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Healthy Balance

Health in Your 40s: The Basics

When people talk about being “Over the hill,” that hill they’re talking about is the big 4 – 0. OK: So you’ve climbed it. Now what?

Staying healthy at 40 The key message for health in your 40s: Yes, a lot of things are changing. But don’t give up on your health; this is a critical time. The preventive measures you take in this decade can set the tone for the rest of your life.

Keep it Up

The Screenings You Need in Your 40s

Continue with your regular screenings for:

  • High blood pressure
  • Weight and BMI
  • Cholesterol
  • STDs
  • Cervical cancer
  • Lipids, blood sugar levels

What to Watch For

Women: More Complicated Pap Smears

You’ll want to find an ob/gyn who can talk to you about the various types of pap smear tests available. JoAnn Pinkerton, MD, of the Midlife Health Center explains, “Pap guidelines have changed: At UVA, we’re now doing a pap/HPV co-test, looking for abnormal pap smears and whether you have one of 13 high-risk HPV types, like HPV 16 & 18, which are more likely to progress into abnormal cells for cancer.” Some providers may be moving to primary screening with HPV. The good news: Cervical cancer screening has improved.

She encourages women to educate themselves about their pap smear options: “So I as a provider have to know what’s the best thing to do, and you as the consumer need to ask what you’re having done.”

Health Hacks by Age

Take Charge of Your Health: Young Adults in Their 20s

Be Healthy in Your 30s

Menopause, Painful Sex, Weight Gain: Surviving Your 50s

Everyone: Middle-Age Means More Stress

Pinkerton has noted that women especially seem to experience more stress in their 40s—and stress increases your risk of heart and other diseases. “Stressors start to build in your 40s because you’ve got aging children, aging parents, and work-related issues because you’re peaking in your career, and so the inclination is to take care of everyone else and not yourself.”

Exercise, sleep and a healthy diet boost your hormones and metabolism, increasing your ability to handle stress.

More Important Than Ever: Exercise, Sleeping and Eating

You’ve always known you need to exercise and eat well. But health risks of being sedentary – sitting all day—increase with age. This and other factors make diet and exercise increasingly important.

Women: Your metabolism slows down in your 40s. Pinkerton’s mantra: Eat less, move more. “You have to do it. If you think that you can continue eating what you have been eating and not exercising the way you did in your 30s and not start to gain weight in your 40s, you’re out of your mind. It doesn’t work that way. There are things happening in your body and your metabolism that mean that you have to make changes.“

For men, diet and exercise can help erectile dysfunction, diabetes, heart disease. Urologist Ryan Smith, MD, notes: “There’s really strong evidence that exercise maintains erectile function.”

But in your 40s, you’re probably busier than ever. So how can you stay healthy? Try these tips:

Dieting at 40: Use a Smaller Plate

Dieting at 40 looks different, Pinkerton explains. “Everyone comes in and says, ‘But I’m not eating any different.’ Well, when you were 20, if you wanted to lose weight, you just cut out the chocolate chip cookies, right? In your 30s, if you wanted to lose weight, you added some exercise and a few more salads. In your 40s, when you want to lose weight, you have to get a smaller plate and put less food on it.”

Fit Activity Into Your Daily Routine

In the US, 64 percent of women are sedentary. Fitting in exercise may be the biggest struggle of everyone’s day. Pinkerton’s advice? Do a little bit often. An example: The 7-Minute Scientific Exercise Program, which you can find online or even as an app for your smartphone.

“Just seven minutes of exercise in the morning jump starts your day,” Pinkerton says. “Then when you see those stairs, you think, ‘I can climb those stairs.’ And you’re more likely to say on Saturday, ‘Let me meet a friend and go walk or jog.” Aim for the goal of moving or exercising for 30 minutes most days of the week.

Tied Down to a Desk Job?

A good rule of thumb: For every 55 minutes of sitting, get up and move for 5 minutes.

New to Think About

Women: Get a Mammogram

While debate continues among some about when you need to start getting mammograms, UVA follows the protocols accepted by the American College of Obstetricians and Gynecologists (ACOG) that say you need to start at 40. “There’s a big difference between what works for cost and mortality data and what’s important for a person,” she says. “Our job at UVA is to take national guidelines and everything else and help women figure out, what is needed for me?”

To that end, if someone in your family had breast cancer, usually the recommendation is get a mammogram 10 years before the diagnosis of the youngest person in your family.

Also good to know: At 40, you may have dense breast tissue. This means you’ll need a 3D mammogram.

Thyroid Issues: Get Your Thyroid Checked

You’ll want to keep tabs on your hormone levels. 


What is perimenopause?

The gradual transition between the reproductive years and menopause, perimenopause (meaning “around menopause”) is generally a transition that takes several years and causes:

  • Shorter menstrual intervals
  • Irregular menses
  • Night sweats
  • Worsening premenstrual syndrome
  • Migraine headaches

If bothersome, talk to your provider, because there is help.

Menopause: It’s Coming

The most common symptoms women in their 40s notice are changes in periods and the onset of hot flashes. Natural menopause occurs when you stop having your period, confirmed when a woman has not had her period for 12 consecutive months.

Women in North America will likely experience natural menopause between ages 45-55, averaging around age 51. Talk to your family, because family members often reach menopause around the same age.

Men and Women: Sleep Problems

Perimenopausal women often have trouble falling and staying asleep. According to the National Sleep Foundation, 61 percent of perimenopausal and postmenopausal women report frequent bouts of insomnia. Men, on the other hand, are more likely to have sleep apnea.

Some of the causes of sleep issues include:

  • Sleep apnea
  • Restless leg syndrome
  • Stress
  • Hot flashes and night sweats
  • Joint pain
  • Incontinence

Everyone: Don’t Ignore Your Sex Life!

It’s a funny thing about hitting 40: Your libido starts to decline, due to stress and work as well as hormone shifts, hormones go down, testosterone decreases. What to do? Don’t ignore your sex life, even if you’re not as inclined as in the past. And stay intimate with your partner, which may or may not include sexual activity.

Yes, You Can Still Get Pregnant

Pinkerton warns women in their 40s not to forget about contraception. Why? The second highest rate of unintended pregnancy is in your 40s.

“If you don’t want to get pregnant, you need to be using adequate birth control. If you do, you need to think about the increasing risks of birth defects with age.”

Need Support?

Get seen in the Midlife Health Center or the Urology Clinic

Men: Heart Disease & Erectile Dysfunction

For men: Some men might start having problems in late 30s and early 40s. Men start losing testosterone, 1-2 percent a year, in their late 20s.

Smith notes that ED symptoms pre-date cardiovascular disease and heart attacks. “If guys are exercising, keeping their heart in check and blood sugar in check, then they’re going to fair much better at keeping their erections,” he says.

Guys go to the doctor for ED because they want it fixed. But, “generally what we tell them is problems in the bedroom can be one of the earliest signs of heart disease.” So Smith counsels men to look at their overall health.

So, don’t smoke, try to exercise, etc., Smith advises.“ The preventive stuff is always better than trying to fix stuff with a pill; we really stress that.”


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