5 tests women 40+ need to be asking for

You eat well, you move your body, and you're doing everything "right,” but something feels off. Your energy is unpredictable, your mood has shifted, and your brain doesn't feel like your own.

I’m Jennifer Roelands, MD, is a double board-certified OB-GYN and integrative medicine expert dedicated to helping women navigate perimenopause, hormone health, and aging, and this story is one I see all too often.

Today, I’m excited to take over the long game to tell every woman over 40 what tests you need to be asking your doctor for when things are feeling off.

Cardiovascular disease is the leading cause of death in women, and yet the hormonal shifts of midlife that significantly change cardiovascular risk go largely untested in routine care. Weight gain, brain fog, and fatigue are all common but rarely assessed by bloodwork.

Here’s where to start:

1. Heart testing: ApoB & LpA
2. Metabolic testing: Fasting insulin
3. Nutrient testing: Vitamin D & ferritin
4. Thyroid Panel: TSH, free T3, free T4, thyroid antibodies
5. Other hormones: Free & total testosterone, SHBG

The common thread across all five of these tests? They require you to ask. None are part of a standard annual wellness panel. But the information they provide is the difference between reactive medicine and proactive, precision care that keeps you thriving through perimenopause and beyond.

Fore more on the “Why?” behind each of these labs, be sure to read my full article: 5 Labs Every Woman 40+ Should Be Getting & Why Your Doctor Probably Isn't Ordering Them.

—Jennifer Roelands, M.D., ABOIM

+Advocate for yourself

• A reproductive endo wants you to get these fertility tests
• Exactly when to start getting different exams, based on age
• 10 things you should know about microdosing GLP-1s

If you do one thing… get more steps for better sleep

I’ve said it before, and I’ll say it again: What you do during the day can significantly impact how well you sleep at night. Case in point? Your daily step count.

When college students tracked their daily step counts and completed daily surveys about their sleep and mental health, the results were clear.²

Students who averaged more steps throughout the day tended to report better sleep quality and fewer symptoms of anxiety, depression, and stress. They also tended to have earlier sleep timing, which is important because when you sleep may matter almost as much as how much you sleep. There wasn’t a set amount of steps to reach; they found the more, the better.

Read more about the connection between more steps for better sleep and mental health.

+Step it up

• Do you really need 10k steps a day?
• Another daytime habit with nighttime payoffs
• Try to walk this much if you have a desk job

Ask an RD: Can food help manage high cortisol levels?

You can't eliminate stress entirely, but you can help your body handle it better. Alongside healthy lifestyle habits, these five foods contain nutrients that may support balanced cortisol levels and a calmer stress response:

• Fatty fish (salmon, sardines): Rich in omega-3s that have been shown to help lower cortisol.³
• Leafy greens (spinach, kale): Packed with magnesium, a mineral that supports relaxation.⁴
• Dark chocolate (70%+ cacao): Provides polyphenols that may help reduce cortisol and improve mood.⁵
• Fermented foods (yogurt, kimchi): Support a healthy gut microbiome, which is closely linked to stress resilience.⁶
• Green tea: Contains L-theanine, an amino acid that promotes calm while supporting focus.⁷

+Stress (a little) less

• A one-day diet to balance cortisol
• Avoid these foods when you’re feeling anxious
• Women, try this one simple thing to avoid a cortisol spike
• 3 sneaky ways cortisol messes with your metabolism (& how to manage it)

That’s it for the long game—we hope you’re geared up for the week ahead of you.