we see ourselves as guardians of our clients' hopes and dreams. This translates to my role on the Board as stewards for the health of others. Advocating for a highly functioning health system is crucial in supporting community members and clients alike. Surrounding ourselves with a solid network is essential. As advocates, our voices are integral in ensuring that everyone's voices are heard.  Q: Can you share a moment that made you want to support healthcare causes?  A: There are those stop-in-your-tracks healthcare moments that make you reassess life's priorities. I've had moments where life comes to a standstill, and what you once thought was important takes a backseat to the basics of life—getting better, one step at a time. In those vulnerable moments, you realize the importance of every person at the hospital. In desperate need, we rely on them. It's eye-opening and gives perspective on what's truly valuable in life.  Q: Tell us about a time when you saw the positive impact of healthcare or philanthropy. How did that influence your decision to get involved?  A: One impactful moment in philanthropy stands out — the Music and Miracles concert featuring the Beach Boys. LP Insurance was a major donor, contributing $100,000 to benefit Sophie’s Place, a music therapy room coming to Renown Children's Hospital. On the day of the event, my wife and I volunteered and saw the remarkable community support for Renown Children’s Hospital. The collective efforts that day raised over $1 million, specifically designated to establish Sophie’s Place. This experience inspired me to want to do more, as I recognized the profound positive impact that philanthropy can have on healthcare and the community.  Note: Sophie’s Place, opening later this year, will offer vital care and healing experiences for young patients at Renown Children’s Hospital.

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According to the American Cancer Society, approximately 13,820 new cases of invasive cervical cancer will be diagnosed, and 4,360 women will die from cervical cancer. However, cervical cancer is preventable with regular screening tests and the HPV vaccine. It’s important to note that medical advances have allowed progress in diagnosing and treating cervical cancer. While it used to be one of the most common causes of cancer death for American women, the incidence of death has significantly declined. What to Know About the HPV Vaccine HPV vaccination is the best way to prevent cervical cancer and is recommended for all youth starting as early as age 9, or for teens and adults up to age 45 who didn’t start or finish the series. In Nevada, only 50.1% of teens ages 13-17 have been vaccinated for HPV.  There are 13 types of HPV, and the vaccine Gardasil 9 protects against 9 of those HPV strains, greatly reducing the incidence of cervical cancer among vaccinated individuals. What to Know About Cervical Cancer Screenings The CDC says the most important thing you can do to help prevent cervical cancer is to have regular screening tests starting at age 21. And there are two common tests that can detect early stages of cervical cancer (or precancer) and improve health outcomes. The pap test (or pap smear). This screening looks for precancers. Women should begin getting pap smears when they’re 21. The human papillomavirus (HPV) test looks for the virus that can cause these cell changes. Cervical Cancer Screening Schedule The American Cancer Society offers the following guidelines for screenings: All women should begin cervical cancer screening at 21. Women between 21 and 29 should have a pap test every three years. Beginning at 30, the preferred way to screen is with a pap test combined with an HPV test every five years. This is called co-testing and should continue until age 65. A pap test (or pap smear) is performed during a regular screening appointment to look for precancers, cell changes on the cervix that might become cervical cancer if they are not evaluated or appropriately treated. Typically outpatient procedures can reduce the risk of long-term health impacts that prevent pre-cancerous cells from becoming cancer cells. Women over 65 who have had regular screenings in the previous ten years should stop cervical cancer screening as long as they haven’t had any severe precancers found in the last 20 years. How to Get Screened Request an appointment with your primary care physician or OBGYN to schedule a screening.

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Kick off 2024 with us as we celebrate the team behind our very own Renown Health Foundation!  When you visit Renown Health, you take a look around and can’t help but notice the robust programs in place. You look left and see our thriving Children’s Miracle Network Hospital at Renown, making a lasting impact on pediatric healthcare in our region. You look right and see the advanced William N. Pennington Cancer Institute, providing leading-edge treatments right here in our community. You look around you and notice an influx of smiling nurses from the Orvis School of Nursing at the University of Nevada, Reno (UNR) who receive tuition assistance, thanks to generous donations to the Gerald “Jerry” Smith Academic Practice Partnership. Then, you think to yourself: “These programs must need a lot of money and support. So, how on earth is this all possible?”  What you may not know is that these programs are funded by the generosity of our community, all made possible by the work of Renown Health Foundation. As the largest not-for-profit health system in northern Nevada, our mission to make a genuine difference in the health and well-being of everyone we serve flourishes because of the donations, sponsorships, endowments and more that our Foundation brings in from philanthropists all over the region.  Making It Happen  The reach of Renown Health Foundation has proven to be virtually limitless, with a clear focus on supporting and raising funds for programs and initiatives that enhance the lives of our patients and their families, all for the betterment of our community for years to come.  Under their growing umbrella, the dedicated team at the Foundation makes miracles happen through administering a wide range of philanthropic programs, including: Children’s Miracle Network Hospitals (CMNH), a nonprofit organization that supports the health of 10 million children in the U.S. and Canada every year. Renown Children’s Hospital is proudly recognized as a member of CMNH. Gerald "Jerry" Smith Academic Practice Partnership, a partnership between Renown Health and the UNR Orvis School of Nursing to provide 24 nursing students a year with full-ride tuition assistance and a guaranteed career in nursing at Renown. Fianna’s Healing Garden, a healing garden bringing serenity to all at Renown Regional Medical Center, built from the vision of Fianna Dickson Combs. Miracles at Montreux Golf Tournament, an annual golf tournament that takes place at Montreux Golf & Country Club and consistently raises hundreds of thousands of dollars for Renown Children’s Hospital. A full slate of individual giving programs, including Legacy Giving, Employee Giving and Leadership Giving.  But it doesn’t stop there – the Foundation is helping our health system build more ways to care for our community by securing major gifts to fund advanced healthcare facilities and innovative healthcare solutions:  William N. Pennington Cancer Institute, the premier oncology institute in the region providing a large array of personalized cancer care services, including Medical Oncology, Infusion Services, Clinical Research and more. Renown Institute for Robotic Surgery, offering the latest advancements in surgical technology with robotic-assisted surgeries, which ensure precision, faster recovery and improved outcomes. Sophie’s Place, a state-of-the-art music therapy room currently in construction at Renown Children’s Hospital. This new space will be specially designed for children and their loved ones to enjoy the healing power of music and engage in the arts. Conrad Breast Center, the latest addition to the planned Specialty Care Center at Renown South Meadows Medical Center which will include breast imaging, infusion and surgery services along with a wellness center. Jeanne and Raymond Conrad donated a $5 million lead gift to support this important project and the Foundation team is currently working to raise an additional $6 million in 2024. It may go without saying that a day-in-the-life of these spirited team members is never a dull one. Every day brings on a new challenge to face and a goal to meet.  “A day at the Foundation is a day full of emails, calls and visits with friends of Renown,” said Abbey Stephenson, Planned Giving Officer. “Our main goal is to raise funds to support the mission of Renown, and most of our outreach efforts are to encourage philanthropy and donations. We have a very collaborative team, so we can often be found in each other’s offices strategizing about fundraising initiatives, communications and next steps with specific supporters.”  “For me, a typical day involves making sure I have a donor scheduled for coffee or lunch, working on proposals that may need research and preparing presentations,” added Jerry Cail, Major Gifts Officer. “Staying connected, I send thank you notes for any donations-usually once a week and make at least three ‘Grateful Patient’ calls to set appointments. I always make sure I am ready to contribute to any meetings I have for the Foundation."  While the scope of the Foundation’s charitable efforts goes beyond hospital walls, they also thrive right here in our own health system. Through our Grants Program, Renown’s departments and programs can leverage the connections and skills Renown Health Foundation has in order to secure funding from a multitude of grant sources.  "Grant funds from foundations, and local, state and federal governments benefit the patients and communities we serve to further our mission, vision and values,” said Pam Citrynell, Development Officer. “Past grants have supported the purchase of state-of-the-art equipment, facility development, pandemic recovery, research and clinical trials, physician and researcher recruitment, community health programs and educational training for our healthcare professionals.”  Every Foundation team member lives their passion every day while at work, frequently expressing gratitude for the immense impact they have the opportunity to make.  “I love coming to work because I get a very real opportunity to make a genuine difference and meet some fantastic people who believe in and support our mission,” said Leah Nelson, Director of Community Giving. “I have had the honor of meeting donors and the families they support. I couldn't be prouder of what our team has accomplished over the years and am excited for what is to come.”  The impact of the Foundation team’s tireless efforts extends far into the future, securing Renown’s lasting legacy in contributing to the continued health and well-being of our community.  “Philanthropy is not only a financial science but a very specific methodology where connecting resources are paramount; it requires careful intelligent management coupled with lots of hard work, patience, and vision,” said Yvonne Murphy, Development Officer. “The work that the foundation does every day makes resources available to enhance the healthcare experience for all those who seek care at Renown. Our work impacts not only this present moment but in fact is a legacy that will bless this community beyond our lifetime.”

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Pictured above from left to right: Jessica Bajwa, Nancy Bell, Laurie Goodman and Troy Fernandez As we approach the holidays and the season of giving, we reflect on the generosity and kindness that our employees here at Renown embody. Since 2007, Renown employees have donated $2,931,018 through Renown’s Employee Giving Program. This program provides our staff with the opportunity to make a difference by funding advanced equipment, research, community health initiatives, professional training and more. Regardless of the dollar amount, every contribution has a meaningful impact and remains entirely within Renown to support our mission. Employees can participate in the program at any time of the year by signing up for recurring payroll deductions or by making a one-time donation of any dollar amount. They can donate to one of Renown’s top priority areas of support or a different fund of their choice.  Meet Jessica, Nancy, Laurie and Troy  Renown employees Jessica Bajwa, Nancy Bell, Laurie Goodman and Troy Fernandez all have their own reasons for participating in the Employee Giving Program, but they all share the same goal: To give back to their community. Jessica Bajwa has been working at Renown for about seven years. She was at an employee event five years ago and found out about the Employee Giving Program through Renown Health Foundation. They explained the different areas she could donate to and how to get signed up. When Jessica looked back on the comforting care and healing her daughter had received at Renown Children’s Hospital, she felt empowered to give back to other children and families staying at Renown, so she enrolled in recurring payroll deductions to donate to Healing Arts. “It’s so easy and convenient to sign up,” said Jessica. “It means a lot to me to give to this area where they provide a healing environment, especially for patients and families at Renown Children’s Hospital – My daughter still has a blanket they gave her when she was there,” Jessica said she likes that the Employee Giving Program allows employees to choose their area of support to donate to and donation amount.   Nancy Bell said she’s proud to give back to Renown after having received a great amount of support from her coworkers during an incredibly difficult time when a family member of hers was being cared for in Renown’s ICU, just three weeks into her employment at Renown. “I had employees from not just my team but also across the organization reaching out to me and checking in to see how I was doing,” said Nancy. Nancy said she was positively impacted by that kind of support through her work family at Renown and decided to start giving back in 2011 by signing up for recurring payroll deductions to donate to the William N. Pennington Cancer Institute – to this day, she is still making donations to this area of support.   When Laurie Goodman began working at Renown in 2013, Renown’s Human Resources team offered her different ways to give back as an employee. “At the time, I was often caring for foster children and seniors,” said Laurie. “My family and I have always wanted to help others in need.” Laurie had been taking care of an elderly woman who was a patient at the old Renown Skilled Nursing Facility and decided to enroll in payroll deductions to donate to this facility. When that facility closed, she received a letter asking which area she wanted to transfer her donations to, and she decided to begin donating to Renown Children’s Hospital to give back to kids in the community. “I’m fortunate for not only my employment at Renown, but my husband’s and daughter’s employment as well. As employees of Renown, we have such great jobs, benefits and opportunities, and I think we should all strive to give back to express our gratitude and appreciation.”  At his employee orientation in 2012, Troy Fernandez heard about Renown’s Employee Giving Program and learned that funds were needed for individuals who needed financial support to pay for healthcare services at Renown. He knew his donations would go to a good cause and signed up for recurring payroll deductions to donate to the Greatest Need Fund. “It feels good to be able to give back to those who are less fortunate than us,” said Troy. “It was very easy to enroll in this program, and I’ve been donating to the same support area ever since.”

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