The fear of being in your 40s

Warning to all you middle-aged men out there – don’t let a niggling health issue become a major illness. Go to your GP, just do it

Like many people, it took me until my 40s to start to feel like I had a handle on life. The insecurities of youth are (mostly) a thing of the past and while I don’t think I’ll ever feel like a real grown-up, I have managed to make it to 43 without any major health scares.

But just as I felt I was coming into my prime, a certain decline started to set in. Unlike when I was in my 20s, it now takes longer to recover from sports injuries, a bad hangover can last for days and shifting pounds in the gym seems to take forever.

Where once I seemed to be able to eat and drink whatever I liked, I now find myself seeing more of my doctor than I really want to. For the first time, I’m being forced to concede that if I don’t start taking better care of my health, I’m going to suffer the consequences.

Men really are worse at looking after themselves than woman and the reality is that many tend not to present to doctors until they absolutely have to

Because once men hit their 40s, a whole host of issues start to raise their heads. That’s also true for women but it’s worth remembering that men die an average of five years younger than women.


In addition, men are notoriously bad at looking after their own health.

If you are a man born in the 1970s, then you come from a generation that was raised on traditional masculine values. Men are meant to be stoical and self-reliant, and ideally, invulnerable. From adolescence to old age, men consistently avoid seeking medical help. But not every pain goes away on its own, and not every concern turns out to be nothing.

"Men really are worse at looking after themselves than woman and the reality is that many tend not to present to doctors until they absolutely have to. When they develop a problem, they try to manage it themselves," says Dr Lawrence Lau, a general practitioner working at the Capel Street Medical Centre in Dublin. "It's only when the symptoms become really bad and discomfort overwhelms reluctance that we see them. They wait and wait and when they do eventually come in, the situation is often really serious or it can even be too late."

Put up with discomfort

In several instances, Dr Lau has seen men at his practice who have put up with serious health issues for up to 10 years before seeking medical help. The tragedy is that often they’ve made an unserious situation way worse by not dealing with it and have put up with discomfort for years for no real reason.

So what are the issues that affect men in particular in their fifth decade? According to Dr Lau, those issues that impact this cohort can be neatly grouped into three areas – genital and urinary issues, heart disease and stress-related illnesses. “The big one is issues to do with the urinary system. It’s in your 40s that we get the early warning signs from your toilet habits. If you’re going to the toilet more often than normal, if you’re experiencing any dribbling after going to the toilet or if you’re waking at night to go to the toilet more times than normal – these cause alarm bells to ring and suggest that you need to get your prostate checked.”

Look, the reality is that it's entirely normal to not want to talk about your sex life or your genital health with your GP but you just have to get over that awkwardness

Erectile problems are also something that affects men in their 40s and, understandably, many sufferers prefer not to talk about the problem. “It happens to lots of men and they don’t want to do anything about it out of embarrassment. The sexual drive decreases naturally at around this age but if you’re not lasting as long during sex or there are significant change in erections then that’s something to get checked.”

There are multiple reasons why this is a good idea. Sexual dysfunction has knock-on effects on relationships and can seriously knock a man’s confidence. In addition, it can be a warning sign that all is not right with the body.

“Just go to your GP – these things are easy to manage and treat, and importantly, they can be early warning signs that there can be problems in your cardiovascular system. Erectile problems can be linked to increased cholesterol and blood pressure problems,” says Dr Lau.

If these are caught early, they can usually be easily treated and the risk of heart attack or stroke in the next 20 years minimised.

“Look, the reality is that it’s entirely normal to not want to talk about your sex life or your genital health with your GP but you just have to get over that awkwardness. They deal with it all the time, it’s literally their job and it is hugely important,” Dr Lau says.

Men don't verbalise their emotions too much and many are in denial about their mental state

Among the subjects most men are uncomfortable talking about, right after sexual dysfunction, is emotional health. But for guys in their 40s, a stoical attitude to work and life formed in their semi-resilient 20s can come back to haunt them two decades later. “Quite a few of my patients come to me at this age and they’re burnt out. Many men love to work, to do things and be active but they don’t realise their limitations. They just keep working at the same rate all the time without a break and then they end up at the doctor as a result,” says Dr Lau.

“They say they’re tired, can’t concentrate and in general they’re not doing as well as they used to but after a few questions I find they haven’t taken a break in years. They put their work and their families ahead of their own health and after enough time it catches up with them. It’s in their 40s that this typically catches up with men and I have to tell them to slow down and make time for relaxation and for themselves. If they don’t, the symptoms get worse.”

Attitudes to work and life – as well as natural life events like losing parents and experiencing death and illness amongst friends and colleagues – all takes more of a toll on people at this age than before.

‘Anxiety and depression’

“Anxiety and depression are also things that frequently arise at this age point. Men don’t verbalise their emotions too much and many are in denial about their mental state. They say they don’t have anxiety and depression but then you ask them what their symptoms are and they fit those conditions.”

When it comes to diet advice, the message from registered dietician Aveen Bannon is that the three areas that impact men in their 40s the most are heart health, digestive health and physical/muscle health.

“Heart health is a big issue for men in this age bracket. Pre-menopausal women have the cardio-protective effect of oestrogen in their systems but obviously men don’t have that. Often, men have been very sporty in the past and been able to get away with eating whatever they want,” she says.

“But in their 40s, often the amount of exercise they do decreases and yet they keep eating in much the same way they always have. At the same time, life becomes more stressful and lots of different health factors come into play.”

All of this leads to health issues that present around this age. A lot of early warning signs get ignored until men get older and then many find themselves in the position of trying to get their blood pressure down, their cholesterol down and their weight down.

“Heart health is incredibly important, but so too are other aspects of health impacted by diet. Take protein intake – as we get older, our protein requirement slightly increases, so men should make sure they’re spreading out their protein intake throughout the day,” says Bannon.

This is important as it helps reduce the loss of lean muscle mass. Men in their 40s who don’t exercise as much as they used to and who don’t eat properly will experience a loss of lean muscle mass.

Most people will be aware of the impact of metabolic slowdown, that the way our bodies take in and burn energy from the food we eat changes over time, slowing and becoming less efficient. This is the reason why in our early 20s, it was possible to live on takeaways and do some moderate exercise but not put on weight.

In your 40s, you only have to look at a cream cake and the pounds go on. “The reason for this is to do with muscle mass. The more muscle tissue you have the more active your metabolism. Naturally, as we age, we experience a slight loss of muscle mass and our metabolic rate slightly decreases,” says Bannon.

The moral of the story is that the more a man minds himself in his 40s, the better a chance he gives himself of living a longer and more full life.

- Health advice for women in their 40s
- Health advice for men in their 40s