Achieve Health NV is a two-physician direct primary care practice in Reno run by Dr. Amy Sanguinetti and Dr. Sara Trigero, both dual board-certified in Internal Medicine and Obesity Medicine. Care runs on direct-pay memberships rather than insurance, with a free meet-and-greet, extended no-rush visits, same or next-day appointments, and direct physician access by phone, text and email plus evening and weekend telehealth. Women's health and hormone replacement sits inside the primary care membership alongside pap smears, chronic disease management and in-office procedures such as skin biopsy and joint injections. Weight management is the practice's other pillar, with body composition testing, intake and yearly labs, and bariatric pre- and post-operative care.
Advanced Gynecology of Reno is a small two provider gynecology office on the south side of Reno. Kyla Sweeney handles the general gynecology side of the practice, including well woman visits, birth control and menopausal symptoms, and she sees women from adolescence onward. She works alongside a fellowship trained minimally invasive gynecologic surgeon, so a patient who turns out to need surgery for fibroids or endometriosis stays in the same office. For menopause the practice sticks to FDA approved treatment and says hormone therapy is decided case by case after a personal evaluation, with non hormonal options offered too. Nothing on the site mentions compounded hormones or pellets. Kyla is a Reno native who trained at Duke and teaches Pilates and barre classes built around pelvic floor strength.
Dr. Mariko Rajamand is a board certified OB-GYN at FEM Women's Wellness in Reno, a practice that combines gynecology, mental health therapy, aesthetics, sleep care and nutrition under one roof. Alongside general gynecology the practice offers hormone replacement therapy for perimenopausal and menopausal patients, and runs a medically supervised weight loss program that can include prescription support. Rajamand holds additional training in complex urogynecologic surgery of the pelvic floor and in minimally invasive robotic surgery, and the practice presents prolapse, leaking urine and pain with sex as problems it treats rather than normal aging. FEM describes itself as Northern Nevada's first and only gynecology practice offering Morpheus8V, an intravaginal radiofrequency microneedling treatment used for vaginal dryness, laxity and discomfort with intimacy. A monthly nutrition program and exercise guidance run alongside the medical services. The practice bills insurance and publishes no prices for any of its services.
