The middle ages of life (between 40 and 60) are supposed to be productive and enjoyable years. But it’s also a time when men and women often start to see their health decline. Hormone changes play a big role at this time of life.

For middle-aged women, the time marks the transition to menopause. Normally, as the ovaries slow their production of sex hormones, the adrenal glands pick up some of the production slack. But when women are under stress, the adrenal gland is busy secreting stress hormones, and can’t produce enough of the sex hormones. So, as the hormone levels drop, the symptoms of menopause become more evident. Daniel Monti, M.D., Integrative Medicine Specialist with Thomas Jefferson University Hospital in Philadelphia, says stress adds a double whammy because the stress hormones cause the development of fat deposits around the middle, impaired sleep and lower energy levels.

In men, testosterone levels start to decline around 40. In most cases, the decline is slow. But for some, the drop in hormone levels is dramatic. Those changes can lead to “male menopause.” Men with the condition may experience weight gain, decrease in sex drive, fatigue and loss of muscle mass.

Makeovers for Life

Monti and his colleague, Integrative Medicine Specialist Anthony Bazzan, M.D., have written a book, called the Great Life Makeover, to help middle-aged couples get back on track with their lives and improve their health and relationships. The book describes three key issues faced by many middle-aged couples: weight, mood and sexual health.

Many people pack on a few pounds as they get older. Weight is a function of diet and exercise. The Great Life Makeover has suggestions on picking the healthiest foods for the body and provides simple recipes. Monti says foods that are highly processed or high in saturated fat are hard for the body to break down and use, causing inflammation, and ultimately, increasing the risk for health problems. Instead, he recommends aiming for plant-based foods that provide energy for the body and are much easier to process, like green leafy vegetables and dark berries. Look for foods with healthy, omega-3 fatty acids, like salmon. Monti also recommends probiotics and supplementation with vitamin D.

In addition to diet, exercise is also important. Monti recommends couples find activities they both enjoy. Having a spouse as a work-out partner increases the chance of sticking to an activity or exercise program and can bring intimacy into the relationship.

Changes in mood and sexual health are often intertwined with fluctuating hormone levels. Bazzan recommends men and women have their hormone levels measured. If necessary, hormone replacement can be offered. Bazzan prefers the treatment be given in the form of creams and patches. He also offers a subcutaneous (under the skin) hormone implant that lasts for six months. AUDIENCE INQUIRY

The book, The Great Life Makeover, retails for $24.99 and can be purchased through local and online bookstores.

For general information on aging and health:

The AGS Foundation for Health in Aging, http://www.healthinaging.org

American Association of Retired Persons, http://www.aarp.org

Centers for Disease Control and Prevention, http://www.cdc.gov/aging

National Institute on Aging, http://www.nia.nih.gov