1. After age 40, your metabolism begins to slow down

As women grow older, the efficiency with which our body produces energy is markedly decreased. Even if the routine of their daily activities doesn’t change as they age, less of the caloric intake is burned. This causes a reduction in the energy produced, and the unburnt calories cruelly turn into fat.

The remedy is simple, but simple is not always easy – both your diet and exercise routine must significantly change. A smaller caloric intake, coupled with an increase in regular exercise, will help you maintain the weight and energy levels of your younger self. Keep this up into middle age and beyond and watch longevity become your best friend. 

2. Why is my hair falling out?

Only a small percentage of women actually lose enough hair to cause bald spots. But in their 40s, most women will experience their hair thinning out a bit. Estrogen plays a significant role in women’s hair growth. It’s not surprising that hair loss increases as the approach of menopause causes estrogen production to decrease.

To alleviate thinning hair, you can reduce the frequency of washing your hair. This allows the natural oils produced by your scalp to better condition your locks. Always use a conditioner, limit the use of styling tools that rely on applications of heat, and limit chemical treatments like coloring. To restore hair growth, Minoxidil has shown some efficacy.

3. Your bladder can sometimes elude your control
Again, the culprit is the decrease in estrogen production that accompanies perimenopause (the period preceding true menopause). Estrogen loss weakens the muscles that support the bladder and the urethra. When the muscles are weakened, any abrupt clenching of the diaphragm can lead to leakage. This means you can no longer safely (or dryly) cough, sneeze, or enjoy a good belly laugh. (If it makes you feel any better, men have their own significant problems in this regard.)

There are several effective remedies for incontinence. They can enable you to resume fearlessly laughing, coughing, and sneezing with gusto. Taking off a few extra pounds will alleviate pressure on the bladder, and reducing your intake of alcohol and caffeinated beverages will make leaks less likely. Kegel exercises will help rebuild the weakened bladder and urethral muscles. If none of these methods provide a cure, your treating OB/GYN can provide medical procedures that are very effective.

4. Memory loss: your brain goes AWOL
There’s got to be a good reason why you’re standing in front of the fridge, right?

Some loss of brain function between perimenopause and post-menopause is so common among women as to be almost unavoidable. One more time, it’s that pesky midlife refusal of the ovaries to pump out the usual dosage of estrogen that causes problems.

Women have estrogen receptors in two brain areas that control memory, and when there’s less estrogen, there are negative structural changes in those areas.

Brain exercises and menopause memory loss. But there’s some good news about memory loss!
Just because brain fog is normal doesn’t mean that you can’t fight it! Your brain’s operational efficiency is largely dependent on the amount of oxygen provided to it by your bloodstream. So, what’s good for your heart is good for your brain. This means a vigorous program of exercise, a healthy diet, and effective stress management. And work your brain! Crossword puzzles, reading difficult books, and similar brain exercises will maintain your brain function, including your recollection that it was the mayonnaise you were looking for.

Also, your brain’s unplanned vacation isn’t permanent. The brain bounces back after menopause. It adapts to lower estrogen levels, and it compensates.

5. Urinary problems will increase as you get older
According to Lauren Streicher, M.D., director of the Center for Sexual Medicine and Menopause at Northwestern University’s Feinberg School of Medicine, estrogen appears to provide protection against the bacteria that cause urinary tract infections. UTIs become more common in women as perimenopause, and then menopause, shut down the ovaries’ production of estrogen.

Most urinary tract infections can be treated quickly and easily with antibiotics, and fortunately, symptoms usually disappear within two days. When taking antibiotics, it’s important to take all of the doses prescribed, even if you are feeling better before you run out of your medication. Failing to take the entire prescription as recommended could result in a relapse of the infection.

6. Often, in your 40s, your menstrual period can become unpredictable
By the time you reach post-menopause, your periods have permanently ceased. However, from perimenopause through menopause itself, the reduction in estrogen production can be wildly unpredictable. This can result in varying menstrual patterns; periods can be either closer together or farther apart. Some cycles will have an extremely heavy flow, and there may be months where your period doesn’t occur at all.

7. Now we have to deal with vaginal dryness as well?
Well, yes, sometimes we do. Another problem that creeps up with age is vaginal dryness. Dr. Aliabadi was asked about sex and vaginal dryness on The Doctors TV show. She responded, “low hormone levels begin to make the vaginal walls thin and dry. Vaginal sexual activity is very important. It helps with stimulating blood flow to the vagina, keeping vaginal muscles toned, and helps to maintain elasticity and the length of the vagina.”

If vaginal dryness is a problem for you, try using an over-the-counter vaginal lubricant or talk to your health care provider for prescription relief with a vaginal hormone cream.

8. Loss of Estrogen
If you’ve been paying attention here, you’ll notice an overarching theme. The ovaries’ reduced production of estrogen, which begins during perimenopause and finalizes in menopause itself, is the villain in most of the above scenarios.