6 Things Women Wish Their Doctors Told Them About Turning 50

2.    Alcohol will hit you harder

You’re not imagining it. As you age, that glass of wine or after-dinner cocktail affects you more than it used to.

“People get more sensitive to alcohol’s side effects,” Rexrode says.

Your body metabolizes alcohol more slowly as you get older. In addition, because muscle mass declines with age, there is less muscle tissue to absorb the alcohol. Meanwhile, the medications you take can also interact with alcohol, intensifying its effects.

The fix: Try a mocktail. Thanks to the growing number of booze-free beverages on the market, you don’t have to drink alcohol to enjoy a delicious after-dinner drink. If you do choose to drink alcohol, follow the U.S. Dietary Guidelines, which call for women to consume no more than one standard drink in a day. Generally speaking, that’s 12 ounces of beer, 5 ounces of wine or 1.5 ounces of spirits.

3.  Heart disease is a greater risk that you realize

More women in the U.S. die of heart disease than any other cause, but many women still don't recognize it as something they need to worry about, says Martha Gulati, M.D., an expert in women’s heart disease at Cedars-Sinai Medical Center’s Smidt Heart Institute in Los Angeles.

In a 2019 survey of 1,553 women published in the journal Circulation, only 44 percent correctly identified heart disease as the leading cause of death for women in the United States.

“When we ask them, ‘What's your leading health concern?’ they say breast cancer,” Gulati says. “In fact, women have a tenfold greater risk of dying from heart disease than they do from dying of breast cancer.” 

A woman’s risk of heart disease rises notably after menopause, and that’s often when women first develop cardiovascular risk factors such as high blood pressure or high cholesterol. Even women who have always been told they have low blood pressure may find that it suddenly rises after menopause, bumping up their chance of having a heart attack or stroke, Gulati says.

The fix: Ask your health care provider to assess your risk of a cardiovascular event in the next 10 years (or do it yourself using this calculator). Then focus on lowering risks you can control by adopting a healthier lifestyle. You will get the most bang for your buck by adding more physical activity to your day, Gulati says. When it comes to your diet, eat more plants and avoid saturated fat.

4.  Sex might become uncomfortable

After menopause, low hormonal levels make the vaginal walls thin and dry, leading to sensitivity, painful intercourse and a loss of desire, says Karyn Eilber, M.D., a urogynecologist at Cedars-Sinai Medical Center in Los Angeles.  

About 17 to 45 percent of postmenopausal women say they find sex painful, according to studies cited by the North American Menopause Society.

Although it can feel awkward, it’s important to communicate problems with your partner and your health care provider, Eilber says, because the condition is treatable.

The fix: For some women, over-the-counter lubricants and moisturizers do the trick. If not, talk to your doctor about different types of hormone therapy. Vaginal estrogen cream is safe for most women, Eilber says, and it “can build back up the lining of the vagina, which helps with lubrication and to maintain elasticity.”  

5. Your sleep patterns change

If you’ve gone through menopause, you may already know how a hot flash can wake you up, drenched in sweat, from a deep sleep. But even after hot flashes subside, other hormonal changes and the increase in your core body temperature that happens in middle age can impact the quality and duration of your sleep, says Kristin Daley, a psychologist and sleep medicine expert who chairs the clinical practice committee for the Society of Behavioral Sleep Medicine.

Women in their 50s are more likely to struggle to get quality sleep.

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You may wake more often during the night or notice that your sleep seems less restful. In addition, you won’t be able to bounce back as quickly from a poor night of sleep or if you experience a time change while traveling, Daley says.

“Our time in bed and our circadian rhythm become more vulnerable to negative influences,” Daley says. “If you were the person who could sleep with the blinds open, you might not be that person anymore. We become incredibly sensitive to light exposures.”

The fix: Research shows you can still get a great night’s sleep by practicing good sleep hygiene. Try to go to bed and wake up at roughly the same time every night. Keep your bedroom as dark as possible. And turn the thermostat down to 65 to 67 degrees Fahrenheit at night. Getting exercise and exposure to bright light every day are also important, Daley says. (See “7 Expert Tips for a Better Night’s Rest.”)

6.  Your bones get more brittle

Beginning around age 50, everyone starts to lose some bone density. For women, however, menopause significantly accelerates that bone loss. By some estimates, women lose as much as 20 percent of their skeletal mass during menopause.

“The drop in estrogen has a very direct effect on bone,” Rexrode says.

That puts women at greater risk of osteoporosis, a bone-weakening disease that can lead to fractures.  Osteoporosis affects about one in five women over age 50, but only one in 20 men.

The fix: Weight-bearing exercise such as strength training, walking, hiking, climbing stairs, tennis and dancing can help strengthen bone. “It shifts the formative structures inside the bone, telling the bones to stay strong,” Rexrode says. At the same time, make sure you get enough calcium and vitamin D, either from your diet or from supplements. Aim for 1,200 milligrams of calcium and at least 600 IU of vitamin D per day. (See “7 Surprising Ways to Strengthen Your Bones.”)