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Feeling Good After 40, In Mind and Body

Local doctors talk about what to expect as you age.

So you recently hit the big milestone (or maybe you passed it a while back). You may feel like you’re still trudging up the hill, and not nearly over it —but it’s important to be aware of the physical and mental challenges you may encounter as you age.


We talked with two local doctors – Dr. Jane Porcelan, an OB/GYN at Women for Women, and Dr. Jane Summers, a psychiatrist specializing in women’s behavioral health and the Director of Women’s Psychological Health Services at the Council for Relationships — about what to expect and how to stay healthy in your 40s and beyond.

Cause and Effect

Both doctors emphasized that your physical health as you age, as always, affects your mental health profoundly, and vice versa. For instance, it’s impossible to know if physical health challenges may cause feelings of depression, or if it is hard to maintain physical health because you’re feeling down. Therefore, it’s important that you pay attention to both physical and mental health, and not assume one is the cause of the other.

The Looming Mystery: Menopause

While the average age for menopause is 51.5, perimenopause — the years preceding menopause — has symptoms of its own and can begin as early as age 35. You may experience any number of physical signs, including thinning hair, night sweats, weight gain or redistribution, cycle changes (skipped or closer periods), and energy loss, or none of them.


Porcelan warns that “life changes could also be stressors” that bring on these same symptoms, so don’t jump to blaming approaching menopause. If perimenopause and/or menopause symptoms are affecting your quality of life, a low-dose birth control pill can help minimize these symptoms and is safe, Porcelan said, so talk to your doctor.


Mood swings and irritability are common during perimenopause, especially among women who experienced premenstrual dysphoric disorder (the emotional part of PMS). Since cycles become unpredictable during perimenopause, so too do the mood swings associated with them and this inability to predict and know the cause of mood swings can amplify the emotional impact, according to Summers.


Many women are greatly aided by psychoeducation — simply learning about why their emotions feel so out of whack. With psychoeducation, women can say to themselves “I’m having a bad day, but I know that this is a symptom and I know it will go away.”

But I Used to Be Able to Eat That and Run for Days!

The changes to our bodies that come with age can have a profound mental and physical affect. It is a wake-up call when you feel “creaky” when bending down to play with a child or pick up a piece of litter, or when you can no longer run up a hill in your neighborhood that you’ve conquered hundreds of times before.


Maintaining a healthy lifestyle — including a wholesome diet (accommodating for the fact that your metabolism is slowing), good sleep habits, and regular exercise including strength training — is important for physical and mental health.


Porcelan and Summers said understanding that physical changes are normal and expected and being flexible to accommodate them will keep you physically healthy and safe, and guard against depression that may come from self-consciousness about your appearance. You may need to change your diet.


“You can’t eat like you did when you were 22,” Porcelan said.


You may also need to alter your exercise program to make it lower impact and prevent injury. But you can still enjoy delicious food and endorphin-producing exercise.


For women, especially, society paints a negative picture of aging and its effects and this can increase negative feelings as our physical appearance changes. If, instead, you can focus on the positive aspects of aging, Summer said, your emotions will benefit.

What About Sex….and Pregnancy?

Sex without worries sounds fun, right? But Porcelan said don’t get ahead of yourself: she recommends that a woman should use birth control responsibly until she has not had a period for a year.


Among the downsides of ditching the pregnancy worry: vaginal dryness and thinning of the vaginal wall are physical symptoms of perimenopause and menopause. Sex can become uncomfortable, and thus undesirable, and partners can interpret this lack of desire personally.


Summers encourages couples to talk about openly about what they are experiencing with their partners, so no one feels rejected. Porcelan recommends taking the time to create romance and considering vaginal estrogen, if needed.

Is There a Fountain of Youth?

The short answer: no. However, Porcelan and Summers agree that there are many things you can do to soften the impact of the aging process:


• Make a plan. Many of the emotional impacts of aging are results of the big changes that happen at this time of life: children leaving home, parents needing care, careers slowing down. Think ahead about how you may fill your time as your children need less of it, what other interests you can embrace as your career trajectory slows and how you may accommodate increasing needs of aging parents.


• Prioritize exercise and sleep. Not only do these things keep you physically healthy, but they are key for keeping a clear head and a positive attitude.


• Don’t be a stranger at the doctor’s office. Get regular check-ups and annual mammograms (after 40) and colonoscopies (after 50). With your doctor’s help, keep an eye on your cholesterol and your bladder health — two common problem areas as we age.


• Know that everyone has bad days, but pay attention to your mood. While hormonal changes associated with aging put women — in particular those who experienced postpartum depression — at risk for depression, everyone feels anxious, sad or frustrated sometimes. People with major depression have diminished mood most of the time, for at least two weeks, or have suicidal thoughts or recurrent thoughts about death.


Above all, don’t hesitate to make an appointment for a consultation if you are feeling down and are worried about depression or other mental disorders.


• Stay connected. Give ample time and effort to your friendships with people of all ages so as to avoid social isolation. Give extra effort to your romantic relationship.

The Grass Really May Be Greener as You Age

Aging gets a bad rap, Porcelan and Summers agree. Women spend a third of their life in menopause, and it can be a beautiful time of life. It’s an opportunity to explore interests and talents that you may not have had time for while raising young children, to travel, to become involved in the community, to take on new roles in your family. Many people become calmer and less focused on the little things as they age.


There are “new challenges, but also new joys,” Porcelan said.



Photograph via iStock. 



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