Turkey Chili

This is my all-time favorite chili recipe. The good news is that chili is not only comfort food, but it can be healthy, too!

Chili contains lots of protein. This recipe is made with turkey, so it is a leaner alternative to ground beef. Chili can help you lose weight. The “capsaicin,” a colorless compound found in the chilies used to season this dish, can increase your metabolic rate by increasing your body heat production. Chili is also high in iron thanks to the turkey and beans and has vitamin C thanks to the tomatoes, peppers and chilies. Plus, it’s a great source of fiber that helps keep you feeling full for a long time after eating. Enjoy the healthy benefits of chili!

8-10 servings
prep time = 30 minutes

2 medium onions, chopped (1 cup)
1 tablespoon vegetable oil
2 tablespoons chopped fresh garlic
1 medium red bell pepper, chopped (1 cup)
1 medium green bell pepper, chopped (1 cup)
2 pounds ground turkey
2 tablespoons ground cumin
1 tablespoon dried oregano leaves
1 tablespoon chili powder
1 can (4 ounces) chopped green chilies, drained
2 jalapeño chilies, seeded and chopped
28-oz. can of whole Roma (plum) tomatoes
3 cups water for thick meaty chili, or 4 cups for “soupier” chili
2 cans (15 ounces) black beans, drained
1 can (15 to 16 ounces) kidney beans, drained
Salt and pepper to taste
Sweet onions, sliced
Low-fat sour cream

-Cook the onions in vegetable oil in a large saucepan over medium heat for about 10 minutes or until the onions are tender.
-Add garlic and the green and red bell peppers, cook 2 to 3 minutes.
-Add turkey and cook 3 to 4 minutes or until the turkey is no longer pink.
-Add cumin, oregano, chili powder, green chilies, jalapeño chilies, tomatoes and water. Reduce heat to low.
-Cover and simmer about 30 minutes.
-Add beans; simmer 15 to 20 minutes longer. I simmer for a total of 2 hours for a rich flavor.
-To serve, add sliced sweet onions to the top and a dab of low-fat sour cream.

If you want to make this recipe spicy, add one whole red habeñero or one whole serrano chili (deveined, deseeded and chopped). Or if you like a Tex-Mex flavor, add an envelope of taco seasoning as you simmer this recipe.

Calories 175
Protein 15 grams
Carbs 13 grams
Fat 6 grams
Fiber 5 grams


By Staness Jonekos, The Menopause Makeover

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Perimenopausal Depression

Are you suffering from hot flashes, night sweats, or cranky moods? Feeling hopeless, apprehensive, or deep sadness for prolonged periods? If so, you may be suffering from perimenopausal depression.

Depression is more common among women than men. Biological, life cycle, hormonal, and psychosocial factors that women experience may be linked to women’s higher depression rate. Researchers have shown that hormones directly affect the brain chemistry that controls emotions and mood.

Perimenopausal symptoms may be the cause of depression, and for some, it may ever be clinical depression.

According to the North American Menopause Society:

A depressed mood –This is a normal, brief period of feeling blue or sad that is commonly experienced and rarely requires treatment.

Depression as a symptom – This type of depression may be due to a wide variety of medical or psychological problems, or to intense reactions to life events (such as divorce, losing a job, death of a loved one). It is usually short-term and most often does not require treatment, although it can progress to clinical depression.

Clinical depression — This is a pathologic disorder believed to result from a chemical imbalance in the brain. A clinical (major) depression requires treatment.

Women who had severe PMS in their younger years may experience more severe mood swings during perimenopause. There are many factors that can cause an increased risk for depression from your genes, to having a prior history to taking certain medications.  Certain endocrine disorders, such as hypothyroidism, or other illnesses, such as chronic fatigue syndrome, are also associated with depression.

Signs and symptoms include:

  • Persistent sad, anxious, or “empty” feelings
  • Feelings of hopelessness or pessimism
  • Feelings of guilt, worthlessness, or helplessness
  • Irritability, restlessness
  • Loss of interest in activities or hobbies once pleasurable, including sex
  • Fatigue and decreased energy
  • Difficulty concentrating, remembering details, and making decisions
  • Insomnia, early-morning wakefulness, or excessive sleeping
  • Overeating, or appetite loss
  • Thoughts of suicide, suicide attempts
  • Aches or pains, headaches, cramps, or digestive problems that do not ease even with treatment.

Mild depression – feeling blue or sad – can be dealt with cognitive therapy, psychotherapy, meditation, Yoga, getting enough sleep, a positive outlook, healthy eating, incorporating appropriate supplements, acupuncture, and exercise. Exercise boosts your endorphins and can lift your mood. Engaging in new activities may help, such as taking Yoga or Pilate’s class, or getting out and trying new things, all while enlisting the support of your family and friends.

If you have lingering or worsening symptoms, you may need medication.  Depression can be a malfunction of your neurotransmitters, particularly serotonin, which is the feel good neurotransmitter. Medicines can be enormously helpful, although you will want to incorporate lifestyle changes as well.

Dr. Wendy Klein, menopause expert and co-author of “The Menopause Makeover:”

If you are still feeling very stuck and sad, talk to your clinician so you can get a referral to a good psychotherapist. If you need medication, in the broader context of menopausal symptoms, there is some evidence that hormone therapy can augment treatment and help people who are on anti-depressants feel even better. That is a decision for you and your clinician.

According to the Study of Women’s Health Across the Nation (SWAN):

The risk of major depression is greater for women during and immediately after the menopausal transition than when they are pre-menopausal.

If you suffer from depression whether mild, moderate or clinical, get support and visit your health care provider to discuss your options.

By Staness Jonekos

Co-Author, “The Menopause Makeover”

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Menopausal Weight Gain: How To Get Your Body Back

It is estimated that the average weight gain during the menopause transition is about 10 to 15 pounds.  Well, I must not be average, because I gained almost 30 pounds in less than a year when I slammed into menopause!   Frustrated that I could not find a solution, I sacrificed myself as a human guinea pig and figured out how to lose it all in just 12 weeks.

To be successful, weight loss during menopause demands a new strategy.  It takes more than cutting calories to lose weight during this life transition! I was surprised to discover, according to new research, that for many women menopausal weight gain is not entirely their fault.

The first culprit is aging. Both men and women lose muscle mass as they age, which can lower the body’s resting metabolism, therefore increasing the risk of weight gain and accumulating body fat around the waist.

Many women become less physically active in their 40s, 50s and 60s because life is busy; it’s a challenge to find time to schedule exercise. Less activity means less muscle mass, which means weight gain.

Now get ready for the double whammy:  Aging plus hormone changes.

Studies claim that the perimenopause transition may contribute to increased fat in the abdomen, changing a woman’s shape from a pear to an apple with more of the fat disturbed around the waist. Here’s proof that weight loss is an uphill battle.

As we age and slide into menopause, it is suspected that declining estrogen levels may lower the rate of energy used during exercise.  Weight loss habits and workout routines used in younger years often aren’t as effective as we age.  It takes more work to lose weight. Not achieving your desired results within a certain time frame may increase frustration and decrease motivation.

Declining estrogen levels wreak hormonal havoc that can cause night sweats, and that is a formula for sleepless nights. Sleep deprivation produces increased levels of ghrelin – the hunger hormone – and decreased levels of leptin – the “stop eating” hormone.  This can equal weight gain.

The list continues. Grab a glass of wine and settle in:


  1. Loss of estrogen may make insulin less effective at lowering glucose, and more effective at storing fat.
  2. Suffering from menopausal symptoms can affect a woman’s emotional health…weight goes up, self-esteem goes down.
  3. Normal life and environmental changes, such as children leaving or coming back home, divorce, death, career changes, can be stressful.
  4. The stress hormone, cortisol, directly affects fat storage and weight gain in stressed individuals.  Cortisol is associated with increased appetite, cravings for sugar, and weight gain.
  5. There’s a link between estrogen and body fat storage.  Post-menopausal women burn less fat than they did in their pre-menopausal years.  Cells not only store more fat but are less willing to part with it.
  6. Medical conditions such as insulin resistance (when your body becomes resistant to the insulin it produces) or suffering from an underactive thyroid can pack on the pounds.
  7. Medications that can trigger appetite, slow metabolism, increase fluid retention, and cause muscle cramps decreasing desire to exercise are:  antidepressants, antihistamines, beta-blockers, corticosteroids, insulin, statins and tamoxifin.


It is no surprise that most women going through “the change” struggle with weight gain more than with troublesome hot flashes.

Weight management during menopause is important because weight gain increases the risk of many diseases, including cardiovascular disease, type 2 diabetes, high blood pressure, osteoarthritis, and some types of cancer, including breast and colon.

There is good news! Put that glass of Merlot down and walk into your kitchen, because incorporating a new strategy can help you obtain and maintain a healthy weight.


How food can set you free.  Feeding the new you!

  1. Eat Protein: Women naturally have less muscle mass and testosterone than men, so lean proteins such as, chicken, turkey, fish, beans, soybeans and tofu, dairy protein/Greek yogurt, low fat cottage cheese, egg whites, are a woman’s best friend during menopause.  Your body expends more energy (calories) to process proteins.
  2. Consume healthy fats: olive oil, flaxseeds, salmon, halibut, tuna, avocados, almonds, and walnuts.
  3. Manage blood sugar with low to medium glycemic index foods:  beans, apples, oranges, cherries, plain yogurt, sweet potatoes, oatmeal.
  4. Fiber is your friend keeping you feeling full longer and regular.
  5. Limit alcohol to 2 or less glasses per day:  That totals less than 10 fluid ounces of wine, 24 ounces of beer, or 3 ounces of 80-proof distilled spirits.  More than two drinks per day may increase the risk of cancer and stroke.
  6. Don’t smoke.
  7. Watch salt intake to reduce fluid retention.
  8. Practice portion control.  Using smaller plates can help.
  9. Keep a food diary and create a food plan.  There are many great apps for your mobile that may help.
  10. Eat every 3-4 hours so you don’t get hungry. Three meals and two snacks per day (three if you wake up early).
  11. Exercise at least 30 minutes most days of the week to maintain a healthy weight; increase workout time if your goal is to lose weight.
  12. Make breakfast and lunch your largest meals.
  13. Nourish healthy emotions: are you happy, are you surrounded by healthy relationships, is your self esteem high?

If you want to enjoy some dessert after dinner, then don’t eat a starchy carbohydrate, such as white rice, with that meal.  For example dinner can be broiled chicken, steamed veggies and a glass of red wine.  Then you can have your cake and eat it, too (small serving).

Weight loss is possible with a few changes.  Negotiating the Glycemic Index is a powerful tool.  Aim for low to medium glycemic foods, toss in some physical activity and have realistic expectations.

Focus on you! Me-NO-pause!

By Staness Jonekos, Author “The Menopause Makeover”


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Will Your Marriage Survive Menopause?

Over 60 percent of divorces are initiated by women in their 40s, 50s or 60s — the menopause years — according to a recent survey conducted by AARP Magazine. Why are women running away from marriage?

I wasn’t even married when I slammed into menopause months before my wedding day at the age of 47. Despite being completely in love, I almost ran away and my fiance almost married bridezella!

Experts say the number one reason for divorce is lack of communication. My response from the ladies corner, “When everything you know to be normal is being kidnapped by changing hormones, communication may be last on the list. Throw in lifestyle changes, health and aging issues, and you are left in a small evaporating puddle of low self-esteem feeling hopeless.”

Many men blame lack of sex as the leading reason for midlife divorce. But is it? AARP poled 1,682 adults ages 45 and older on the importance of sex. Two-thirds of men (66 percent) and about half of women (48 percent) agreed that a satisfying sex life was important to their quality of life. That is only an 18 percent difference. So is it lack of sex, or a breakdown in communication chasing the women away?

Navigating a course in uncharted territory can test any relationship emotionally and sexually. It can also bring a couple closer — it did for me.

Purchasing midlife marriage insurance can help combat the unforeseen hazards during the menopause transition. How do you qualify for this love insurance? The first step is to understand how menopause can affect your love life.

Ladies first.

Menopause is a life transition that can affect you physically and emotionally. Your body is experiencing fluctuating hormones that can cause hot flashes, night sweats, itchy skin, migraine headaches, breast tenderness, vaginal dryness and irregular periods. Eighty percent of women will experience uncomfortable symptoms, and the majority struggle with midlife weight gain.

Many women feel unattractive going through so many uninvited changes. Some suffer from exhaustion, depression and moodiness leaving them feeling isolated and confused.

During menopause a woman’s brain also goes through changes. Dr. Louann Brizendine (author of The Female Brain) says, “The mommy brain unplugs. Menopause means the end of the hormones that have boosted communication circuits, emotion circuits, the drive to tend and care, and the urge to avoid conflict at all costs.”
There are additional factors on top of fluctuating hormones that may contribute to a lack of communication and interest in sex.

Dr. Wendy Klein, co-author of The Menopause Makeover and leading menopause expert, informed me, “If a woman is taking medications, such as antidepressants, mood stabilizers, contraceptive drugs, antihistamines, sedatives, antihypertensives and/or medications for blood pressure, this can also decrease sexual desire.”

Midlife stresses brought on by career change, the loss of a loved one, empty nest syndrome or caring for elderly parents can contribute to a declining libido.

Throw in aging issues and the last thing on a menopausal woman’s mind is communicating. This woman is in self-survival mode, and may be in no mood to connect or make whoopi.

If she is in an unsupported relationship while managing this collection of changes, leaving the marriage may appear like her only salvation.

Gentlemen — your turn.

How many factors listed above is your partner experiencing? It is no surprise why men are afraid of menopause. His woman is changing in front of his eyes.

Women are not alone suffering from changes. Men also have midlife challenges, both physically and emotionally. Declining testosterone can affect libido, moods and sexual performance. Generally a man’s hormones change gradually compared to the woman’s experience during menopause, so it may not be obvious to the man that he too is changing. Some of these unwelcomed changes may include midlife stress, as well as health and aging issues. If both partners are experiencing change, the relationship may be on an emotional roller coaster.

Approximately 47 percent of women experience sexual difficulties with a decrease of sexual desire being the most common, according to the National Health and Social Survey and the Global Study of Sexual Attitudes and Behaviors.

It is no surprise that most men associate menopause with having less sex. But, it does not have to be this way. The man can actually help save a shaky midlife marriage with some handy tools to power charge the relationship. Women who have a supportive partner often have a smoother transition through menopause. When she is happy, he is happy.

Acquiring midlife marriage insurance takes action to make a difference.

Midlife Marriage Insurance For Him
1. Listen to her; don’t criticize or try to fix her.
2. Go with the flow; be prepared for mood swings.
3. Be compassionate, and validate her experience (that means agree with her, don’t try to fix her).
4. Be romantic. Bring her flowers for no reason. Make her dinner. Give her a massage. Make it about HER.
5. Cuddle more. Tell her you love her and that she is beautiful. You may just get lucky. If not, do not take it personally.
6. If YOU are not in the mood, keep her company shopping, she will love the company ;)
7. Support healthy eating and exercise choices. Join her for a walk or go on a hunting expedition at the grocery store to find new healthy foods.
8. Don’t ignore her menopause symptoms. Talk about it. Ask her what she needs to feel better.
9. Offer support if she needs to visit her healthcare provider to discuss menopause symptoms, a low libido or depression.
10. If numbers one through nine fail – disappear for a while. She may be seriously cranky and need space to focus on herself.

Success depends on going through this transition as a team! Both partners must contribute to have a successful marriage.

Midlife Marriage Insurance For Her
1. Track menopause symptoms and discuss treatment options with your healthcare provider.
2. Make a commitment to a healthy lifestyle. Exercise most days of the week. Eat nutritious meals. Watch portions.
3. Update your beauty regimen.
4. Build a support group.
5. Communicate with your partner. Don’t shut him out – let him know what you need. Understand he may be confused by your changes.
6. If you are not happy in your current relationship, discuss counseling.
7. Be receptive to creative adjustments in lovemaking activities.
8. If your libido is low and/or you are suffering from vaginal dryness, discuss your treatment options with your healthcare practitioner. There are hormone and non-hormone options available.
9. Pamper yourself.
10. Try to stay positive.

Communicate, support each other’s needs, get counseling if needed, add romance, adjust lovemaking activities, and your odds increase that your marriage will survive menopause. Being on the same team will nourish a healthy, loving relationship that can last a lifetime.

Life is constantly changing, and marriage is no different. Have real expectations, and acknowledge that your relationship goes through transitions. This will help you weather difficult times.

Midlife is an opportunity for both men and women. If you are prepared, informed and willing, your marriage can survive menopause. A loving relationship supported with good communication can strengthen your love life at any age.

This menopausal bride made it down the aisle of love. Both my partner and I said “I do” to communication and romance during menopause. We are still happily married five years later and ready to leap over the seven-year itch together.


Montenegro, X. The Divorce Experience: A Study of Divorce at Midlife and Beyond. AARP, May 2004.
Brizendine, L. The Female Brain. New York: Broadway Books; 2006.
Jonekos, S. and W. Klein. The Menopause Makeover. Ontario, Canada: Harlequin Enterprises; 2009.

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Posted in relationships, homepage

How To Invest In Your Long-Term Eye Health

Fluctuations in our estrogen levels during menopause bring all sorts of uncomfortable symptoms, from dry vaginas to dry eyes!  I can’t even wear contacts because of dry eyes!

If you’ve already begun or completed menopause, you’ve probably noticed a decline in your overall vision– it simply isn’t as sharp as it once was, even when you’re wearing prescription glasses. One common complaint is driving at night– 40% of drivers over 40 feel uncomfortable behind the wheel after dark.

Why your vision declines after 40

Changes to our eyes occur gradually, over decades, until we suddenly recognize changes in our vision. As we age, our pupils shrink and dilate less in the dark, which reduces the amount of light entering our eyes. This can even make it seem as if we’re wearing dark sunglasses at night.

We’re also at greater risk for age-related macular degeneration (AMD), the deterioration (or thinning) of the macula, a critical part of your eye responsible for your central vision. In some cases of AMD, blood vessels can form under the retina and leak blood and fluid into the eye. Macular degeneration is the number one cause of vision loss in adults over 55.

Two crucial nutrients, zeaxanthin and lutein, can help protect our eyes against further deterioration and support the natural functions of your eyes.

“Zeaxanthin and lutein protect the most important retinal real estate of the eye–-the macula–which allows us to see detail. It is therefore critical to maintain the quality and health of this area of retinal tissue in a modern society that depends upon using computer screens and driving automobiles safely,” said Dr. Stuart Richer, doctor of optometry.

Even through a healthy diet including leafy greens, certain fish, and other foods, you’ll still only absorb  a trace amount of these nutrients. The dose of zeaxanthin and lutein we need to protect and improve our vision can be found only in a supplement like EyePromise Vizual EDGE. The natural supplement helps dim the harsh light from glare, improve contrast when looking ahead, and reduce eye stress from bright lights.

I encourage you to take the time and invest in your long-term eye health and feel more confident driving at night.

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Ankle Osteoarthritis and Stem Cell Therapy

My future was changed forever when I sprained my ankle in a college ballet class. This injury was 40 years ago yet a third degree sprain like mine was treated the same way as today: P-R-I-C-E (protect from further injury, restrict activity, apply ice, apply compression, and elevate the injured area).

Little did I know that the ligaments I injured had started physiological changes that would compromise my joint stability. The healing response that was initiated in an attempt to repair the damage actually increased my risk for degenerative changes that eventually led to osteoarthritis. It is the most common type of arthritis caused by the degradation of a joint’s cartilage. There are up to two million acute ankle sprains each year in just the USA alone.

Fifteen years after the initial ankle sprain I had severe pain and was forced to seek out medical attention in an attempt to walk normally again. Being in my mid-thirties and hearing that my only option was an ankle fusion, limiting motion for the rest of my life, was devastating news. My new mission was to find an ankle expert that was a pioneer.

NOTE reference photo of my left ankle X-ray 40 years after the injury, bone on bone, compared to a healthy normal ankle on the right side.

After five appointments with orthopedic surgeons in the Los Angeles area, I discovered Dr. Richard Ferkel at the Southern California Orthopedic Institute (SCOI). He became my lifetime ankle hero. He specializes in arthroscopic and reconstructive surgery of the ankle, as well as cartilage restoration, but it was his work with the U.S. Olympic teams, the NFL and NBA that really impressed me. If professional athletes entrusted their careers and joints to him, so would I.

Dr. Ferkel did a procedure to clean up the bone spurs, called arthroscopic debridement, and microfracture and drilling to help stimulate cartilage growth.

This procedure, along with lifestyle changes that included eliminating all high-impact activities, bought me over 20 years of good mobility with manageable pain. Once I hit my fifties with an injury over 30 years old, my quality of life was once again compromised with limited motion and bad pain.

Dr. Ferkel then suggested viscosupplementation, an ankle injection procedure with lubricating fluid. It is also called hyaluronic acid injections and commonly used to treat knee osteoarthritis. It was not FDA approved for ankles (and insurance would not cover it), but I wanted to proceed if it meant a decrease in pain and an increase in mobility. It worked, and I did the injection every year for five years. After each injection, it felt like a little cushion in my ankle; there was a spring in my walk again. Acupuncture also greatly helped manage the pain when I could find the time to do it.

Although it was not a cure, my quality of life improved. When I traveled and needed to do a lot of walking, I would take Celebrex, (also know as a COX-2 inhibitor) a nonsteroidal anti-inflammatory drug (NSAID) that works by reducing hormones that cause inflammation and pain in the body.

There were no real fixes, just management options. Total ankle replacements (TAR) only last about eight to ten years, so that was not an option either. Fortunately for knees and hips total joint replacement surgery is an excellent option with longer-term beneficial results.

Looking at the end of my fifth decade, I was still not interested in ankle fusion, ankle arthrodesis, which can relieve pain but it also limits motion. I still had decent ankle motion and an ankle fusion would reduce existing mobility. My other fear was it could compromise other functioning joints that would eventually become taxed when the injured ankle joint was no longer mobile.

After extensive research there was promise for adult stem cell therapy that is an intervention strategy that introduces new adult stem cells into damaged tissue in order to treat disease or injury.

Stem cells are unprogrammed cells in the human body that have the ability to change or “differentiate” into other types of cells. Since they are obtained from the patient, the risk of rejection is almost non-existent. Knees have shown good results with stem cell therapy.

A 2014 study revealed that mesenchymal stem cell (MSCs) therapy on knees with osteoarthritis had the potential for cartilage regeneration. Today this procedure is considered a reliable alternative treatment for chronic knee OA.

Ankles are still the last frontier in this area. After 40 years since the initial injury, the biomechanical changes across my ankle joint surface had produced severe osteoarthritis. Daily walking became so painful I started planning my day around managing how much walking was needed to accomplish basic life duties.

I had dreams about running, and being free to move without pain. Friends no longer called to go hiking or power walking. It was difficult to maintain a healthy weight without being able to just simply walk. I was envious of friends who counted steps to lose weight, I planned my day around how few steps were needed to survive daily tasks.

Something had to be done, and it wasn’t going to be ankle fusion. That said, I spoke with many people who opted for ankle fusion and it changed their lives. Many even returned to athletic hobbies.

Stem cell therapy was my next move and Dr. Ferkel felt it could be a good option to help reduce pain and increase mobility.

It was an “experimental” procedure because it is not yet FDA approved. Based on research using stem cells from the iliac crest (hip bone), it had promise.

Dr. Ferkel told me,

“The goal is to reduce pain and keep mobility.”

He knew I had a fantasy that those stem cells would grow new cartilage, which it would not in my case of almost total bone on bone. For many who have a smaller injury, stem cells are now an excellent option, even on ankles.

During the surgery they had to collect the stem cells from the hip joint and distract my ankle joint (separate it from my leg) for the injection of bone marrow aspirate.

Concentrated bone marrow aspirate contains healing and growth factors, as well as healing cells called pluripotent cells. Bone marrow is the tissue that is found in the hollow spaces in the interior of our bones.

A centrifugation machine called the Magellan® MAR0Max™ was used to concentrate the platelets and growth factors, as well as the pluripotent (or stem) cells, creating an injectable product that is delivered directly to the ankle. The processing time is about 12-17 minutes, and the entire surgery was less than an hour.

My personal ankle plan now is to wait for another ten years until I am a candidate for a total ankle replacement. I will continue to utilize hyaluronic acid injections, take Celebrex when needed and be open to new options until it is time for my total ankle replacement.

We are all different, and fortunately there are good options available for ankle osteoarthritis now.

My hope is that those with similar injuries catch it early so new treatments like stem cell therapy may stop the progression of osteoarthritis, and joint replacements become a thing of the past for everyone.


By Staness Jonekos



Wodicka R, Ferkel E, Ferkel R. Osteochondral Lesions of the Ankle. Foot Ankle Int. 2016 Sep;37(9):1023-34.

Ramponi L, Yasui Y, Murawski CD, Ferkel RD, DiGiovanni CW, Kerkhoffs GM, Calder JD, Takao M, Vannini F, Choi WJ, Lee JW, Stone J, Kennedy JG. Lesion Size Is a Predictor of Clinical Outcomes After Bone Marrow Stimulation for Osteochondral Lesions of the Talus: A Systematic Review. Am J Sports Med. 2016 Nov 16. pii: 0363546516668292.

Jo CH, Lee YG, Shin WH, Kim H, Chai JW, Jeong EC, Kim JE, Shim H, Shin JS, Shin IS, Ra JC, Oh S, Yoon KS. Intra-articular injection of mesenchymal stem cells for the treatment of osteoarthritis of the knee: a proof-of-concept clinical trial. Stem Cells. 2014 May;32(5):1254-66.

Mehrabani D, Mojtahed Jaberi F, Zakerinia M, Hadianfard MJ, Jalli R, Tanideh N, Zare S.
The Healing Effect of Bone Marrow-Derived Stem Cells in Knee Osteoarthritis: A Case Report. World J Plast Surg. 2016 May;5(2):168-74.

Burke J, Hunter M, Kolhe R, Isales C, Hamrick M, Fulzele S. Therapeutic potential of mesenchymal stem cell based therapy for osteoarthritis. Clin Transl Med. 2016 Dec;5(1):27.

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Menopause Makeover Voted Best Menopause Book of the Year!

Healthline selected their top 10 books that shine a light on menopause.  “The Menopause Makeover” was selected this year, and we are super honored to be in the company of other fantastic books that support the menopause journey.

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How to Sleep Through Menopause

By Staness Jonekos

Co-author of The Menopause Makeover

We have all had sleepless nights, but for millions of post-menopausal women it happens 61 percent of the time, affecting their quality of life and their relationships. I, too, suffered from insomnia, thanks to irritating night sweats provoked by fluctuating hormones. Being sleepless through menopause made me irritable and fatigued daily. I had difficulty concentrating and it created tension with my husband because I was cranky and impatient.

There are two types of insomnia. According to the National Institutes of Health, primary insomnia is its own disorder. A number of life changes can trigger primary insomnia, including long-lasting stress and emotional upset. Primary insomnia generally occurs for periods of at least one month.

Secondary insomnia is a symptom or side effect of some other problem, and is the most common type. Most menopause-related sleeplessness is secondary insomnia.

What causes secondary insomnia?

• Certain medical conditions: sleep apnea, arthritis, chronic pain, headaches, asthma, overactive thyroid, hot flashes, heartburn, sleep disorders (restless leg syndrome, sleep-related breathing problems)
• Medicines: asthma medicines, allergy and cold medicines, beta blockers
• Substances: caffeine, stimulants, tobacco, alcohol

Being a busy woman, daily exhaustion is normal. Throw in menopausal aging and it was no surprise that I was staring at the ceiling nightly trying to fall and stay asleep.

Karen Giblin, Founder of Red Hot Mamas North America, recently conducted a sleep survey with Sunovion Pharmaceuticals Inc.

Giblin says, “Of the 900 sleep survey participates who suffer from insomnia, 79 percent of menopausal women have trouble staying asleep, and 63 percent struggle just trying to fall to sleep.”

I was not alone! Most of us blame night sweats for insomnia, but I was surprised to find out that many menopausal insomniacs don’t suffer from night sweats at all. So what’s keeping us up at night?

Empty nest syndrome, caring for aging parents, relationship changes, career adjustments and mid-life stress, bundled together with hormones in flux is a recipe for sleepless nights. Progesterone is our sleep-promoting hormone, so a decrease in this hormone contributes to a night of tossing and turning. Declining estrogen can make you more susceptible to stress, fueling this sleepless potion.

I suffered from several of the sleep depriving offenders. It took just one severe night sweat to start the cycle of thrashing around, changing my PJs and laying in bed awake, waiting for a repeat performance.

Insomnia during menopause clearly can affect the quality of your life. Women suffering from insomnia live with daily fatigue and irritability, and that can contribute to intimacy issues with her partner.

Giblin says, “62 percent of women ages 40 to 65 said they have not talked to their healthcare provider about insomnia.”

I was one of them, because I never considered insomnia an actual symptom worth discussing with my clinician.

A former menopausal insomniac herself, Giblin continues, “Sleeplessness during menopause can compromise your health, both physically and mentally. People who get too little sleep develop poor health and higher percentages of chronic diseases.”

Indeed, insomnia can increase your risk for high blood pressure, heart disease, diabetes and problems with your immune system. Getting proper sleep is important to your health!

Let’s not forget the recent studies last year that found a lack of sleep contributes to weight gain. When you are sleep-deprived, your metabolism does not function properly. Sleep is also necessary for the nervous system to function properly.

Sleeping tips during menopause

• Create a sleep schedule, and follow it each night
• Do not go to bed until you are tired
• Avoid caffeine, nicotine and alcohol right before bed
• Enjoy decaf tea
• Do not watch the news right before going to bed
• Do not watch TV in bed
• Take a soothing bath or shower before bedtime
• Your bedroom should be a sleeping sanctuary and a place for lovemaking
• Avoid daytime naps
• Clear your mind before you get under the covers
• Make sure your room is dark
• Keep your bedroom cool to prevent night sweats, keep a fan nearby
• Wear cotton pajamas, and have an extra pair handy
• Exercise daily. Vigorous exercise should be done during the morning or afternoon.
• Yoga may help promote good sleep
• Try aromatherapy for relaxation
• Own a comfortable bed
• Wear socks to bed to help control core body temperature

We are all different and require different amounts of sleep to feel rested during the day. The North American Menopause Society (NAMS) says, “Most adults require 6 to 9 hours of sleep each night.” I was lucky to get 3 hours of uninterrupted sleep a night – what’s a menopausal gal to do?

Talk to your healthcare provider about insomnia

• Keep a sleep diary
• Track a typical night
• Document what keeps you up at night.
• How long did it take for you to fall asleep?
• How long did you sleep in total?
• How did you feel the next day?
• Talk to your partner and see if he/she has noticed any differences in your sleeping habits.
• Discuss any lifestyle changes you’ve made to improve your sleep.
• Ask if menopause is affecting your sleep
• Are there any current medications that could be contributing to your insomnia
• What lifestyle changes do you need to make to get better sleep
• Are you experiencing more stress?
• Discuss a strategy to manage your insomnia

When lifestyle changes fail NAMS recommends consulting a clinician to rule out sleep disorders or breathing problems.

Dr. Wendy Klein, co-author of The Menopause Makeover, says, “It is best to tailor therapy for menopausal insomnia to the needs of the individual woman. Generally, combining medical and non-medical therapies is better than either one alone.”

Supplements such as botanical valerian have been found to improve sleep after two weeks of use. Talk to your doctor about the risks and benefits before taking over-the-counter products to treat insomnia. If depression is contributing to your sleep problems, your healthcare provider may prescribe an antidepressant or other prescription medications.

For some women, prescription sleep medications can help bring relief. The National Institutes of Health states: some medications are meant for short-term use, while others are meant for longer use. Side effects can occur, so talk to your healthcare provider about the risks and benefits of using medicines to treat insomnia.

Getting a good night’s rest during menopause benefits your health, both physically and emotionally, and can contribute to a smoother transition.

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How To Feel Sexy During Menopause

by Staness Jonekos, co-author of The Menopause Makeover

The baby boomers may have been the generation of the sexual revolution, but for many slamming into menopause, sex is the last thing on their minds!  Both sexes can suffer from a declining libido as we age, but women don’t have a little blue pill to pop to get their mojo back. What’s a menopausal girl do to reignite the flame of desire?

After women pass through perimenopause into menopause, almost 50 percent are left with an unanticipated loss of libido and vaginal dryness.  Vaginal dryness can affect the libido.

Estrogen, important for maintaining vaginal health and lubrication, is the hormone that actually plumps up the cells in the vagina. When estrogen levels decline, the vaginal walls can become thinner, less elastic and dryer.

Not only does the physical act of intercourse become a challenge as a result of vaginal dryness, but the emotional dialogue that goes on in one’s head when lubrication no longer comes naturally, can increase stress levels for the woman and the man.  This double whammy can end in frustration and confusion.

Treatment Options

  • Bioadhesive lubricant, such as AstroGlide, can provide immediate relief.   Replens, a vaginal moisturizer, may be applied twice a week. Lubrication can offer vaginal protection and both are available over-the-counter.
  • If vaginal dryness is your only menopause symptom, you may consider using local estrogen treatment.
  • Low dose hormone therapy may bring relief.

It is important to discuss vaginal dryness with your doctor to confirm that you are not suffering from a vaginal infection.

Approximately 47 percent of women experience sexual difficulties, according to the National Health and Social Life Survey and the Global Study of Sexual Attitudes and Behaviors, with a decrease of sexual desire being the most common.

Other aspects that may contribute to a declining libido are pain during intercourse, lack of sexual thoughts, aversion to sexual activity, lack of receptivity and relationship dissatisfaction.

Addressing the physical, emotional, and environmental changes that often accompany mid-life, can make a proper diagnosis challenging.

Factors that affect sexual health

  • Emotional: Feeling unattractive, being depressed, feeling tired, suffering from lack of sleep, moodiness, feeling isolated, not being happy
  • Fluctuating hormones
  • Medications:
    • Antidepressants
    • Mood stabilizers
    • Contraceptive drugs
    • Antihistamines
    • Sedatives
    • Antihypertensives
    • Blood pressure medications
  • Medical conditions:
    • Depression
    • Thyroid disease
    • Androgen insufficiency
    • Diabetes
    • Cardiovascular disease
    • Neurological disorders
  • Cultural issues
  • Relationship satisfaction
  • Midlife stress:  career change, relationships, loss, divorce, caring for parents and financial concerns

If you are suffering from hot flashes and a poor self-image, combined with taking antidepressants and blood pressure medications, can be a recipe for a declining libido.

As many as half the patients who take SSRIs report some sexual dysfunction.

Per The North American Menopause Society (NAMS): “In contrast, the antidepressant bupropion (Wellbutrin), which works in a different way from SSRIs, was found to improve sexual functioning compared with placebo in a small study of nondepressed women and men with desire and arousal difficulties. This finding is interesting but requires more study to confirm it before bupropion should be used specifically for treating sexual problems.”

Once you find the culprit that kidnapped your mojo, you have options.

Managing a declining libido

  • Discuss options with your practitioner.  If fluctuating hormones are affecting your libido, there are therapies available.
  • Review current medications and medical conditions.
  • Talk to your partner
  • Consider counseling or sex therapy, or both
  • Adjust lovemaking activities: try warm baths before genital sexual activity, extend foreplay, incorporate massages, change your sexual routine, experiment with positions, discuss sexual fantasies
  • Use lubrication
  • Maintain a healthy lifestyle, exercise most days of the week, and consume alcohol moderately
  • Commit to new stress-management practices, like acupuncture, biofeedback, yoga

When women notice that their sex drive is diminishing; many seek out a prescription from their doctor for a does of testosterone thinking it will fix the problem.

Dr. Wendy Klein, co-author of The Menopause Makeover, says  “The use of testosterone to treat a diminished libido is still controversial.  The FDA has not approved testosterone therapies for women suffering from a declining libido, but there have been preliminary scientific studies and extensive anecdotal reports that support the use of this therapy for improving the libido.”

A little compounded testosterone gel may be worth considering, but keep in mind that it has not been FDA-approved to treat a declining libido and long-term safety data is lacking.  Women who are on testosterone therapy should be monitored for increased lipids, excessive hair (hirsutism) and acne.

DHEA is another hormone that is often promoted as a libido booster.  When you purchase DHEA, it is a dietary supplement, not a drug that is regulated by the government.

Dr. Wendy Klein says, “If your DHEA level is tested and shown to be below normal, then it may be reasonable to take a supplemental dose of 25-50 mg daily.  However, if your DHEA level is normal, then there is no reason to take DHEA as a supplement.”

If you do decide to use an alternative therapy be sure to tell your healthcare provider so that he or she can be on the lookout for side effects and interactions.

Besides the effects of menopause, it is also normal for your libido to decline with age. Between the ages of 55 and 65 sexual activity slows for men and women, but don’t give up.

There are many benefits to having a healthy sex life:

  • Sex burns about 200 calories during 30 minutes of active sex.
  • Regular sex promotes circulation and lubrication.
  • Having sex three times a week can make you look and feel ten years younger, thus boosting self esteem.
  • Sex is the safest sport you’ll ever enjoy.
  • Sex releases endorphins into the bloodstream producing a sense of euphoria that can reduce depression.
  • Sex is a stress reliever. It is ten times more effective than Valium.
  • Sex can relieve headaches by releasing the tension that restricts blood vessels in the brain.
  • Sex is a natural antihistamine that can help with asthma and hay fever.
  • Sex can lower your cholesterol by tipping the HDL/LSL (good kind/bad kind) cholesterol balance towards the HDL (good) side.
  • Regular sex can boost estrogen levels. Estrogen keeps your hair shinny and skin smooth; helps reduce the chances of getting dermatitis, and rashes.
  • The actual sex act triggers the release of oxytocin that promotes more good feelings.
  • Sex can help you sleep better because the levels of oxytocin, a sleep-inducing hormone, can be five times higher than normal during love making.

Discussing your declining libido with your healthcare provider and partner is the first step to managing a healthy sex life. It is also a perfect time to build strong communication skills with your partner. The more your partner understands your menopausal journey the more supported you may feel.   If less sex is agreeable to you and your partner, enjoy other bonding activities.  Men may also notice changes that can affect their libido. Being able to discuss your libido will open the door for him to connect and communicate as well.

Going through menopause can be exhausting.  Feeling good about yourself when everything is changing, from your waistline to your sex life, can be challenging.  Often, nonhormonal options may rescue a lagging libido and spice up your sex life.

Once you have passed through the doors of perimenopause, feeling sexy is possible with proper management.  With continued interest, you can get your groove back and feel sexy during menopause and beyond.

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