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Published on June 09, 2020

Women's Health After 40

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Turning 40 – it’s a dreaded birthday for some, or a welcomed milestone for others.

Regardless, for women it presents new challenges in managing their health and wellness.

OB/GYN Dr. Angela Chien offers information on the changes that impact women as they cross over the "40 barrier".


Why are the 40’s a challenging time for women, in terms of managing their health?

Dr. Angela Chien: The 40’s are a crazy time because there is no “one size fits all” when it comes to health - some women are still having babies, while others are entering menopause!

Changes do start to occur throughout the body – hormones change, but sometimes at an irregular pace – the average age of menopause for U.S. women is 51, with most women hitting it between ages 45 and 55.

Leading up to this you can experience a number of changes for a full decade before your menstrual cycle finally stops.

Every part of your body is affected, from your appearance to the health of your heart and bones.

Sleep can be a challenge. Studies show that women in their 40’s have a harder time getting quality sleep.

There can be a variety of reasons, but it makes maintaining the rest of your health all that much harder.


What are some common health issues women deal with and need to be aware of as they enter their 40’s?

Dr. Chien: Irregular periods start to become more common. It’s difficult for women to predict and manage their periods and understand their fertility cycle.

I have patients that are placed on birth control to help with this – which they find funny because they often assume they are no longer fertile.

Speaking of fertility - women need to remember that they may still be fertile! Just because you hit that 4-0 number does NOT mean that you can suddenly stop contraception.

I’ve had patients come see me because they felt “off” and were sure it was early menopause – turns out they were pregnant at 45!

Heavy bleeding is another major issue – women need to know that this isn’t something that just have to live with.

A very common procedure called an ablation can often lessen or eliminate bleeding entirely. And, there are other options to help with this as well.

Options for conception is another area of concern.

Women, especially those who have put off pregnancy because of their career, need to know that they have options when it comes to preserving their own eggs or using donor eggs if they wish to have a baby.


You are in your 40’s – what are some of the challenges you’ve experienced or hear commonly from your patients?

Dr. Chien: Exercise! Fitness simply becomes harder as we age. I have to work out harder and more frequently than I used to, in order to get the same results.

No one wants to hear it – but good old fashion exercise is a must if women want to stay fab in their 40s.

After 45, most women who don't lift weights start losing a significant amount of muscle, most of it from the lower body. If you lose muscle, you’ll have a harder time keeping off excess weight and staying healthy.

Diet also becomes more critical.

Healthy eating is always important at any age, but as we head over 40, our bodies become more susceptible to conditions like high blood pressure and diseases like heart disease and diabetes – we need to focus on prevention.

The 40’s can also be a time of emotional transition.

Many women are established in their careers, but still juggling parenthood and other issues.

Hormones do start to change and this can affect one’s emotional well-being.

These are all things that should be discussed with your healthcare provider.


What are the recommended health screenings for women in their 40’s?

Dr. Chien: Mammograms become important.

After 40 women need to be sure to get on a regular schedule because early detection can make the difference in the treatment of breast cancer.

No one likes a mammogram, but after 40 is the time to bite the bullet and make it a priority.

Also, pap smear guidelines have changed.

It’s still very important to get pap smears to look for cancer, but the newest guidelines say that women can get them every 3 years instead of annually, if they are cleared to do so by their doctor.

The 40’s are also a great time, if you haven’t already, to start baseline annual screenings for overall health – blood pressure, cholesterol and blood glucose are all great things to start paying attention to.


What other advice would you give to women to inspire them to be Fab After 40?

Dr. Chien: Embrace it! Life is really still just beginning.

Pay attention to your health and wellness and it will be easier to feel and stay fab.

Give yourself the time to maintain your fitness – don’t take short cuts in this arena. Studies show that working out may lower a woman's risk of breast cancer by 37 percent, osteoporosis by 45 percent, and heart disease by 14 percent.

Remember that your body is changing – the most important thing to pay attention and seek out solutions – you do not have to just “deal with” with conditions like heavy bleeding.

Angela Chien Meet the Expert

Angela Chien, MD

Dr. Angela is board certified in obstetrics and gynecology, and practices at EvergreenHealth Obstetrics & Gynecology Care in Kirkland, WA.

Read Dr. Chien's full profile

Learn more about Gynecology services

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