Over 40 and Feeling Off? Seven New Guidelines for Women’s Health

For women in midlife, hormone shifts can affect everything from muscles and bones to sleep and heart health, says Dr. Kanchi Chadha, MD, FACOG, director of the Midlife Women’s Health and Longevity Center at Hackensack Meridian Health.

In a conversation with Broadcast Retirement Network host Jeffrey Snyder, Chadha discussed how the understanding of healthy aging has changed and what women can do to protect their health in their 40s, 50s and beyond.

Snyder opened by asking whether the definition of healthy aging has changed over time. Chadha said it has, noting that more attention has been paid to midlife women’s health in recent years and that clinicians now have more options than previous generations did.

She said one of the biggest modifiable risks is a sedentary lifestyle. Even 30 minutes of strength or resistance training can help, she explained, while inactivity can raise the risk of cardiovascular disease, diabetes, metabolic syndrome and poor bone health.

Muscle loss becomes more common with age, Chadha said, partly because estrogen levels decline. To counter that, she recommended resistance training two to three times a week for about 30 minutes per session, using light weights or resistance bands if needed.

Bone health is another major concern. Chadha said that although bone density screening is typically approved at age 65 and older, waiting that long can mean missing a chance to intervene earlier. She encouraged weight-bearing exercise, resistance work, and adequate calcium and vitamin D intake, along with supplements when diet alone is not enough. Even activities such as Tai Chi can help support bone strength.

Nutrition also changes in midlife, Chadha said. In the 40s and 50s, the body processes cholesterol and carbohydrates differently than it did earlier in life. She advised prioritizing protein, fiber from fruits and vegetables, and slightly reducing carbohydrate intake without becoming deficient in other nutrients. She also urged women to consider family history and inherited risks such as hypertension, diabetes and hypothyroidism when making diet and lifestyle choices.

Processed foods, she said, should be limited. Chadha pointed to research linking processed meats and similar foods with colon cancer risk, and she noted that colon cancer screening recommendations have moved earlier in recent years, from age 50 to 45. She stressed the importance of following physicians’ guidance on screening methods and timing.

For colon screening, Chadha said colonoscopy remains the standard test because of its sensitivity and specificity. A colonoscopy is generally performed every 10 years, while stool-based options such as Cologuard are used more frequently according to guidelines.

Sleep was another major topic. Chadha said poor sleep and insomnia can raise cortisol levels and contribute to weight gain. She recommended a consistent sleep routine, avoiding screens before bed, keeping a regular sleep-wake schedule, not eating late at night, and avoiding late-evening workouts. If sleep problems persist, magnesium glycinate may help. She also said obstructive sleep apnea is often underdiagnosed in midlife women and can occur even in people who are not overweight and do not snore, making a sleep study worthwhile when symptoms suggest it.

On hormone therapy, Chadha said the term has shifted from hormone replacement therapy to menopause hormone therapy, or MHT. She explained that MHT is FDA-approved for three main uses: treating hot flashes and night sweats, helping prevent bone loss in women with osteopenia, and addressing genitourinary symptoms of menopause such as vaginal dryness, recurrent urinary tract infections and painful intercourse.

She added that other indications are being reconsidered, including cardiovascular disease and dementia, but those reviews are still ongoing. For women who cannot take hormones because of a history of breast cancer, blood clots or stroke, she said there are now nonhormonal options, including neurokinin receptor antagonists, certain SSRIs or SNRIs, oxybutynin, cognitive behavioral therapy and weight loss.

When Snyder asked how women can find the right provider, Chadha pointed to the Menopause Society’s provider directory, which lists practitioners with MSCP certification. She said those clinicians have studied current guidance and passed an exam showing they are up to date on midlife women’s health care.

Chadha also warned about compounded medications and unverified treatments, including some testosterone pellets, which can lead to irreversible side effects such as voice changes, clitoral enlargement and hair loss. She said misinformation from social media and unproven supplement marketing can push patients toward expensive products that have no real evidence behind them.

She encouraged women to seek comprehensive care from multidisciplinary centers when possible. At Hackensack Meridian Health in Paramus, New Jersey, she said, patients can access primary care, social work, DEXA scanning, mammography, lab testing and hormonal specialty care in one place, allowing the team to treat the whole person rather than separate symptoms in isolation.

Snyder agreed that misinformation online makes it harder for people to know what to trust and said accurate sources can improve both longevity and quality of life. Chadha closed by emphasizing the value of evidence-based care and the importance of staying informed.

The Arena Media Brands, LLC THESTREET is a registered trademark of TheStreet, Inc.