Last week, in part one of this series we focused on women’s health in their 20s and 30s and the importance of establishing good health habits that will stand to you in the future.
This week we concentrate on the health of women in their 40s. It is a decade that can be physically and emotionally challenging as women cope with a variety of pressures, such as their career, a mortgage, a growing family or perhaps, increased caring responsibilities for parents. There is the added issue, too, of perimenopause coming down the tracks with all hormonal changes it brings.
Dr Mary Ryan, author and consultant endocrinologist, says it’s a time to listen to your body.
“It’s a time to do all the things recommended for your 30s – look after your diet, get good sleep and exercise but for those in their 40s, I say ‘exercise appropriately’. That’s because I see so many women running roads looking exhausted and you can’t do that. You’ve got to listen to your body and not overdo it. Your hormone control centre (pituitary gland) is getting tired because your eggs are depleting and your oestrogen levels are going down while your Follicle Stimulating Hormone (FSH) levels are going up.”
The pituitary gland controls the hormones to all the muscles as well, she says, so women may experience aches and pains.
“You might notice anxiety too and your periods may also become more irregular or heavy in your 40s.”
She advises informing yourself about perimenopause as symptoms can start seven to ten years before your periods stop. The average age of menopause (periods stopping) for Irish women is 52 so perimenopause symptoms could start from age 42-45, or younger.
“Some 15-20% of women sail through menopause and 20% really suffer with flushes, sweating and lack of sleep,” Dr Ryan points out.
She says muscle and bone health should also be prioritised in your 40s also.
“A lot of women coming to me are not eating enough vegetables and protein. Protein is very important because you are losing muscle at this time. You need to do resistance exercises, too, to build muscle back up. I use a rowing machine myself because all the muscles are used doing that.”
Weight gain
Exercise helps you control your weight also, she adds.
“Many women get upset about weight gain in their 40s. This happens due to hormonal change and insulin resistance which causes fat to collect around the tummy.”
Keeping that weight off the tummy is very important, she states.
“All the fat cells around there are very inflammatory which puts you at risk of type 2 diabetes and heart disease so getting rid of that fat is very productive. You have to really look at your diet and cut back on sugar and make sure you have the right balance of protein and carbohydrates.”
Dr Ryan recommends not putting everything down to perimenopause, however, because symptoms may be the result of a thyroid issue.
She recommends women in their 40s get a blood test once a year to check these levels.
“The thyroid can go ‘off’ at this time because the hormone control centre is tired,” she says. “This can affect the immune system and cause a condition called Hashimoto’s Disease (underactive thyroid) or Graves Disease (overactive thyroid). Overactive is more common around menopause and symptoms can include palpitations or sweating. Putting on excess weight is a symptom of an underactive thyroid as is getting dry eyes, dry hair and dry skin.”
If you are experiencing symptoms like these, you should go for a check-up and treatment if it is needed, she advises.
Your 40s are a pivotal decade for your health, as hormones shift and metabolism changes. \iStock
Alcohol intake
Bantry GP and director of Women’s Health with the Irish College of General Practitioners (ICGP) Dr Laura Cullen highlights the need to decide on long-term contraception when you hit your 40s.
“Plenty of women experience unplanned pregnancies in their 40s which can be stressful so it’s really important to address contraception when you know your family is complete. Ask yourself are you going to do something long term like use hormonal or copper coils or maybe your partner will decide on a vasectomy. Contraception should be men’s responsibility too.”
She also advises women to inform themselves about menopause from reliable sources so that they know what’s happening to their bodies.
“Symptoms (of perimenopause) can happen insidiously,” she adds, “so it’s important to know what’s happening to you so that you can get help if you need it.”
She reiterates Dr Ryan’s advice about getting enough protein in your diet and taking exercise also. She also highlights the need to keep an eye on alcohol intake in your 40s.
“Drinking at home became more common during the pandemic. With women, alcohol issues can be much more hidden,” she says. “It can be a slippery slope, going from two bottles of wine at the weekend to three or four bottles a week, but more than 11 units a week is too much. Remember, each bottle of wine can contain 9-10 units.
“Liver specialists are alarmed currently by the number of women presenting with liver problems, with wine tending to be the issue.”
Dr Cullen also suggests that one’s 40s are a good time to get into a regular routine of self-breast examination.
“You need to have a good feel around, not just the breasts but under the arms and along the collar bone and also look for skin and nipple changes,” she says.
“See your GP if you find something that wasn’t there before.”
She also recommends continuing with regular CervicalCheck smear tests and paying attention to heavy periods.
“I know of women in their 40s who use towels in the car or bed or use two pads and a tampon. That’s not normal and can make women anaemic. Women should know that heavy periods are very manageable. A Mirena coil may help. It has been a game changer in women’s health.”
Blood tests
Blood tests should be done regularly during this decade of life also as family history may come into play.
“If cholesterol levels are rising, keep a close eye on them,” she says.
Duleek pharmacist Kathy Maher refers back, firstly, to the six pillars of health mentioned in part one of this series, that are important for everyone, regardless of age: diet, physical activity, good sleep patterns, stress management, avoiding risky substances and maintaining positive social interactions.
“These six pillars are important but what I notice with women in their late 30s into their 40s is that they are looking after younger to middle teen children and they may have a care burden associated with older parents as well. I call this time in a woman’s life the ‘sandwich years’. You are financially constrained, still have a mortgage and you’re trying to carve a career and progress through your own life as well as caring for others.
“We find an awful lot of women come to us [pharmacists] because they are experiencing stress from looking after someone else. That stress can have a big impact on mental health.”
Increased anxiety because of lowering oestrogen levels can be an issue too.
“Some women say ‘I think I’m losing my mind’. This anxiety can be very distressing but it is very important that they speak about it.”
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Last week, in part one of this series we focused on women’s health in their 20s and 30s and the importance of establishing good health habits that will stand to you in the future.
This week we concentrate on the health of women in their 40s. It is a decade that can be physically and emotionally challenging as women cope with a variety of pressures, such as their career, a mortgage, a growing family or perhaps, increased caring responsibilities for parents. There is the added issue, too, of perimenopause coming down the tracks with all hormonal changes it brings.
Dr Mary Ryan, author and consultant endocrinologist, says it’s a time to listen to your body.
“It’s a time to do all the things recommended for your 30s – look after your diet, get good sleep and exercise but for those in their 40s, I say ‘exercise appropriately’. That’s because I see so many women running roads looking exhausted and you can’t do that. You’ve got to listen to your body and not overdo it. Your hormone control centre (pituitary gland) is getting tired because your eggs are depleting and your oestrogen levels are going down while your Follicle Stimulating Hormone (FSH) levels are going up.”
The pituitary gland controls the hormones to all the muscles as well, she says, so women may experience aches and pains.
“You might notice anxiety too and your periods may also become more irregular or heavy in your 40s.”
She advises informing yourself about perimenopause as symptoms can start seven to ten years before your periods stop. The average age of menopause (periods stopping) for Irish women is 52 so perimenopause symptoms could start from age 42-45, or younger.
“Some 15-20% of women sail through menopause and 20% really suffer with flushes, sweating and lack of sleep,” Dr Ryan points out.
She says muscle and bone health should also be prioritised in your 40s also.
“A lot of women coming to me are not eating enough vegetables and protein. Protein is very important because you are losing muscle at this time. You need to do resistance exercises, too, to build muscle back up. I use a rowing machine myself because all the muscles are used doing that.”
Weight gain
Exercise helps you control your weight also, she adds.
“Many women get upset about weight gain in their 40s. This happens due to hormonal change and insulin resistance which causes fat to collect around the tummy.”
Keeping that weight off the tummy is very important, she states.
“All the fat cells around there are very inflammatory which puts you at risk of type 2 diabetes and heart disease so getting rid of that fat is very productive. You have to really look at your diet and cut back on sugar and make sure you have the right balance of protein and carbohydrates.”
Dr Ryan recommends not putting everything down to perimenopause, however, because symptoms may be the result of a thyroid issue.
She recommends women in their 40s get a blood test once a year to check these levels.
“The thyroid can go ‘off’ at this time because the hormone control centre is tired,” she says. “This can affect the immune system and cause a condition called Hashimoto’s Disease (underactive thyroid) or Graves Disease (overactive thyroid). Overactive is more common around menopause and symptoms can include palpitations or sweating. Putting on excess weight is a symptom of an underactive thyroid as is getting dry eyes, dry hair and dry skin.”
If you are experiencing symptoms like these, you should go for a check-up and treatment if it is needed, she advises.
Your 40s are a pivotal decade for your health, as hormones shift and metabolism changes. \iStock
Alcohol intake
Bantry GP and director of Women’s Health with the Irish College of General Practitioners (ICGP) Dr Laura Cullen highlights the need to decide on long-term contraception when you hit your 40s.
“Plenty of women experience unplanned pregnancies in their 40s which can be stressful so it’s really important to address contraception when you know your family is complete. Ask yourself are you going to do something long term like use hormonal or copper coils or maybe your partner will decide on a vasectomy. Contraception should be men’s responsibility too.”
She also advises women to inform themselves about menopause from reliable sources so that they know what’s happening to their bodies.
“Symptoms (of perimenopause) can happen insidiously,” she adds, “so it’s important to know what’s happening to you so that you can get help if you need it.”
She reiterates Dr Ryan’s advice about getting enough protein in your diet and taking exercise also. She also highlights the need to keep an eye on alcohol intake in your 40s.
“Drinking at home became more common during the pandemic. With women, alcohol issues can be much more hidden,” she says. “It can be a slippery slope, going from two bottles of wine at the weekend to three or four bottles a week, but more than 11 units a week is too much. Remember, each bottle of wine can contain 9-10 units.
“Liver specialists are alarmed currently by the number of women presenting with liver problems, with wine tending to be the issue.”
Dr Cullen also suggests that one’s 40s are a good time to get into a regular routine of self-breast examination.
“You need to have a good feel around, not just the breasts but under the arms and along the collar bone and also look for skin and nipple changes,” she says.
“See your GP if you find something that wasn’t there before.”
She also recommends continuing with regular CervicalCheck smear tests and paying attention to heavy periods.
“I know of women in their 40s who use towels in the car or bed or use two pads and a tampon. That’s not normal and can make women anaemic. Women should know that heavy periods are very manageable. A Mirena coil may help. It has been a game changer in women’s health.”
Blood tests
Blood tests should be done regularly during this decade of life also as family history may come into play.
“If cholesterol levels are rising, keep a close eye on them,” she says.
Duleek pharmacist Kathy Maher refers back, firstly, to the six pillars of health mentioned in part one of this series, that are important for everyone, regardless of age: diet, physical activity, good sleep patterns, stress management, avoiding risky substances and maintaining positive social interactions.
“These six pillars are important but what I notice with women in their late 30s into their 40s is that they are looking after younger to middle teen children and they may have a care burden associated with older parents as well. I call this time in a woman’s life the ‘sandwich years’. You are financially constrained, still have a mortgage and you’re trying to carve a career and progress through your own life as well as caring for others.
“We find an awful lot of women come to us [pharmacists] because they are experiencing stress from looking after someone else. That stress can have a big impact on mental health.”
Increased anxiety because of lowering oestrogen levels can be an issue too.
“Some women say ‘I think I’m losing my mind’. This anxiety can be very distressing but it is very important that they speak about it.”
Read more
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