Hormone Balance and Aging: How Do Our Hormones Change In Our 40s and Beyond?
Over 50 hormones have been identified in the human body, from melatonin and insulin to oxytocin and dopamine. But when most people talk about hormones, they’re typically thinking of the sex hormones—estrogen, testosterone, progesterone, and DHEA. These hormones are the ones most likely to change with age, from our embarrassing teenage years of puberty to menopause and andropause—the so-called “male menopause” characterized by declining testosterone levels—in our mid-life years.
But how exactly do our hormones change as we reach our 40s and beyond—and how do these alterations affect our health and longevity? Let’s find out.
Why Are Sex Hormones Important?
The hormones estrogen, testosterone, progesterone, and DHEA have roles that go far beyond reproduction, with functions including:
- Reproductive health: In women, estrogen and progesterone are needed to regulate ovulation, menstruation, and pregnancy, while men require testosterone for sperm production.
- Sexual development and function: Everyone who went through puberty knows firsthand the effects of hormones on secondary sexual characteristics (like hip widening in females and voice deepening in males). Healthy hormone levels are also needed for sex drive and function.
- Bone health: In women especially, estrogen maintains bone density and strength. This is a leading reason why older women have increased rates of bone loss, as menopause drastically reduces estrogen levels.
- Emotional health: Fluctuations in hormones (and unhealthy balances of them) can drastically influence mood and emotions. Estrogen and progesterone—and their fluctuation during the different phases of the menstrual cycle or menopause—are particularly involved with emotions and mental health.
- Muscle health: Testosterone is well-known for its role in supporting muscle mass and strength—in both men and women.
- Cardiovascular health: Estrogen plays a protective role in heart health by supporting blood vessel health and cholesterol levels. When estrogen levels decrease after menopause, women may have an increased risk of cardiovascular conditions for this reason.
- Brain health: Estrogen levels may also influence cognitive function—especially memory and concentration. Research suggests that estrogen is neuroprotective against oxidative stress, modulates cerebral blood flow, and may promote neuroplasticity.
Women, Hormone Balance, and Healthy Aging
Menopause is the most well-known time of hormonal changes in a woman’s life (other than any pregnancies she may have). While the average age of menopause is 51, there is an almost two-decade span of typical onset, ranging from age 40 to 58.
Marked by the cessation of menstrual periods, menopause is characterized by many hormone-related symptoms like hot flashes, mood changes, brain fog, night sweats, and reduced libido—all of which can be attributed to drastic declines in estrogen and progesterone production.
However, women don’t have to wait until menopause to experience these fun symptoms, as perimenopause—the several-year period before menopause actually occurs—can involve the same hormonal fluctuations. Perimenopause, which begins in some women in their 30s but most often starts between ages 40 to 44, can cause estrogen levels to surge and drop unexpectedly, leading to irregular periods, insomnia, mood swings, and more.
Starting menopause earlier—which leads to lower lifetime estrogen levels—is linked to reduced lifespan. In a study of over 1,200 women, those who experienced premature menopause (age 39 or younger) had a 46% increased risk of mortality from any cause compared to women with average-aged menopause.
Upon reaching her 40s, females also see a decline in fertility, as the ovaries have reductions in both the quantity and quality of eggs remaining while FSH (follicle-stimulating hormone) levels increase. FSH levels increase in perimenopause and menopause because this hormone causes ovarian follicles to produce estrogen—but with age, fewer estrogen-producing follicles remain. This creates a feedback loop where your brain signals to produce more FSH to prompt the follicles to make estrogen, but there aren’t enough of them to use the FSH, leading to higher blood FSH levels.
Testosterone and DHEA also decrease with age in women, leading to changes in libido, energy levels, and body composition (favoring fat storage over muscle mass).
Estrogen is linked to mood, cognition, heart health, and bone density. Some research suggests that hormone replacement therapies given close to the onset of menopause (rather than later on) can benefit cognition and reduce the impact of memory loss or brain fog from declining estrogen levels, although more studies are needed on this topic.
Men, Hormone Balance, and Healthy Aging
Where women have menopause, men have “andropause”—the time when androgen hormones like testosterone and DHEA decline with age.
Testosterone production typically starts to slowly decline in the mid-to-late 30s in men, but symptoms can become more noticeable in his 40s. Common symptoms of andropause include fatigue, decreased muscle mass, mood changes, reduced libido, and sexual dysfunction.
In a study with men over age 64, those with higher testosterone levels had greater skeletal muscle mass, grip strength, walking speed, and physical performance. Testosterone levels also impact longevity, as seen in this study of over 10,200 men that found those with the lowest testosterone to have the highest rates of all-cause mortality, especially after age 60.
Men in their 40s and beyond also experience decreases in DHEA, a hormone produced by the adrenal glands. Compared to our younger years, DHEA levels at age 75 are about 15% of what they were in youth. DHEA is a precursor for other hormones (including estrogen and testosterone) and aids in muscle maintenance. It also plays a role in cognitive function, mood, and antioxidant defense.
DHEA has been found to enhance the muscle-building and metabolic effects of weight training and improve mood and memory. Unlike estrogen and testosterone, DHEA is available as a supplement rather than a prescription treatment.
How Can You Support Healthy Hormones With Age?
While many of these hormonal changes—especially those related to menopause—are inevitable, there are things we can do to support these processes and lessen symptoms.
Stress management, regular physical activity, and maintaining a healthy diet filled with protein, healthy fats, and antioxidants can help to support hormone health with age. Restoring NAD+ levels with precursors like NMN or NR may also benefit our hormones, as NAD+ is required for proper sirtuin functioning. Sirtuins can enhance estrogen and androgen receptor sensitivity, meaning that the hormones can be better utilized by the body.
Limiting toxin exposure as much as possible can also help hormonal health at any age. Our modern environment is filled with endocrine-disrupting chemicals (like BPA, PFAS, phthalates, parabens, and pesticides) that mimic, block, or interfere with the body’s hormones—especially estrogen. Chronic or heavy exposure to endocrine disruptors is linked to premature menopause and can reduce testosterone levels. Try to reduce your exposure to endocrine-disrupting chemicals by limiting single-use plastic, buying non-toxic and fragrance-free skincare, cleaning products, and personal care items, reducing pesticide intake by buying organic produce, and filtering your drinking water.
Overall, hormones are meant to fluctuate with different ages and life stages—however, sometimes, they can go too far in one direction. Lower estrogen and testosterone levels with age are associated with worse health outcomes, so supporting healthy hormones can reduce symptoms and improve overall vitality and longevity as we age.
Auyeung TW, Lee JS, Kwok T, et al. Testosterone but not estradiol level is positively related to muscle strength and physical performance independent of muscle mass: a cross-sectional study in 1489 older men. Eur J Endocrinol. 2011;164(5):811-817. doi:10.1530/EJE-10-0952
Aydemir D, Ulusu NN. The possible role of the endocrine disrupting chemicals on the premature and early menopause associated with the altered oxidative stress metabolism. Front Endocrinol (Lausanne). 2023;14:1081704. Published 2023 Feb 14. doi:10.3389/fendo.2023.1081704
Jung BH, Jeon MJ, Bai SW. Hormone-dependent aging problems in women. Yonsei Med J. 2008;49(3):345-351. doi:10.3349/ymj.2008.49.3.345
Morgan KN, Derby CA, Gleason CE. Cognitive Changes with Reproductive Aging, Perimenopause, and Menopause. Obstet Gynecol Clin North Am. 2018;45(4):751-763. doi:10.1016/j.ogc.2018.07.011
Muehlenbein MP, Gassen J, Shattuck EC, Sparks CS. Lower testosterone levels are associated with higher risk of death in men. Evol Med Public Health. 2022;11(1):30-40. Published 2022 Dec 26. doi:10.1093/emph/eoac044
Sripada RK, Marx CE, King AP, et al. DHEA enhances emotion regulation neurocircuits and modulates memory for emotional stimuli. Neuropsychopharmacology. 2013;38(9):1798-1807. doi:10.1038/npp.2013.79
Villareal DT, Holloszy JO. DHEA enhances effects of weight training on muscle mass and strength in elderly women and men. Am J Physiol Endocrinol Metab. 2006;291(5):E1003-E1008. doi:10.1152/ajpendo.00100.2006
Xing Z, Alman AC, Kirby RS. Premature Menopause and All-Cause Mortality and Life Span Among Women Older Than 40 Years in the NHANES I Epidemiologic Follow-Up Study: Propensity Score Matching Analysis. J Womens Health (Larchmt). 2023;32(9):950-959. doi:10.1089/jwh.2023.0189