In a woman’s life the age 40 is a landmark. To many it marks a different phase in their lives vastly different from the previous years. The changes are profound physically, mentally, emotionally and socially. Not all are for the worse – SOME WOMEN TRULY BELIEVE that life starts at 40!

In this article, we recant why we regularly reiterate that women in this age group need regular medical supervision.


Abnormal Uterine Bleeding

AUB can present as irregular periods, heavy flow, bleeding in-between the periods and bleeding after intercourse. While this can be a sign of a benign disease or hormonal imbalance, tests to rule out cancer need to be done most definitely in this age group and are easily available. Some of these tests are available on an outpatient basis too.

Urinary Incontinence

Incontinence is a treatable condition and not a sign of ageing. Many women in their 40s struggle with incontinence of the bladder and sometimes of the bowel. It affects their quality of life significantly and stops them from doing the things they love, such as running, dancing or even being at a job for long hours. Sometimes, incontinence is a sign of infection, cancer and other serious diseases and therefore needs medical attention at presentation. Also, when patients present early, simple interventions such as supervised Kegel exercises help significantly.

Prolapse and Pelvic Floor Dysfunction

Pelvic floor dysfunction primarily starts at the time of childbirth. When they are young, women compensate by the use of their accessory muscles. With menopause these symptoms get worse. Pelvic floor exercises when done early are immensely helpful. Treatment of prolapse is primarily surgical with plenty of excellent and effective options available.


Most women stop having their periods at the age of 52 years. Women who stop having their periods before 40 years of age as well as women who don’t stop having their periods after the age of 55 years need investigation and possible treatment. The lack of estrogen following menopause makes the woman lose the protective effect it has on the bones and heart. Women are therefore more prone to having weak bones and ischemic heart disease at this stage. Some women experience menopausal symptoms such as excessive fatigue, hot sweats and flushes. These symptoms can be easily treated.


There is a definite dip in the rates of becoming pregnant after the age of 40.

While fertility treatment such as IVF becomes less effective after this age, spontaneous pregnancies while not impossible are a lot lower and miscarriage rates are high. Pregnancies over 40 years of age, come with their own problems but is a regular occurrence in today’s world.


Many women consider that contraception is not required after the age of 40. This is not true and leads to many unplanned pregnancies and unnecessary induced abortions. A change in the type of contraception is a must. Reduction in the amount of hormones a woman consumes, over the age of 40, is paramount in reducing the risks of some cancers.

Sexual Dysfunction

Lack of libido, difficulty during intercourse and cultural influences lead to sexual dysfunction, which is especially common in this age group. This unfortunately leads to larger problems in some families and ends as the root cause for many marital rifts. Simple treatments for many of these problems are easily available but a consultation with your doctor is a must.

Medical Problems

Many women develop medical problems like diabetes and hypertension during this period. These illnesses, in the majority present without much warning. Periodic health check-ups are therefore a must.

Osteoporosis and Bone Health

With menopause, bone health starts to decline. Women in this age group also tend to decrease physical activity. It is important to check your vitamin D levels regularly and make sure there is plenty of calcium in the diet in the form of dairy, eggs and nuts. Weight-bearing exercises are also very important and need to be included as part of the daily routine in addition to walking or running.

Obesity and Lack of Energy

Obesity is a prevalent, poorly addressed condition which is the reason for a lot of other diseases like diabetes, dyslipidaemia, endometrial cancer, breast cancer, heart disease and poor bone health.

Women in this age group typically present with a lack of energy and this starts off a vicious cycle. Regular simple exercise at least 5 days a week in the form of walking for 40 minutes with yoga and meditation can be good starting points. The diet also needs to be addressed and necessary changes made.

With proper attention, regular check-ups and input from your doctors, life after 40 can be as productive and peaceful as you wish!

The key is being body and mind aware, not discounting or ignoring small symptoms and giving your-self top priority!


Dr. Vaishnavy Laxman
Consultant Gynaecologist
Kauvery Hospital, Chennai