Aging happens to all of us. When we reach those anticipated birthdays, we often find ourselves facing new and unfamiliar health challenges. What are the most common health problems in middle adulthood, and what symptoms should those between the ages of 40 and 65 be on the lookout for?

1. Menopause

Menopause is probably the one phase of your life you’re both looking forward to and dreading. People look forward to it because it marks the end of your menstrual period, since your ovaries stop producing estrogen and progesterone, but it also brings with it things like hot flashes, sleep disruption, low energy levels and other symptoms. Most women experience this shift in their early 50s, but it can happen as early as your 40s.

Menopause happens in three stages — premenopause, perimenopause and postmenopause. You’ll reach the last one after you’ve been without a period for 12 months. Every woman will experience this during middle adulthood.

2. Breast Cancer

Most women who are diagnosed with breast cancer receive this diagnosis after the age of 40. In fact, the median age for a breast cancer diagnosis is 62, but the potential for developing this type of cancer begins to increase once you reach age 40 and peaks when you’re over 70.

Once you reach 40, mammograms become part of your annual OB-GYN appointment — but you should be doing breast self-exams every month to check for lumps or changes in tissue. If you notice anything out of the ordinary, make an appointment with your doctor as soon as possible.

3. Heart Disease

Heart disease is the most common cause of death for both men and women in the United States. Once you reach middle adulthood, especially if you’ve already experienced menopause, your risk starts to climb. Menopause itself isn’t a disease, but the hormonal changes your body goes through during this part of your life sparks change that can increase your risk of experiencing a cardiovascular event. Obesity, diabetes and mental health concerns like depression and anxiety also increase your chance of succumbing to heart disease.

Maintaining a healthy diet and staying active can help reduce your chances of experiencing heart disease. Talk to your doctor if you have any questions about how to eat healthily or remain active in middle adulthood.

4. Muscle Loss

Once you reach menopause, your body stops producing as much estrogen. As the levels of this hormone decline, you start to lose bone and muscle mass while the amount of fat your body stores starts to increase. This can make it harder to lose weight and rebuild muscle.

Contrary to popular belief, strength training will not make you bulky or turn you into a bodybuilder. Once you reach middle adulthood, it can help to prevent other health problems like osteoporosis and arthritis, as well as ward off injuries. If you’re not sure where to start with strength training, take the time to talk to a personal trainer or someone who can instruct you how to do the exercises properly so you don’t end up inadvertently injuring yourself.

5. Osteoporosis

The name osteoporosis literally means porous bones, and it affects as many as 54 million Americans every year, making it one of the most common health problems in middle adulthood. Women are four times more likely to experience osteoporosis than men, and the risk increases after you reach menopause. In fact, in the first five years after you reach menopause, you can lose up to 20% of your body’s bone mass. This loss can lead to fractures that don’t heal properly.

You can mitigate the effects of osteoporosis by increasing the amount of vitamin D and calcium in your diet and exercising regularly. Keeping yourself at a healthy body weight and quitting smoking can also reduce your chances of experiencing these fractures.

6. Arthritis

Contrary to popular belief, arthritis isn’t a disease that is limited to the elderly. People of all ages can be affected, and nearly two-thirds of those with arthritis are under 65. Osteoarthritis generally shows up after age 40, while other types of the disease can occur at any time.

As with osteoporosis, regular exercise and a healthy diet can help prevent you from developing arthritis in middle adulthood. Obesity increases your risk of osteoarthritis, so make it a point to maintain a healthy weight.

Common Health Problems in Middle Adulthood

While these may be six of the most common health problems in middle adulthood, this is by no means a comprehensive list. Make sure you’re scheduling regular appointments with your doctor to discuss your health and options as you move into this next phase of your life. Take care of yourself so you’ll be able to enjoy your golden years!