The Surprising Signs of Ageing, Decade by Decade–and the Smart Moves to Make Now

Wouldn't it be amazing if you could look into a crystal ball and know exactly what health challenges might be waiting for you five, 10 or 20 years in the future? This would give you plenty of time to make positive changes now to stay healthy later, potentially changing your destiny for the better.

While we may not have mystical powers to see into the future, we can tell you, in general, what to expect each decade of your lifespan – including some surprising changes – and how to prepare yourself mentally and physically to age well. Follow this advice to fully enjoy the next stages of life.

What to Expect in Your 40s

What You’ve Probably Heard About

Get ready to say hello to perimenopause. This is when oestrogen has major fluctuations in the run-up to menopause, potentially causing hot flushes, mood swings, sleep woes, and magically disappearing and reappearing periods.

What May Surprise You

If you're experiencing uncomfortable, or even painful sex, that may be because vaginal dryness can start even before menopause hits; as oestrogen production winds down, vaginal tissues become thinner, drier and less pliable. That's why healthcare professionals should be talking about this with women in their 40s, says Sheryl Kingsberg, a psychologist and menopause specialist.

Sheryl points out that a lubricant or moisturiser may not be enough to counteract the hormonal changes. That's why supplemental vaginal oestrogen – via a ring, a vaginal insert, a cream or a suppository – is the first line of treatment, she says. (If you're worried about whether the use of hormones may increase the risk of breast cancer even slightly, keep in mind that topical oestrogens like these are safe for almost everyone because very little of it enters the bloodstream.)

Sheryl also highly recommends using a vaginal moisturiser twice a week to soothe irritated tissues. You'll want a high-quality lubricant for sex, too – but skip the 'natural'-sounding water-based ones, says Dr Lauren Streicher, a menopause and sexual health specialist and host of the podcast Inside Information: Menopause, Midlife, and More.

Water-based lubricant products often contain ingredients, such as glycerin and propylene glycol, which will pull moisture out of the cells of the vaginal tissue and actually make them feel even more fragile and dry. Instead, choose a silicone-based product or a water-based one with an osmolality rating of less than 380mOsm/kg, Sheryl says.

Other Smart Moves to Make in Your 40s

Deal With Incontinence ASAP

If you leak a little bit every time you laugh at an SNL sketch or cough, you can blame the effects of pregnancy, childbirth and hormonal changes on your pelvic floor muscles. Some medications can help, but working with a pelvic floor physiotherapist can keep the problem from getting worse with age, says Sheryl.

You can improve a weak pelvic floor with exercises, stretches, hands-on techniques, biofeedback and electrical stimulation.

Get Smart About Brain Health

The spectre of Alzheimer's disease and other forms of dementia can be so scary that you may not want to even think about it for a few more decades. However, research indicates that menopause is an early trigger for brain changes that may eventually lead to the disease.

Making lifestyle changes now, such as doing cardio exercise, leaning into a plant-rich diet and getting a proper night's sleep, can help you push potential cognitive impairment further and further down the road.

Step Up Your Preventative Health

Talk to your doctor about when to have your first colonoscopy, if you haven't already, and make mammograms a part of your wellness routine.

If you're newly dating and didn't get the HPV (human papillomavirus) vaccine as a teenager, it may still be worth a chat with your doctor. Even started later, the vaccine can offer some protection, says Dr Scott Roberts, an infectious disease specialist. “It protects against the genital wart-causing strains of HPV as well as the cancer-causing strains,” he adds. In Australia, HPV vaccination isn't routinely recommended or funded beyond age 25, though your doctor can advise if it's appropriate for your circumstances.

What to Expect in Your 50s

What You’ve Probably Heard About

You need to really start thinking about your heart: oestrogen helps protect the heart, so when the hormone declines during menopause, the risk of cardiovascular disease rises sharply. In fact, by age 55, more women than men have risk factors such as high blood pressure and high LDL cholesterol.

Safeguard your heart by talking to your healthcare provider about strategies for lowering your blood pressure and cholesterol if needed, regulating blood sugar, exercising most days of the week, sleeping well, maintaining a healthy body weight, managing stress, quitting tobacco if you still smoke, and eating meals that are high in plant foods and low in saturated fat.

What May Surprise You

Even if your youngest baby is now in college – or even has a baby of his or her own – complications from your previous pregnancies, such as preeclampsia and eclampsia, can raise the risk of high blood pressure fourfold and double your chance of heart disease and strokes later in life. “It changes the equation for how we think about a woman's risk of developing cardiovascular disease, even if they're way beyond the reproductive years,” says Dr Erica Spatz, a cardiologist.

So even if you don't think something that happened decades ago will affect your health now, tell your doctor about your full medical history (especially if you've changed docs since your baby-rearing days).

Watching your heart health has added payoffs for your brain, too. Research shows the closer you adhere to heart-healthy habits in midlife, the lower your risk of dementia as you age.

Other Smart Moves to Make in Your 50s

Protect Yourself Against Pneumonia

When you get your annual flu shot, ask about a pneumococcal (pneumonia) vaccine, too. The Australian Immunisation Handbook recommends it for all adults 65 and over. It's free under the National Immunisation Program at that age, with earlier access for First Nations Australians from age 50 and for people with certain health conditions.

Keep Shingles on the Roof

When they're on your skin, they're not only extremely painful and potentially debilitating, but they also can lead to complications, including vision impairment. The shingles vaccine (Shingrix), given as two shots two to six months apart, helps prevent the reactivation of the dormant virus in people who've had chickenpox. It's free under the National Immunisation Program for adults 65 and over, First Nations Australians 50 and over, and immunocompromised adults 18 and over at high risk of shingles.

Do a Supplement Check

At around age 50, you can begin to produce less stomach acid, which you need to break down foods to let you absorb vitamin B12. So talk to your doctor about supplements of the vitamin.

You may also need a vitamin D supplement because your body is less able to produce it through sunlight exposure than those of younger people.

Keep in mind that supplements are intended to supplement the diet. They are not medicines and are not intended to treat, diagnose, mitigate, prevent or cure diseases.

What to Expect in Your 60s

What You’ve Probably Heard About

This is the age to really start focusing on brain health. And doing so should actually be a lot of fun: when you take up a new activity such as quilting, salsa dancing, pickleball or learning Japanese, your brain churns out new neural connections that help keep it young.

What May Surprise You

Staying in touch with old friends – and making some new ones – is incredibly important at this age, especially as your kids leave home, you retire from the job where you chatted with coworkers, clients or customers all day long, and you see friends and even partners move away or pass away. Loneliness and isolation are big risk factors for cognitive decline, dementia, cardiovascular disease, stroke, type 2 diabetes, depression and anxiety, and even earlier death.

“Many women in their 60s and beyond find it really hard to make new friends,” says Dr Gail Saltz, a psychiatrist and psychoanalyst. “It takes a serious, concerted effort and putting yourself out there, which can be harder to do at this stage because there are fewer natural touchpoints.”

If you're thinking of relocating, consider a community where you can walk to a lot of places, so you'll be more likely to meet up with neighbours. Consider joining groups related to your interests (book clubs, organisations at your place of worship) while embracing the casual connections of everyday life (go ahead and chat up the barista at your favourite coffee shop or the person next to you in line, for instance). Research shows that people who have more of these types of interactions score higher on measures of life satisfaction. They also get a brain boost.

“Unexpected interactions – in which a person tells you something and you have to say something back, so you're thinking on your feet – provide exactly the kind of stimulus that's good for a brain in terms of staving off cognitive decline,” says Dr Saltz.

Other Smart Moves to Make in Your 60s

Step Up Your Exercise

Being physically active is good for every system in your body as you age – from brain to heart to digestion. Focus on functional movement, the kind that helps you with day-to-day tasks. The big goals now are grip strength, a marker for overall muscle strength, and joint flexibility, which at least one study links to a longer life.

“People who are more flexible tend to have a better chance to recover their balance when they're unstable, and in case of a fall they would be less prone to getting severely injured,” says study author Dr Claudio Gil Araujo, an exercise medicine researcher in Brazil.

Spark a Lagging Libido

For many 60-somethings, fewer responsibilities and no kids in the house can mean a new burst of sexual activity. But if you're just not feeling it – and, importantly, if you want to feel more in the mood – ask your doctor about treatments, including additional systemic testosterone and local vaginal DHEA.

In the US, doctors also prescribe the nonhormonal medication flibanserin (Addyi) off-label for postmenopausal women, says Dr James Simon, a menopause and sexual health specialist. (Flibanserin isn't approved or available in Australia.) The antidepressant bupropion may also help: “It has positive effects, principally on arousal and orgasm,” he says. (In Australia, bupropion is sold as Zyban and is approved only to help people quit smoking, so using it this way would be an off-label decision for your doctor to make.) And at low doses, trazodone, another antidepressant often used as a sleep aid, may increase sexual desire.

Stock Up on Condoms

Yes, really. Though getting pregnant in your 60s would be a real miracle of modern medicine, getting a sexually transmitted infection is a legit possibility if you're hitting up the dating apps or the singles bars.

In fact, chlamydia diagnoses among Australians aged 40 and over rose by more than 70 per cent in the decade to 2022, according to Kirby Institute data. Practise safe sex, and be sure to see the gynaecologist every year to check your STI status (sometimes there are no symptoms), as well as to head off other common problems such as pelvic organ prolapse, says Sheryl.

What to Expect in Your 70s and Beyond

What You’ve Probably Heard About

Our senses of hearing and sight can naturally start to dim, but hearing aids are better, smaller and less expensive than ever before. And your eye doctor may recommend cataract surgery, which not only clears the cloudiness but also corrects your vision, meaning you may no longer need glasses or contacts.

What May Surprise You

Hearing loss affects more than your ability to hear the TV or your granddaughter's giggles over the phone: Uncorrected hearing loss has been linked to isolation, dementia and even a shorter lifespan.

Hearing problems can also have an impact on how you care for yourself. “If you're not hearing as well, you can't take in, understand, or remember what your doctor told you to do, so you're less likely to treat your health issues properly,” says Melissa Karp, an audiologist in Charlotte, North Carolina. “You also have an increased fall risk.” There's a similar impact when you don't correct your vision.

Keep in mind that hearing aids need to be fitted properly, adjusted and objectively verified to work well. Plus, tucking something into or behind your ear no longer has the same stigma. “You see people wearing earbuds and huge headphones all the time, and hearing aids are actually a lot less noticeable,” Melissa says. “And I always tell patients that people are much more likely to notice your hearing loss than your hearing aids.”

Other Smart Moves to Make at 70+

Get Creative in Bed

If hormonal changes are making standard-issue vaginal intercourse uncomfortable, there are plenty of new positions and erotic areas on your body to explore. Plus, you should be able to talk to your gynaecologist about any issues related to your sex life, no matter your age.

If your doc doesn't acknowledge your concerns or offer help, consider finding someone new. “Sexuality is important to everyone's physical health and quality of life, no matter what their age,” says Sheryl.

Relax About Your Weight

Research suggests that it's actually fine to carry a little bit of extra weight in your older years, assuming you're not obese to start with. In fact, being a little heavier can help protect against an early death; both thinner and much larger body types have a greater mortality risk. Talk to your doctor about a healthy weight range for you.

Boost Your Balance

Falls can have life-changing consequences, so be sure to include balance training in your exercise routine. This includes movements like standing on one leg and walking heel-to-toe. Also, check for fall hazards like throw rugs, and find ways to make your home safer.

The Surprising Role of the Ovaries in Aging

You may not think much about your ovaries after they've done their job of producing eggs during your childbearing years, but these two little almond-shaped organs found on either side of the uterus have a surprising effect on how you age, far beyond the reproductive years.

Here, Jennifer Garrison, an ovarian ageing researcher, discusses what her work – and research from many others – shows.

When Ovaries Age, Things Start to Go South

The ovaries are endocrine organs, “producing dozens, if not hundreds, of hormones – in addition to oestrogen and progesterone – that are signalling like a second brain to almost every tissue in a woman's body,” says Jennifer.

Your ovaries “communicate with your bones, heart, liver, muscles and skin” through chemical messengers, and ovaries promote health at every age. Heart disease and osteoporosis have been linked to the drop in oestrogen as women reach menopause – and brain health may worsen as well. “There are risks associated with the changes in the ovaries, including cognitive decline, which can set the stage for Alzheimer's disease,” Jennifer explains.

Ovaries Age Faster Than Every Other Organ

They age “at about two and a half times the rate of the other tissues in the body,” Jennifer says. “This likely has big consequences for health span, the time we remain healthy and free from disease.” She points out that women have shorter health spans than men at baseline.

Menopause Makes Your Body Age Faster

When your ovarian function declines, the rate of ageing of other tissues in your body can increase, Jennifer says. Menopause can speed up your cells' ageing rate by almost six per cent. This can have a significant effect on how well you feel overall.

What This Means for You

We know that the older a woman is when she goes through menopause, the longer she is likely to live, Jennifer says. Now her lab is exploring whether slowing down ovarian ageing might keep women healthier longer as well. But each woman has her own ageing journey.

“Hormone therapy may help, though our knowledge about it is incomplete,” Jennifer says. “My vision is that there will eventually be a menu of options for women, including lifestyle changes – nutrition and exercise – and medications that would help to preserve ovaries' function into older age.”