What a doctor wants women over 40 to know

Dr Louise Wiseman MBBS, BSc (Hons), DRCOG, MRCGP
·7-min read
Photo credit: Flashpop - Getty Images
Photo credit: Flashpop - Getty Images

From Red Online

Women often see their 40th birthday as a significant milestone that represents middle age. But should women be worried about getting older? Does the female body really change over 40? And can you influence the menopause by what you eat, drink and how much you exercise?

Dr Louise Wiseman, a former GP and one of our writers at Netdoctor, has recently published her first book Your Best Life – A Doctor’s Secret Guide To Radiant Health Over 40. Here Dr Wiseman shares 10 expert tips so women of all ages can start living their best life:

1. Ageing is a state of mind

How we think about ageing can affect how we actually age. Stereotyping in society can mean that many women actively dread the onset of old age. But studies have shown that if different generations interact together everyone benefits. Countries where communities support each other, regardless of age, have potentially longer living inhabitants.

We have two ages; ‘felt age’ (how old we feel) and ideal age (what we want to be). If we feel positive about where we actually are now it can add 7.5 years to our lifespan! Spending time with older and younger people is great for health and being surrounded with ‘expert ager’ role models is invaluable. Remember, the oldest lady in the room is inevitably the most fascinating.

2. Self-care is a priority, not a luxury

Women over 40 often have many responsibilities including children, elderly parents, work and home life. Stress management is key. When we are stressed, we produce more cortisol (the stress hormone) and actually divert bodily pathways from making the hormones that help us – oestrogen and testosterone.

There is now increasing evidence that making a conscious effort to relax can help management of stress. Meditation encourages less use of the part of the brain geared for action and stress (the amygdala) and more use of the prefrontal area instead that regulates emotions and calms panic. The amygdala was useful when we were cavewomen responding to being chased by a bear but is not so useful now!

In the 21st century the amygdala is stimulated by traffic jams, texts and arguments. The result is uncensored adrenaline and cortisol on overdrive, leading to a higher chance of high blood pressure, heart disease, diabetes and obesity. This ‘21st century amygdala’ needs careful handling. Meditation, mindfulness and even simple pen to paper journaling can really help a woman over 40 sail easier through the rocky shores of midlife.

3. We can change the way we age

The tips of our chromosomes (our genetic material) are called telomeres. These are continually broken down by an enzyme called telomerase. The longer the telomere the better our health and lifespan, the shorter the quicker we may age. You can protect your telomeres against being broken down and reverse some of this 'shortening' or 'ageing' by making a few simple lifestyle adjustments including taking more exercise, yoga and relaxation. Even feeling safe in our homes and environment can help protect our chromosomes in this way. Seeking out a leafy park for a walk has a similar effect.

4. Protecting memory is vital

It is difficult to find good studies of dementia prevention in research because so many factors are at play in developing memory loss. A few pointers may help preserve memory as we age – making sure our blood pressure is controlled from our 30s upwards, keeping our minds active by learning new skills and increasing our physical activity. Getting outside whether it is for a run or a creative pastime can also be great socially which may also enhance the sharpness of our minds. We tend to also learn from others, so socialising is key.

5. Menopause is different for everyone

Women will have different experiences of menopause whether or not it is natural or induced by medical treatment they receive (eg chemo, surgery). For some women periods just stop effortlessly, for others periods may come closer and heavier before they reduce. Some women are symptom free, others suffer for a long time. Women feel changes in the perimenopausal period which can last many years (from the onset of cycle changes until one year after the final period) that can really affect their daily life.

Following a healthy diet of vitamin and mineral rich foods, healthy proteins and healthy fats can all help energy levels and wellbeing at this time. Hormones can be manipulated for the worse if you are having too much refined sugar, overly processed food and not managing stress.

Self-medicating with alcohol or caffeine can also make some menopausal symptoms worse (hot flushes and sleeplessness) and replacing nutrient dense foods with alcohol can further exacerbate symptoms. Avoiding triggers for flushes, using meditation, acupuncture and cognitive behavioural therapy (CBT) have all been proven to help. Some women suffer enough that a consultation with a GP with a good knowledge of HRT and other options is essential.

6. Bones need movement

Being aware of your bone health is vital. The natural decline in oestrogen (which is protective of bone) after the menopause means women are more at risk of losing mineral and developing osteoporosis (bone thinning). Bone drainers and replenishers exist in our lifestyle and we can manipulate this to keep our bones strong and try and prevent fractures in later life.

Simple steps like stopping smoking, exercising, avoiding excess alcohol and gallons of caffeinated coffee can all help. Certain women are more at risk of bone thinning (eg due to medication such as steroids or early menopause) and doctors work with patients to prevent this. It can be in the form of medication or supplements but in all cases staying active is key and being aware of your vitamin D and calcium needs.

7. Muscles keep you young

We lose a small amount of muscle every decade. We burn fat in our muscle and it helps preserve a good metabolic rate. By exercising you can reverse some of the ageing effects – aerobic function improves, metabolic rate rises and effectively we are making our bodies act 'younger'. We are then at less risk of obesity, diabetes and muscle wasting and using large muscle groups keeps us healthily burning calories throughout the day.

8. Take the Blue Zone mentality to food

Looking at the Blue Zones (areas where people live longest in the world) has provided a wealth of information about what to eat and how. Being social around food, eating mindfully and sharing all factor in how long people may live.

But what is the healthiest way to eat? A plate should ideally contain half vegetables, quarter carbs and quarter protein. Following a Mediterranean diet is great in preventing many diseases. Women gain greatly from specific food groups such as healthy protein, magnesium, iron and good fats. Omega 3 is another power punch in fighting inflammation and keeping us happy and all these things are best obtained safely from foods rather than a supplement.

9. Sleep is beautiful

Sleep is not only for beauty. Putting the screens down long before bed reduces our night time blue light exposure and the natural restorative and protective processes in our brain and bodies can help us recharge and balance hormones. Sleep can even be anti-ageing. Managing hot flushes might be part of the arsenal to gain sleep but a good sleep hygiene regime is vital for all women of all ages. Knowing what triggers a bad night (caffeine, excess alcohol, nicotine, spicy food) is as important as what makes for a good night’s sleep (certain foods, bathing, magnesium salts, lavender sprays).

10. Friendship is essential

As we age our connections help us thrive and so developing and maintaining female friendship for women of all ages is vital. It has protective effects upon our health and evidence proves it can help us recover from diseases and live longer. Friendship is not frivolous but essential.

Dr Louise Wiseman believes that turning 40 is a beginning, not an end. She has used her clinical experience and the expertise of specialists in all fields of medicine to focus her research on what real women need. The result is a top-to-toe guide to women’s health that should be on every woman's shelf. Your Best Life – A Doctor’s Secret Guide To Radiant Health Over 40 is available now at Troubador.

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