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Healthy at every age: Your 40s

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The secret to staying well and happy this decade? Catch health problems early, before they become a big deal.

We all want to have a long and healthy life and to stay strong, active and vibrant as we age. No matter how old you are, certain basic habits are key for feeling good and fending off disease: Eat healthy food. Get enough sleep. Exercise. Wear sunscreen. And get regular health screenings. But other health advice may vary based on your age. In this special five-part series, we offer focused wellness tips for your 20s, 30s, 40s, 50s and 60s and beyond. 

Read the whole series:

Welcome to the official start of midlife. You’ve accomplished a lot, and there’s so much ahead of you. Now is a great time to double down on your healthy habits. You’ll also want to have regular visits with your primary care provider (PCP). Your body may begin to go through some changes, but you can still make this a healthy decade. Here’s how to boost your wellness now.

1. Stay on top of your health screenings

As you get older, your risk of serious illnesses such as heart disease and cancer begins to rise. But that doesn’t mean you’re at the mercy of your age. Sticking to your regular physical exams can go far in protecting your health. Here’s what to expect:

Your doctor may want to check your cholesterol and blood sugar levels more often now. These tests help your doctor spot early signs of heart disease and diabetes.

Be sure to get a complete eye exam at age 40.1 You’ll want to get this checkup even if your eyesight seems pretty good. Your doctor will likely add drops to your eyes to widen your pupil. That makes it easier for them to check the inside and back of your eyes. They’ll also check the pressure inside your eye. If it’s high, it could be a sign of glaucoma, an eye disease that can lead to blindness if not treated.1

Both men and women should get their first colon cancer screening at age 45.2 Screening tests look for signs of cancer in the last part of your large intestine (colon and rectum). You have choices. They include an at-home stool test and a visual test done by your doctor (colonoscopy). Ask your doctor which one is best for you.

Women should also talk to their doctors about breast cancer screening. A mammogram is an X-ray test that looks for changes in breast tissue. It’s a proven tool for catching breast cancer early, when it’s easier to manage. In fact, having regular mammograms can lower your risk of dying from breast cancer.3

Knowing exactly when to get a mammogram can be confusing, though. Different medical organizations have different rules. And they don’t always agree.4 That’s why you should have a conversation with your doctor about when to start.

Women between 40 and 44 should think about starting yearly mammograms. And those 45 to 54 should get mammograms every year.4 If you have dense breasts, the doctor may also suggest an ultrasound of your breasts. That test uses special sound waves to find changes. If you have a family history of breast cancer, you may start getting mammograms earlier.

Did you know that you can help pay for screening and diagnostic tests with funds from your medical expense accounts? Learn more about how they work and check eligible services here.

2. Try to fight belly fat

Do your clothes feel tighter even though you haven’t changed what you eat or your exercise routine? You’re not imagining it. For most people, their bodies stop burning calories and quickly as they once did.5 The result? Staying at a healthy weight is harder.

Weight gain around your middle is a problem, says Sarah Kent, MD. She’s a family medicine physician at USMD, part of Optum, in Cross Roads, Texas. “That's because belly fat is linked to higher risk of death, heart problems and overall poor health.”

Belly fat is found deeper in your belly and surrounds your organs.6 This type is thought to be more dangerous than the kind found right below your skin. It can lead to high blood pressure, inflammation, heart attack and stroke.

So how do you target belly fat? The same way you tackle weight gain in general: by moving more and eating a little less. Tweaking your habits will help you lose weight overall.

A few simple switches to focus on first: Try to cut back on sugary foods and drinks. And limit alcohol. Exercise needs to be part of the program, too. Aim for exercises that get your heart rate up (walking, jogging, swimming) and ones that build strength. We’ve got a two-week plan that can jump-start your fitness routine.

3. Watch for perimenopause symptoms

Many women in their 40s are taken by surprise by perimenopause. This is a stage when the body starts transitioning to menopause, when periods end. The average age for menopause is 51.7 But perimenopause usually kicks in during your 40s and sometimes sooner.

“As you near the end of your menstrual cycle, you may have several symptoms,” Dr. Kent says. These include:

  • Periods that change in length
  • Difficulty sleeping
  • Hot flashes
  • Mood changes

Blame them on changing levels of the female sex hormone estrogen, which are starting to decrease.

Perimenopause symptoms are normal. But it can be hard to cope with them. See your doctor if you’re having issues. They may suggest medications to ease symptoms. These include birth control pills and antidepressants.

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4. Protect your mental health

The 40s can be a tough decade for some people.8 There are often major transitions during this decade that can take a toll on your mental health. Some examples: Your kids may be leaving home and you’re dealing with an empty nest. Or you may have aging parents to take care of. You may be managing both.

Women may be at a particularly high risk for depression during this time.9 Changing hormone levels that happen during perimenopause and menopause can cause or add to mood changes.

Are you depressed? Signs include:

  • Feeling sad
  • Feeling worthless
  • Irritability
  • Loss of interest in normal activities

See your doctor if you have these symptoms nearly every day for at least two weeks.10 Psychotherapy or medicines can help you get through this stage in life.

5. Don’t dismiss hair loss

Many people think of thinning hair as mostly a male problem. And it is quite common in men. But women can also have hair loss in their 40s.11 This could be due to your family history or changing hormone levels.

Whether you choose to do anything about thinning hair is up to you. But Dr. Kent says you may still want to let your doctor know that it’s happening.

“Hair loss can sometimes be caused by medical problems that should be treated, such as thyroid disorders,” she explains. Other possible causes include:

  • Polycystic ovarian syndrome (in women)
  • Untreated sexually transmitted infections
  • Disorders that affect the hair follicle

For both men and women, medications like minoxidil can also help stimulate hair growth. There are other prescription options approved for hair loss in men, too. Learn more about them and even get them shipped directly to your door from the Optum Store.


  1. American Academy of Ophthalmology. Get an eye disease screening at 40. Published April 8, 2022. Accessed July 12, 2022.
  2. American Cancer Society. American Cancer Society guideline for colorectal cancer screening. Last updated June 2020. Accessed July 18, 2022.
  3. Centers for Disease Control and Prevention. What is breast cancer screening? Last reviewed September 2021. Accessed July 12, 2022.
  4. Centers for Disease Control and Prevention. What Is Breast Cancer Screening? Accessed September 8. 2023.
  5. Centers for Disease Control and Prevention. Preventing weight gain. Last updated June 2020. Accessed July 15, 2022.
  6. Centers for Disease Control and Prevention. Healthy weight. Last updated May 2022. Accessed July 15, 2022.
  7. American College of Obstetricians and Gynecologists. The menopause years. Published December 2018. Accessed July 15, 2022.
  8. Social Indicators Research. The midlife dip in well-being: A critique. Published May 5, 2020. Accessed July 12, 2022.
  9. North American Menopause Society. Depression and menopause. Accessed July 15, 2022.
  10. National Institute of Mental Health. Depression. Last reviewed February 2018. Accessed July 15, 2022.
  11. American Academy of Dermatology. Thinning hair and hair loss: Could it be female pattern hair loss? Accessed July 25, 2022.

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