Say hello to the “sandwich years”, where the manic combination of working, caring for small children, having older children with hectic schedules, and looking out for ageing parents can lead you to forget about the one thing in your life that used to be so important: you.
The key to navigating these years is finding ways to manage those pressures and ensuring they don’t affect other parts of your life.
Easier said then done? Not so! While things like a healthy sex life, sleep schedule, stress management and fitness routine might seem like a thing of the past, there are a number of things you can do to get back into the swing of things.
We’ve asked a number of experts to share the very best tips and tricks to help you do so…
Erectile dysfunction can happen at any age but studies show an increase in prevalence from 40 onwards, says David Goldmeier, a leading consultant in sexual health based at Imperial College London. “In the younger man, it’s usually related to performance anxiety, but in older groups it’s caused by all the same conditions that predispose to heart problems and strokes: high blood pressure and cholesterol, diabetes, being overweight.
“So anyone experiencing a persistent sexual problem should go to their doctor.” Treating these problems through lifestyle changes such as exercise, diet and giving up smoking, can improve erectile dysfunction.
“Once all the underlying causes have been looked at, you can use any of the PDE5 inhibitors such as sildenafil (Viagra).”
Stress over work, children and caring for elderly parents can leave people in their 40s exhausted and time-poor. “Couples go to therapy and say there’s a problem with the sex, but when you start to talk it’s because there are problems in the relationship. People are so busy, there’s no time to talk about it,” says Amanda Major, a sex therapist and head of clinical practice at Relate.
Another mistake people make is having sex when they’re too tired, she says. “They end up feeling resentful, frustrated and used, and the experience is almost ‘by rote’.”
Try changing your habits – especially tech habits – and make time not just for sex, but for talking, touching and reconnecting. Remember, too, that a loss of interest in sex can be an early sign of depression. “This can be more obvious to see in men than in women,” says Dr Elise Dallas, clinical lead of women’s health at private GP service Babylon. “However men are not so great at coming forward.” For mild to moderate depression, a GP can refer you for CBT, she says, adding that the picture can be complex because anti-depressants can cause sexual problems of their own.
If vaginal dryness is an issue, consider whether you need to switch contraceptive, says Dr Dallas. “People in their 40s are often wanting a longer-lasting form, such as the coil – but it can cause dryness and affect libido.”
Heavy snoring caused by sleep apnoea is common as people hit midlife, says Dr Guy Leschziner, a world-renowned neurologist. Sleep apnoea is where the soft tissues in the throat collapse during sleep, temporarily – but often repeatedly – obstructing breathing, disturbing sleep, although you may not remember in the morning. It’s associated with being overweight, and particularly with weight around the abdomen and neck.
“If you’re snoring, feeling tired in the day, or waking yourself up choking or gasping this could point to sleep apnoea,” says Dr Leschziner. “The first thing to try is weight loss, as that often improves it.”
It can also be treated with a continuous positive airway pressure (CPAP) device – a small pump and breathing mask to keep the airway open.
As children start to fly the nest, leaving you with a spare bedroom, Dr Neil Stanley, an independent sleep researcher and author, suggests this may be a good age to consider a ‘sleep divorce’: separate beds, or even bedrooms. “It’s got nothing to do with the strength of your relationship,” he says. “It’s just pragmatic. We know from research that the majority of sleep disturbance is down to your bed partner, whether it’s physical movement or the noises they make.”
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Dr Chetna Kang, a consultant psychiatrist at London’s Nightingale Hospital, says: “Struggling to concentrate or making more mistakes are common cognitive signs of stress, physical symptoms could be stomach aches or upsets and getting more colds than usual, while common behavioural signs of stress are not sleeping well or sleeping excessively.”
Dr Mithu Storoni, a neuroscientist and author of the book Stress Proof, recommends the following counter-intuitive strategy: “After a stressful event is over, never relax,” she says. “There’s a saying that an empty mind is a devil’s workshop – and it really is. Studies are showing that it’s how we perceive our experience of something stressful that’s important.
If your mind keeps replaying what has just happened, the biological pathways that are active in the moment of stress continue to be active and you take longer to recover. “Instead, you need to do something so absorbing that your mind cannot revisit the scene – knitting or playing a game like Tetris work really well for this sort of distraction,” she says.
For the sandwich generation, hectic lifestyles can get in the way of exercise, and stress itself can trigger the start of the dreaded middle aged spread.
“The stress hormone cortisol forces the body to access its sugar resources so it doesn’t burn away as much fat,” says Matt Roberts, celebrity personal trainer and author. “This can accumulate as visceral fat around your belly and organs, which can then increase your risk of type 2 diabetes and high cholesterol.”
To bust stress try brisk walking, spin classes, jogging and swimming.
Meanwhile, the trend for endurance activities such as long-distance cycling, Iron Mans and marathons among middle-aged people is actually quite welcome in biological terms, says Dr Polly McGuigan, senior lecturer in biomechanics at the University of Bath.
“The first muscle fibres we start to lose as we get older are our fast twitch muscle fibres, which are the ones we use when sprinting, or heavy lifting. But our slow twitch muscle fibres are recruited more during endurance activities.”
However, take it slow, use a proper training programme and keep working on muscle strength to avoid injury, she says.
Women in their 40s may be approaching the perimenopause and menopause, and fluctuations in oestrogen may already be affecting bone density, says Professor Greg Whyte OBE, a world-leading sports scientist, so try racket games such as squash, tennis and badminton, or “good old-fashioned load-bearing jogging and fast-paced walking”.
As for the ever-expanding spare tyre, Roberts recommends lifting heavy weights three times a week to really elevate metabolism: think weighted squats, lunges, bench presses and dead lifts. “Combine that with high intensity interval training [HIIT] three times a week with long rest intervals.”
Core development work is important, now too, he adds: try pilates, or anything that works the internal abdominals.