Welcome to middle age. As you turn 40, you're more likely to be “settled” in life, work and family. But experts emphasize that you shouldn’t be “settled” when it comes to your health at this milestone. Your 40s are an important time to repair earlier lifestyle mistakes and get your weight within normal range, says Diana Bitner, MD, a physician at Spectrum Health Medical Group in Grand Rapids, Michigan.

Read on as our experts sketch out the six health issues forty-somethings should focus on now:

1. Your metabolism slows down.

Most women gain 15 pounds between the ages of 40 and 55, so this decade is the time to zero in on a diet you can stick with, says Kathryn Boling, MD, a family medicine physician at Mercy Medical Center in Baltimore. This means amping up the fruits and vegetables and eliminating fast foods and fried foods from your go-to list. Cutting down on salt and processed carbohydrates can reduce water retention and that bloated feeling, but don’t cut out whole grains — they’re a good source of fiber, according to the Mayo Clinic.

2. You'll have 'the change.'

For most women, periods are regular until their mid-40s. But then menopause may begin and change that. “Perimenopause cycle changes tend to begin for most women around age 45, and the average age of menopause is 52,” Bitner says. “Habits such as a high-fat diet and smoking can hasten menopause as well as a family history of early menopause or significant health problems such as rheumatoid arthritis.”

What can you expect as your body enters this phase? Your ovaries will start producing less estrogen and progesterone — two types of hormones. As your estrogen levels decline during perimenopause, expect night sweats, hot flashes and vaginal dryness. And as progesterone levels fall, your periods may be irregular, heavier and longer, according to the North American Menopause Society.

3. Your body may start to ache.

At this age, you don’t want to jump right into an exercise regimen. “Exercise caution and care to prevent an injury,” Boling says. Turns out, it’s around 40 that we begin experiencing general aches and pains and can suffer from adult repetitive strain disorders like plantar fasciitis, tennis elbow and more. “This is the time when things like shoulder bursitis, hip bursitis, leg cramps and mechanical lower back pain tends to surface,” says Barbara Bergin, MD, an orthopedic surgeon in Austin, Texas. Still, you want to do what you can at this point in life to actively maintain muscle mass. “Resistance exercises such as interval training or weight-training are very important at this stage of life,” Bitner says.

Unless you have a family history of breast cancer, mammograms usually start at age 40. Unless you have a family history of breast cancer, mammograms usually start at age 40. (Photo: Monkey Business Images/Shutterstock)

4. You'll need a mammogram.

It was once a given that women should get a first mammogram at age 40, but these days, the recommendations vary. The American Cancer Society now says women with an average risk of breast cancer can start mammograms at 45. And the U.S. Preventive Services Task Force suggests waiting until 50. But other groups, such as the American College of Obstetricians and Gynecologists and American College of Radiology and the Society of Breast Imaging, still say to start at 40.

Confused? Speak with your physician about when to schedule an initial mammogram if you haven’t had one yet, Gartenberg says. There’s no one-size-fits-all approach to breast screening and it’s best to be in-the-know about your family health history — both your maternal and paternal side — to trace any hereditary breast cancer. “This is the decade when hereditary factors can truly start to affect a woman’s health,” she says.

5. Your bones get weaker.

This is the decade when bones become thinner, says Elissa B. Gartenberg, DO, a board-certified family physician practicing traditional medicine and holistic care in Scottsdale, Arizona. In fact, one in every two women over 50 will experience an osteoporosis-related fracture in their lifetime, according to the National Osteoporosis Foundation. Be sure your diet is rich in calcium (or supplement with a multivitamin) — your goal is to get three servings of calcium in you daily diet or a total of 1,000 to 1,500 milligrams per day. Also, fit weight-bearing exercise into your day, and if you smoke, quit.

6. Stress levels may rise.

Midlife can be one of the most stressful phases of life, no matter if you’re single, married, have young kids or are an empty-nester. “In my practice, I get a lot of questions such as ‘is life turning out like I thought’ or ‘did I make good choices?’” Bitner says. “At this age, my patients are dealing with aging parents and a continued juggling of many responsibilities so stress management is extra important.”

To combat stress, try to follow the Seven Essential Elements of Daily Success (SEEDS) strategy, Bitner advises. Those seven elements are water, sleep, micronutrients, macronutrients (complex carbs, protein, healthy fats and only one simple carb serving per day), adequate fiber, exercise (aerobic, strength training and stretching/yoga) and a metered breathing/gratitude practice. “Once we’re caring for ourselves with the basics, we’re better able to form connections, keep a positive outlook and ask for help in resolving even the most difficult issues,” she says. “I have seen this plan work countless times.”