Women in their 40s are a versatile bunch. They may be nearing the top of their career trajectories, or they might be taking time off from work to care for young children or aging parents. Some women in their 40s seek reproductive assistance to get pregnant. Others visit the doctor to find relief from hot flashes, which are a sign of perimenopause.

Women in their 40s may feel more self-assured than they did in their 20s. They may notice changes in their bodies due to aging, and healthy lifestyle habits—such as smart diet and exercise choices—may seem more important now than in decades past.

“Your metabolism slows down as you age, and your caloric needs decrease,” said Gabriela Dellapiana, MD, a maternal-fetal medicine specialist at Cedars-Sinai. “You may need to take in fewer calories to maintain a healthy weight. Exercise helps lower the risk of heart disease, stroke and diabetes, and it can cause changes in body composition, but it’s not enough to cause weight loss.”

The average American woman reaches menopause (going 12 months without a menstrual period) at age 51. Your body enters perimenopause—the transition to menopause—two to five years earlier. For many women, perimenopause lands in their mid-40s. They may notice hot flashes, mood changes and other menopause-like symptoms.

“Night sweats, depression and irritability all interfere with our functioning and sleep,” said Eynav Accortt, PhD, a clinical psychologist and director of Cedars-Sinai’s Reproductive Psychology Program. “If night sweats are keeping you up at night and, as a result, making you irritable during the day, how are you supposed to work and be there for your partner or kids in the evening and your parents on weekends? For help and assistance with perimenopause symptoms, see your gynecologist.”

Read: Perimenopause Explained

Depression or anxiety may strike at any age, including when hormones shift during perimenopause. Discuss your mental health with your doctor at any time, even if you’re there for another reason.

“You may not need to see a mental health provider for that first conversation. You can speak to your gynecologist if you’re feeling overwhelmed, depressed or anxious,” Accortt said. “They might prescribe medication, especially if you’ve dealt with depression before and know what worked in the past. Or, they may refer you to a psychologist for therapy.”

Read: The Difference Between Postpartum Anxiety, OCD and Psychosis

Some women start leaking a bit of urine in their 40s.

“When someone in their 40s comes in with urinary incontinence, it’s usually stress incontinence. This is when you lose urine when you cough, laugh, sneeze or do physical activity,” said Brittni Boyd, MD, a urogynecologist at Cedars-Sinai. “During perimenopause, the muscles of our pelvis become weakened and aren’t able to compensate like when we were younger. Women who were previously pregnant are at greater risk of having damaged their pelvic floor muscles, which may contribute to stress incontinence leaks.”

Incontinence isn’t harmful, but it can be unpleasant. Many women find it embarrassing to discuss, even with their doctors, but it’s actually quite common.

“If it’s interfering with your quality of life, talk to your doctor,” Boyd said. “It’s important for women to know that there’s help. They don’t have to live with the symptoms.”

If you’re hoping to get pregnant in your 40s, discuss your reproductive health with a doctor.

“Women are delaying childbearing later and later, but many don’t realize that their reproductive window is closing or has closed,” said Jessica Chan, MD, a reproductive endocrinologist at Cedars-Sinai. “After age 40, the chance of a healthy, natural conception is extremely low. Don’t try to get pregnant on your own for six months. See a fertility specialist as soon as possible.”

If you become pregnant in your 40s, it can be safe for you to carry the baby, according to Chan. Don’t skip any prenatal appointments, because women are at higher risk of certain pregnancy complications once they reach their 40s.

Read: Your Fertility and Your Future

If you use birth control for pregnancy prevention, don’t stop when you hit perimenopause. You may experience menopause-like symptoms, but you’ll continue to get menstrual periods, albeit on an erratic schedule.

“If you are still getting your period, there is still a rare chance you could get pregnant. Our general recommendation is that women who do not wish to get pregnant should continue contraception until menopause, which is defined as no menstrual bleeding for an entire year,” said Natasha Schimmoeller, MD, a Cedars-Sinai OB-GYN.

If your birth control contains hormones and you develop high blood pressure, let your OB-GYN know. They may advise that you switch to a different method. Fortunately, birth control is safe for most women in their 40s.

“If you have high blood pressure and use estrogen-containing birth control, there’s an increased risk of heart attack and stroke,” Schimmoeller said. “The only methods that contain estrogen are certain pills, the vaginal ring and the patch. That leaves many other safe methods.”

As you get older, your hormone levels shift, prompting your skin to produce less of the oils that help trap moisture. This contributes to dry skin. To keep your skin looking and feeling soft and supple in your 40s and beyond, moisturize regularly.

“When our skin gets dry, the fine lines and wrinkles are more apparent,” said Sravya Bhatia, MD, a dermatologist at Cedars-Sinai. “Use face moisturizers, body moisturizers and lip balms. The best time to moisturize is right after washing, whether you’re coming out of the shower or you’ve washed your face.”

If you develop unexplained dryness, redness, itching or burning, switch to a new moisturizer, cleanser or anti-wrinkle product, especially if you’ve used the same product for years.

“Your skin changes as you get older, and it’s important to adapt,” Bhatia said. “A product that you loved might need to be changed as your skin is changing.”

The 40s are a good time to think about your financial health—in addition to your mental and physical health—because finances may eventually impact your overall health.

“It’s stressful to not feel financially stable in our older years, especially if we have chronic illnesses and can’t afford additional care,” Accortt said. “There are things that we can do in our 40s to prepare for greater financial security in our 70s and 80s. Now is a great time to think about saving for retirement or setting aside money for future health issues if you aren’t already doing so.”