In your 40s the visible effects of less-than-ideal lifestyle choices may begin to show – on your contemporaries, of course, sooner than on yourself! But time catches up with us all, and it is often in this stage of life that we first really become aware of the ageing of our bodies.
When men put on weight, it tends to accumulate around the waist in the form of abdominal fat. Unlike other fat which collects under the skin, this deeply-seated visceral fat builds up within the abdomen, filling the space between internal organs and increasing the possibility of inflammation throughout the body. If you can’t pinch or grab a fold of skin on the bulge of your belly, you should consult your doctor about whether your abdominal fat may be putting you at greater risk for heart disease, stroke, some cancers, and diabetes.
A rapidly-growing health problem in the modern Western world, Type 2 diabetes is being diagnosed at younger ages than ever before. The condition is distinctly related to lifestyle and dietary habits as well as to genetic influences; risk factors include being overweight, having a family history of the disease, and having high blood pressure. Some signs of a diabetic or prediabetic condition are frequent thirst, blurry vision, and unusual hunger. Your doctor or pharmacist can perform a simple blood glucose test to determine how well your body regulates blood sugar. The test will be done in the morning after overnight fasting (no food or drink for eight hours) and measures your ‘fasting blood glucose level’, which should in most people be between 4 and 7 mmol/l. Depending on the results, your doctor will advise you on how to manage the condition (generally starting with changes to your eating and exercise habits) and tell you when you need to be tested again.
In your 40s you should have a routine physical check-up every two years, at which time your doctor will advise you as to whether you should also step up the frequency of your regular blood-pressure and cholesterol screening tests. If you are or have ever been a smoker, you should have a chest x-ray now too. And if you’re still smoking, you should definitely consider quitting – though of course you know that!
Most men diagnosed with skin cancer are in their 40s, and have generally had the disease for some time, having either ignored or not noticed the early signs of melanoma. It’s vitally important to keep up with regular self-checking, paying particular attention to the head, neck and upper back, as well as having the doctor or dermatologist do a full-body examination every three years. You should of course continue checking for signs of testicular cancer too.
This is the age at which your vision could begin deteriorating so visits to the optometrist should be scheduled every two years, which will also allow for early detection and treatment of other eye conditions such as glaucoma, macular degeneration and cataracts.
Six-monthly dental check-ups are important, not only for keeping your teeth healthy but to screen for signs of gingivitis (gum disease) and periodontal disease, which can be linked to heart conditions and diabetes.
Between the ages of 40 and 50, you should have at least one hearing test.
From 40 onwards, you should have an annual digital rectal exam as the most reliable way to identify haemorrhoids (piles), lower rectal injuries, and any abnormalities in the prostate – including benign prostatic hyperplasia (BPH, which is not cancerous), or early-stage prostate cancer. The test, in which the doctor uses a gloved, lubricated finger to feel for changes to the prostate gland, can be carried out by a GP or a urologist. Unappealing though the prospect of this test undoubtedly is, prostate cancer is the leading fatal cancer in non-smoking men in their 40s so it is well worth picking up on the earliest signs of the disease and treating it at that stage.
Screening for prostate cancer is also possible by means of a blood test for prostate-specific antigen (PSA), although current findings suggest that this test may not be suitable unless there are specific risk-factors such as a family history of any form of cancer. A positive PSA result always needs to be confirmed by a digital rectal exam anyway.
To add to the joys of this stage of life, you could notice a gradual decrease in energy, sexual drive, brain functioning and ability to sleep – what is known as ‘slow-down syndrome’. To some extent this is a normal and unavoidable part of growing older, but if you’re concerned about it your doctor can carry out hormonal testing by taking blood or saliva samples; if testosterone levels are lower than 300 nanograms per decilitre of blood you may benefit from testosterone replacement in the form of skin patches, skin gel, tablets or injections.
Apart from the dawning realisation that immortality probably isn’t an option, if you have maintained good health habits in the form of diet and exercise and if you also keep up a regular schedule of ‘wellness’ tests, you should be able to continue enjoying life to the full in these middle years and beyond.