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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

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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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Every patient, regardless of how they may identify, greatly benefits from preventive healthcare and early detection. Members of the LGBTQIA+ community face unique considerations when it comes to their health, and a proactive approach to preventive screenings and vaccines is important in order to address their individual health needs.  Dr. Karen Thiele, Family Medicine Physician with University Health and Assistant Professor of Family and Community Medicine at the University of Nevada, Reno School of Medicine, breaks down key steps that LGBTQIA+ patients should take to safeguard their health.  PrEP and PEP  Pre-exposure prophylaxis (PrEP) is a strategy to prevent human immunodeficiency virus (HIV) infection. It is an important measure for those who are HIV-negative but may be at risk of contracting it. The highest risk sexual practice is receptive anal intercourse, due to the relative fragility of rectal tissue. This medication can stop HIV from spreading in the body and help patients maintain their HIV-negative status. PrEP is available in both pill form, which is taken every day, and injection form, of which the first two injections are initiated one month after another while all other injections are initiated every two months.  Post-exposure prophylaxis (PEP) is an antiretroviral drug regimen taken after potential HIV exposure to prevent an HIV-negative individual from converting to HIV-positive status. PEP is only for emergency situations and must be started within 72 hours of exposure – sooner is always better than later – and must be taken for 28 days.  PrEP and PEP are available in many ways, including visiting your primary care provider (PCP) or an urgent care location.   HPV Immunization  All genders and identities can protect themselves against human papillomavirus (HPV), a sexually transmitted infection (STI) that can lead to the risk of cervical, mouth, head, neck, throat, anal, vaginal, penile and vulvar cancers. HPV is so common that nearly all sexually active people, regardless of sexual orientation and practices, will be exposed at some point in their lifetime.  The HPV vaccine (common brands include Gardasil and Cervarix) is a safe and effective method to prevent HPV, according to the Centers for Disease Control and Prevention (CDC). This vaccine protects against infections that can lead to HPV-related cancers and precancers, as well as genital warts. While patients should start receiving the vaccine at 9 years old years old, unvaccinated adults up to the age of 45 can also receive the vaccine through their PCP – better late than never!  STI Testing  Sexually-transmitted infections form from bacteria, viruses or parasites that can be transmitted by person-to-person sexual contact through semen, vaginal, blood and other bodily fluids. According to the U.S. Department of Health and Human Services, there are more than 20 million estimated new STI cases across the nation each year.   Luckily, most STIs are preventable. Annual STI testing for HIV, gonorrhea, chlamydia and syphilis is important to stay on top of your sexual health. Because these STIs may sometimes have no symptoms, screening is recommended regularly and with any change in sexual partners. Depending on the specific condition, tests for these infections include urine, swab and blood tests. Speak with your primary care provider on a screening schedule that works best for you.  Prostate Exams  Prostate exams look for early signs of prostate cancer in patients who still have a prostate. The CDC recommends those who are at least 55 years old get regular prostate screenings; however, for patients with a family history of prostate cancer, screenings may be recommended as early as 45 years old.  These exams are done via two common methods – a prostate specific antigen (PSA) blood test and a digital rectal examination (DRE). Your provider can help you determine your risk and when you should start getting screened.  Pap Tests and Pelvic Exams  Patients of all genders who have a cervix, uterus, vagina and/or ovaries will benefit from regular pelvic exams and Pap screenings. A pelvic exam consists of a provider looking inside the vagina and at the cervix for anything unusual. A Pap test, also known as a Pap smear, involves your provider using a small, soft swab to collect cervical cells to check for early signs of cancer.  Generally speaking, people with these organs should have a Pap test every three years starting at age 21 through the age of 30. After age 30, patients should receive a Pap test with HPV co-testing every five years until age 65. These recommendations are changing based on new research, so it is important to have a conversation with your PCP about the current guidelines so you can make an informed choice about what schedule you should follow. A gynecologist or your primary care provider can counsel you and perform these screenings.  Mammograms and Breast Exams  People with breast tissue, especially dense breast tissue, are at risk for breast cancer, and regular breast screenings are your best line of defense. At-home breast self-exams are the first step – you will want to check your breasts for any lumps, changes, fluid leaks, irregular tissue thickening or anything else that feels unusual.  The Breast Cancer Risk Assessment tool, provided by the National Cancer Institute, is a good place to start to identify your risk. Talk with your primary care provider about the risks and benefits of starting screening at age 40 so you can make an informed decision about when to start. If you have any family history of breast or ovarian cancer, your PCP will offer you genetic testing for BRCA 1 and 2 mutations. Nevadans over the age of 18 can also get BRCA genetic test for free by enrolling in the Healthy Nevada Project.  Mammograms are important screening tools, but for a significant portion of people with breast tissue, density of the breast tissue may make mammograms less helpful in detecting cancer. Your primary care provider can help you decide what additional imaging (such as breast ultrasound) might be best for you.

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March is Colorectal Cancer Awareness Month, and we want you to receive the best preventative care possible. Early detection can help prevent serious illness, yet many people still choose to skip their annual exams and routine screenings. Bonnie Ferrara, MD, MPH, Section Chief for Primary Care at Renown Medical Group, further explains the importance of this simple, easy way to stay healthy. Why are annual exams so important? The benefits of early detection and prevention to save lives and reduce the impacts of disease have been proven. These exams are the perfect opportunity to get your health questions answered. “This is your chance to sit down with your provider and talk about your overall health and your family’s health history as well as your concerns for the future,” says Bonnie Ferrara, M.D., family medicine. “It’s the opportunity for your provider to talk with you about your lifestyle, tobacco use, exercise and alcohol use, all of which make a difference in your future longevity.” The annual wellness exam is also an ideal time for most adult patients to discuss health screenings. In addition, these visits are the perfect time to address issues that may not directly relate to a particular medical problem or immediate illness. A good rule of thumb is to schedule these appointments around your birthday each year to make sure you and your provider are both updated on your care. Why would you need an annual exam if you aren’t feeling sick? According to Dr. Ferrara, seeing your care provider when you aren’t sick is one of the best times. “It is better if you try to arrange this visit when you are not feeling ill,” she says. “It is an opportunity to talk about wellness. Not only how to contribute to your wellness but also the changes that you can make that will make huge dividends in the future for your wellness. In addition, it allows us to do some education about what to expect in the coming years as far as your health and lifestyle changes.” What can you expect at an annual exam? Annual exams usually check your: History – lifestyle behaviors, health concerns, vaccination status, family medical history Vitals – blood pressure, heart rate, respiration rate and temperature General appearance – your care provider can find out a lot about you just by watching and talking to you Dr. Ferrara adds, “If this is a Medicare annual wellness exam, it is an opportunity to talk to your provider about depression and dementia as well as be tested for those.” You can also leverage your annual exam to speak to your provider about managing your chronic health problems. "As a provider, these visits give us the opportunity to hear how the medications and lifestyle changes we have recommended are working and if you are having problems with these, we have the opportunity to make suggestions of how to do things better for the future," Dr. Ferrara.

Read More About Why are Annual Exams & Routine Screenings Important?

Lung cancer is the leading cause of cancer deaths in both men and women in the U.S. The good news is the five-year survival rate increases dramatically if lung cancer is treated before spreading to other parts of the body. Julie Locken, MD, of Renown Health Imaging, explains more. What are the signs and symptoms of lung cancer? As you might expect, most lung cancer symptoms appear in the chest and can affect your breathing. Watch for signs such as: Persistent cough Constant chest pain Shortness of breath Wheezing Bloody or rust-colored phlegm Hoarseness Swelling of the neck Pain or weakness in the shoulder, arm or hand Recurring pneumonia, bronchitis or other lung infections Loss of appetite and loss of weight can also be signs of lung cancer That said, there are usually no symptoms in the early stages of lung cancer, which means getting screened can truly be a lifesaver. If you have a history of smoking, you should get screened as a precaution.  What are the risk factors of lung cancer?  Around 80% of lung cancer cases stem from a history of smoking tobacco. But there are other known causes, such as secondhand smoke, radon, asbestos and diesel exhaust. It’s important to do what you can to eliminate exposure to all of these to reduce your lung cancer risk.  People with an immediate relative – a parent, sibling or child – diagnosed with lung cancer and people between 50 and 80 years old are also at higher risk and may need to consider screening.  People who are at the highest risk are those with a history of smoking tobacco, particularly smokers who averaged one pack of cigarettes per day for 20 years or more, as well as former heavy smokers who quit in the last 15 years.

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Dr. Nariman Rahimzadeh’s career path has been anything but typical. From humble beginnings as a shuttle bus driver for Renown Regional Medical Center, then named Washoe Medical Center, to his service as Chief of Staff for Renown South Meadows Medical Center, the steps and detours he took along the way – and the strong support from his colleagues and family members – make up a tale of perseverance, conviction, compassion and inspiration.  However, his healthcare career journey began several years before he even joined Washoe Medical Center in the 1990s.  It all began 7,446 miles away in Iran.  This is Dr. Rahimzadeh’s story.  Defining Moments  The moment Dr. Rahimzadeh knew he wanted to dedicate his career to the healthcare field started during his childhood. Growing up in Iran during the midst of the Iranian Revolution, a thought that often came to mind was, “Who is helping all the people injured in the war?”  The answer? The doctors.  “In Iranian society, doctors are extremely valued, as they are the first to help people in need,” said Dr. Rahimzadeh. “I knew I wanted to give back to society in some way, and I see my time in Iran as very formative in my future career. I just didn’t know it yet.”  After immigrating to the U.S. with his family during his preteen years, he only had one mission: to support his family. “My desires were to help my family not fall behind,” he said. “I didn’t have career aspirations at the time. All I knew is that I wanted to help my family and my community, which immediately opened its arms up to us, as well as be a good student and a good ambassador for Iran.”  Dr. Rahimzadeh remembers several influential people that helped solidify his aspiration from “helping people” to “helping people as a healthcare professional.” Their family physician and other medical professionals in the family’s lives were monumental in helping him make this decision. Coupled with his natural love for the sciences, the decision to become a doctor became clear.   But the question remained, “How do I get started in the healthcare field?”  No Links to Healthcare? No Problem  With no physicians in his immediate family and no direct connections to healthcare, Dr. Rahimzadeh set off to follow the advice he received from the influential people in his life: get a job at a healthcare facility, regardless of what the job title is.  Some of his friends had recently joined Washoe Medical Center as patient transporters and mentioned job openings that were available. He sprang into action and headed to Washoe Medical Center to apply.  Just one problem – he didn’t have the EMT certification requirement.   Enter Barry O’Sullivan, who would be Dr. Rahimzadeh’s first supervisor at Washoe Medical Center (and a friend he still speaks with to this day). Barry saw promise in Dr. Rahimzadeh immediately. As a result, Barry made a suggestion to him that would ultimately set him on the course towards medicine.  “Barry told me that he had an open position that I could work while completing the senior year of my undergraduate degree and studying for my EMT certification and eventually becoming a patient transporter. He told me Washoe Medical Center would support me in this endeavor. So, I asked what the job was and learned it was driving a shuttle bus.”  Without hesitation, Dr. Rahimzadeh responded, “I’ll take it.”  And so, his fulfilling journey with Washoe Medical Center, and eventually Renown Health, began.  While he finished up the last few months of his degree at the University of Nevada, Reno, (UNR) Dr. Rahimzadeh proudly drove the shuttle bus a few days a week. The job not only helped him pay for his degree and put food on the table, but it also allowed him to begin living out his passion for helping people in the healthcare field.  Dr. Rahimzadeh graduated with his bachelor's degree in Pre-Medicine from UNR and finished his EMT certification program. Sure enough, Barry and Washoe Medical Center lived up to their promises and helped him secure his first direct healthcare job as an EMT and Patient Transporter with REMSA. But he didn’t stop there – after several years as a ground transporter, his career literally took flight. He joined REMSA Ground Ambulance and eventually Care Flight as a Flight EMT II, caring for patients that were flying to Washoe Medical Center from nearby communities that needed lifesaving medical care.  Helping save lives every day as a member of the emergency medical team is an ultimate feat, especially when it comes to Dr. Rahimzadeh. And he didn’t stop there.  Valuing One-on-One Connections  In the 1990s, as it is today, the U.S. experienced a significant primary care provider shortage which resulted in many medical schools encouraging students to complete their residencies in a primary care specialty, like internal medicine – which is precisely what Dr. Rahimzadeh set out to do at the University of Connecticut.   However, his mind would soon change about the course of his career.   “I had a deep, introspective conversation with my residency program director, openly and honestly chatting about my future,” Dr. Rahimzadeh said. “I ended up taking a week off of my residency and wrote a long pros and cons list about what I wanted to do with my life in the medical field.”  Eventually he decided on anesthesiology because of the opportunity to have a one-on-one relationship with every surgery patient, regardless of their procedure.  “Even though it’s for a short duration of time, it is a very impactful relationship,” he said. “I feel I am making a difference in the outcomes and lives of patients every day.”  Dr. Rahimzadeh finished his internal medicine residency in three years and passed his board exam, and he went on to do the same thing for anesthesiology. He then ventured back home to Reno.  Career Progression at Its Finest  Dr. Rahimzadeh knows that people don’t always get to settle down in a place that influenced their upbringing, care and dream, yet he was able to make that vision a reality for himself.  “I feel like Renown Health and myself have this intertwined relationship that led to my growth as a person and as a physician,” he said. “For that, I feel very blessed."  Upon his arrival back to Reno with two residencies under his belt, Dr. Rahimzadeh was quickly hired at one of the two anesthesiology groups in town at the time. He started his career with Sierra Anesthesia and after working for the group for several years, he joined Associated Anesthesiologists of Reno in 2014, which went on to become one of the largest anesthesiology groups in northern Nevada. The group continuously worked very closely with Renown, taking care of all of its surgical patient needs and eventually becoming Renown Medical Group employees as of April 1, 2022, with Dr. Rahimzadeh setting up his home base at the Renown South Meadows campus.  Today, Dr. Rahimzadeh wears three “hats” at Renown. As a medical professional first and foremost, his largest “hat” is his general anesthesiologist role, where he cares for patients in the operating room. Another significant “hat” is his role as the Medical Director for Surgical Services, where he reviews surgical patient charges alongside his dedicated team of nurses and ensures optimal patient outcomes by verifying they have had the appropriate workup to proceed with surgery in a safe manner. To round out his immense responsibilities with Renown, he serves as Chief of Staff for Renown South Meadows, where he makes connections with colleagues and collaborates with leaders to review protocols, policies and address concerns that arise.  Outside of Renown, Dr. Rahimzadeh is still a contributor within his own anesthesiology practice. He also is the current President of the Nevada State Society of Anesthesiologists and the Director to the Board of Directors of the American Society of Anesthesiologists, helping bridge the gap in anesthesia concerns between his northern and southern Nevada colleagues.  He reflects on the opportunities Renown and our local community have extended to him by saying, “If you can dream big enough and continue to chase your dreams, you can make it happen right here.”  On the COVID-19 Frontlines Nothing could prepare us for the dire situation hospitals on the east coast – especially those in Livingston, New Jersey – were experiencing at the beginning of the pandemic. Livingston was known as the “second hardest hit area” by COVID-19 in April of 2020. Hospitals were overwhelmed with patients in the ICU fighting for their lives. They needed help, and they needed help now.   Unable and unwilling to sit idly by, Dr. Rahimzadeh and six of his colleagues from his practice traveled to Livingston to help. They jumped in on the frontlines alongside other anesthesiologists and intensivists to offset the sudden influx of COVID-19 patients. Many lives were saved, and Dr. Rahimzadeh was a direct part of that.  “When you care and work with people that also care, you can move the needle a lot – it doesn’t matter where you're from,” he said.  Home Means Nevada – and Renown  Renown Health is deeply rooted in the northern Nevada community. Dr. Rahimzadeh is proud to be among a diverse team who have taken responsibility for its community for generations.   "We live in a very passionate and caring community, which is often underestimated,” he said. “It’s clear to me that Renown refuses to settle. Renown is incredibly progressive in providing the best for the community. We never remain stagnant, we keep moving forward and we take care of your loved ones. This health system has never been able to sit still and settle for the status quo. That stands out to me.”  One story especially sticks out to Dr. Rahimzadeh as the moment when he knew that Renown was home. In 1997 while working as a patient transporter, his grandmother passed away on the sixth floor of the Sierra Tower at what is now Renown Regional Medical Center. At the funeral, a huge bouquet of flowers arrived. Not being especially close to anyone in Reno yet, Dr. Rahimzadeh's family had no idea who sent the beautiful arrangement. Turns out, it was Rod Callahan, the Chief Operating Officer (COO) of Washoe Medical Center at the time.   “At that point, I knew I wasn’t just a part of a workforce with thousands of employees,” said Dr. Rahimzadeh. “The COO cared so much about me that he felt compelled to send such a wonderful gift during a tragic time. That’s the value of a local, community-focused hospital; the people here know you and care about you. There’s a reason why people stay at Renown for so long – we feel that connection.”  Dr. Rahimzadeh also reflected on how far Renown South Meadows has come, from the time he immigrated to the U.S. to today. “Growing up, Renown South Meadows was kind of a ‘mom and pop shop’ primarily serving senior citizens in one wing and surgical patients in the other,” he said. “Now, I am so proud to see how far it has come. It really made its niche in the community in a great way. The future is bright!”  It’s clear that Dr. Rahimzadeh is leaving a lasting legacy with his family, from the local community to global medicine. His son is a senior at Baylor University in Texas with a strong desire to go into medicine, just like his dad. His daughter is a junior at Bishop Manogue Catholic High School in Reno and enjoys being involved in her community. His loving wife is a speech therapist in the area. The Rahimzadeh family is thriving together, and they all share the same conviction about northern Nevada and Renown:  “This is home.”

Read More About A Renown Anesthesiologist's Unique Journey

Early detection is a significant piece of the breast cancer puzzle. Susan Cox, Renown Health Director of Cancer Operations, discusses what you need to watch for and how the latest technology can help detect potential cancer sooner. When should women start getting breast exams? It depends on risk factors: Average-risk women: Most medical organizations recommend the first mammogram between 40 and 44. Higher-risk women: Dependent on their high risk, which will dictate when they start screening, but generally around the age of 30 and not before 25 years old.

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According to the U.S. Department of Health and Human Services, there are more than 20 million estimated new sexually transmitted infection (STI) cases in the United States each year, with rates continuing to increase.  What you may not know is most STIs are preventable. We talked with Renown Adolescent Medicine Specialist, Caroline Barangan, MD to learn more about STIs.  How Can You Get an STI?  The CDC (Center for Disease Control) says that STIs are acquired through sexual contact. There are bacteria, viruses or parasites that can cause an STI which may pass from person to person in blood, semen, vaginal and other bodily fluids.  How Do You Know if You Have an STI?  STIs can have a range of signs and symptoms such as:  Warts, bumps or sores on or near the penis, vagina, mouth or anus Swelling, redness or severe itching near the penis or vagina Discharge from the penis Vaginal bleeding that’s not your period Painful or uncomfortable sex Vaginal discharge that has an unpleasant odor, causes irritation or is a different color or amount than usual  Weight loss, diarrhea or night sweats Aches, pains, fever and chills Jaundice (yellowing of the skin and whites of the eyes) Painful or frequent urination  Sore throat if you engage in oral sex It’s important to know that the majority of people who have an STI commonly have no symptoms at all, which is why it’s important to get regularly tested once you have had any sexual activity. Young people less than 25 years of age should be screened on a yearly basis at minimum.

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If you and your partner are looking for a more permanent birth control method, you might consider a vasectomy. Although vasectomies are common, knowledge about them isn’t quite as common or talked about. If you are considering a vasectomy, talking with your primary care doctor is a great way to learn more and start the process. We consulted with Dr. Aurosis Reddy a primary care doctor with Renown Health – South Carson, about key topics to discuss with your doctor when considering a vasectomy. What is a vasectomy? A vasectomy – also called male sterilization – is a form of male birth control that blocks sperm from reaching semen, according to the American Urological Association (AUA). How effective and safe are vasectomies? Vasectomies are one of the most effective methods of birth control with a long-term success rate of over 99%. A vasectomy has been a safe and successful birth control method for many years. More than 500,000 men elect to have vasectomies every year in the U.S., and the number is rising. A vasectomy is also generally a low-risk procedure with a low complication rate ranging between 1-2%. What does the recovery period look like? A vasectomy is typically a quick procedure that takes under thirty minutes and can be performed in an outpatient setting under local anesthesia. Recovery from a vasectomy is also considered relatively easy. After a vasectomy, most can: Resume everyday activities within two to three days Resume normal exercise in one week Start engaging in sexual activity again in one week Your doctor can provide more details on what your individualized recovery process will look like.

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Unfortunately, men are less likely to visit their doctor for exams, screenings, and consults than women. So with the help of Bonnie Ferrara, MD of Renown Health, we've put together a list of eight screenings to help men stay on top of their health game. 1. Blood Pressure Tests Ages 20+ Blood Pressure tests measure the pressure in your arteries as your heart pumps. Biennial (every two years) checks are recommended if you have normal blood pressure or more frequently if you have high blood pressure (hypertension) or low blood pressure (hypotension). The United States Preventative Services Taskforce cites normal blood pressure below 120 systolic (top number) and 80 diastolic (bottom number). 2. Cholesterol Screening Ages 20+ High levels of cholesterol increase your risk of stroke and heart disease. A simple blood test will help your healthcare provider determine your numbers and if you're at risk. If you have a family history of diabetes or heart disease, you may need yearly screenings. But, again, your doctor can provide the best course of action.

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Much like general physical and mental health, sexual health is an essential aspect of your overall well-being. Therefore, educating yourself on your sexual health is an important piece regarding your overall wellness. Secure & Private Virtual Visits Did you know that many sexually transmitted disease appointments can happen virtually, in the privacy of your own home? Our providers can perform a screening examination for sexually transmitted illness (without symptoms) when it’s convenient for you. This is a great option if the topic makes you uncomfortable during an in-person visit, or if you can’t find time to visit your primary care provider or local urgent care. After the telehealth appointment, your provider will determine the  next steps for you. Remember, in-person visits are always an option as well.   Here’s how you can take charge of your sexual health:  Get Comfortable with Getting Tested  Surprisingly, some people with STDs don't show symptoms, meaning they may not even know they have an STD unless they get tested. Even if an STD shows no symptoms, the result of non-treatment can be serious. Bret Michael Bellard, MD, with Renown Medical Group, shares that it’s important for people to get tested for STDs because if left untreated, they can cause the following health problems: Loss of fertility Pregnancy complications Other health issues  When to Visit Your Primary Care Provider  Who should get tested and how often? “The recommendations are that everyone from ages 13 to 64 should get tested at least once for HIV. All sexually active adults should also be tested for other STDs once a year, and all pregnant women should be tested at the start of their pregnancy,” says Dr. Bellard. Some STDs, like syphilis, can be passed from mother to baby, so it's important for women to get tested as soon as they know they’re pregnant.  Dr. Bellard recommends going to your primary care provider for testing. “They can also give advice on prevention and other health topics.” If you don’t have a primary care provider, this is a great reason to get established with one. Women with an established OB/GYN can have STD testing done simultaneously with their annual pelvic exam. The providers in Renown's network care for patients of all ages and specialize in family medicine, internal medicine, pediatrics and OB/GYN.   Practice Safe Sex  STDs are preventable. Practicing safe sex and getting tested routinely are your best defenses against all types of STDs.  For many, the conversation about sexually transmitted diseases is awkward and many avoid it. To lower your risk of contracting an STD, don’t wait until you’re “in the moment” to have the conversation with your partner about the last time you were both last tested. If you haven’t gotten tested in-between new partners, use latex condoms every time you have sex until you are both confirmed negative of STDs. Condoms are not 100% effective at preventing disease or pregnancy. However, they are extremely effective if used properly.   To establish Primary Care, visit renown.org/virtualvisits or call 775-982-5000

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Has a male in your life been affected by depression? It could be your father, husband, or son. Or maybe your brother, a friend – or even, your co-worker. They all have one thing in common, they’re men and they may not always be able recognize when they need help. Here’s how you can support the men in your life by understanding their unique signs of depression. Dr. Coard, Ed.D., Psychologist with Renown Behavioral Health, weighs in on the topic of depression and the warning signs. More than 6 million men are diagnosed with depression each year, and surprisingly, depression in men can differ from women. The signs of depression are not easily recognized and it’s common for men to be in denial about what they’re going through. They can demonstrate anger and aggression instead of sadness – making it difficult for loved ones, or even their providers, to recognize. Behavioral Signs of Depression in Men High levels of the hormone cortisol are released during stressful situations affecting the neurotransmitter, serotonin (a feel good hormone), contributing to depression. You can identify depression or suicidal tendencies by paying close attention to the following behavioral changes: Anger, irritability, or aggression Avoiding family or social situations Losing interest in family responsibilities, passions and hobbies Lack of sex drive Becoming controlling/abusive in relationships Risk-taking behavior such as; unsafe sex, overspending or gambling Not being able to concentrate or remember details Excessive drinking or drug use Having frequent thoughts about death Talking about suicide Attempting suicide Factors That Lead to Depression in Men Life Events Work stress or long-term unemployment can be huge contributing factors relating to depression. This type of life event can be overwhelming, making it impossible for a man to cope. Changes in Relationships The loss of a relationship can be a significant contributing factor to the emergence of depressive symptoms and past experienced physical, sexual, or emotionally abusive relationships. With this in mind, counseling can often help individual to overcome this type of trauma. Grief and Loss Overwhelming sadness due to the loss of a loved one can trigger depression. Although normal, each person goes through their own grieving period. For example, normal responses to death are insomnia, poor appetite and loss of interest in activities. Pay attention if grief seems prolonged or out of the ordinary. Health Problems In particular, depression coexists with medical conditions. As men age, this can be passed off as normal aging, but it could be more serious. In addition, illnesses such as thyroid disorders, Addison’s disease and liver disease can cause depressive symptoms. Diabetes, cancer, heart disease, or Parkinson’s disease can affect any age, thus triggering or worsening depression. Some older men also feel like they may be suffering from dementia because of difficulties with memory this may be a symptom of depression. A trip to the doctor may be in order to help alleviate concern and worry. Depression in Men and Suicide Frequently the emotional pain occurring with depression can distort a man’s ability to see a solution beyond suicide. Individuals with depression become very rigid and constricted in the way they solve problems. The statistics below speak for themselves, helping us understand the need to reach out to those who need our support. Male suicide rates are on rising – men die by suicide 3.53 times more often than women, accounting for 70% of all suicides. Sadly, every day 129 men commit suicide. White males accounted for 69.67% of suicide deaths in 2017. In 2017, firearms accounted for 50.57% of all suicide deaths. Middle aged Men who are middle aged have the highest suicide rates. 40% of those identifying as transgender have attempted suicide in their lifetime. Males who are guy or transgendered are at an increased risk for suicide attempts, especially before age 25. Veterans often suffer from post-traumatic stress disorder (PTSD) and depression, and are more likely to act on a suicide plan. How You Can Help Now that you can identify some of the warning signs of depression, here’s how you can help: Talk about your concern and communicate that you’re there to help him. Let him know depression is a medical condition and will usually get better with treatment. Suggest professional help from a Primary Care Provider, Psychologist or Therapist. Help set up appointments and offer to accompany him – let him make the decision, but make it clear you’re there for him, no matter what he decides. If you feel he is in a dire or life-threatening situation, contact 911. Call the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255) to talk to a trained counselor. Call the Veteran’s Crisis Line at 1-800-273-TALK (1-800-273-8255) and press “1”

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