This article, is written by Dr. Nina Patrick, with editorial contributions from our team.

Dr. Patrick is a bioengineer, entrepreneur, and science communicator specializing in longevity and neuroscience. Through Nina’s Notes, she breaks down complex science into easy-to-understand insights, helping readers live longer, healthier lives while staying informed on cutting-edge research.

Link to the guidebook: https://ninapatrick.xyz/product/mens-health-after-40/

A Message from Dr. Luísa Batista, Medical Director, TejoMed

Men’s health is often overlooked, not just by doctors, but by men themselves. Cultural norms, reluctance to seek care, and a healthcare system that prioritizes quick fixes leave many men without the support they need to optimize their health. Yet, most conditions that impact men as they age: heart disease, metabolic decline, and hormonal imbalances, can be prevented or managed with the right approach.

In conventional healthcare settings, men often face a frustrating cycle: rushed and impersonal appointments, long waiting times, reactive treatments instead of prevention, and a fragmented system where no single doctor truly knows their full health history. This model is built for crisis management, not longevity, strength, and peak performance.

TejoMed and Concierge Medicine: A Smarter Approach

This is where concierge medicine changes the game. Unlike the traditional system, where doctors juggle 2,000 to 4,000 patients, concierge medicine operates on a membership model. Patients have one dedicated doctor who deeply understands their medical history, lifestyle, and long-term goals.

Concierge doctors see fewer patients, typically just a few hundred, allowing for:

• Extended, unrushed consultations that address root causes instead of just symptoms.

• Proactive, preventive strategies that optimize metabolic health, hormone balance, and overall longevity.

• A direct relationship with your doctor, who is available when needed, including same- or next-day appointments.

• A data-driven approach using advanced diagnostics, biomarker testing, and body composition analysis for precision health strategies.

Aging is inevitable, but how you age is up to you. Having a trusted, long-term relationship with a doctor who truly listens and adapts your care plan over time is one of the most valuable investments you can make.

This guide lays the foundation for what every man over 40 should know, but true transformation happens when you take action. Your future health starts today.

The Science of Male Aging: Understanding What Happens After 40

A male body at 40 isn't the same machine it was at 25, and that's perfectly normal.

Around this age, testosterone levels naturally begin to decline by about 1-2% annually [1]. Your metabolism slows, making it easier to gain weight and harder to maintain muscle mass. 

Bone density gradually decreases, and your cardiovascular system becomes less efficient at pumping blood during exercise.

Understanding these changes gives you the power to address them head-on. With the right maintenance and care, you can keep performing at your best. Your body is now more sensitive to both positive and negative influences, meaning the healthy choices you make have an even bigger impact. 

The key is recognizing that these changes aren't your destiny. They're simply your body's natural evolution, and you have significant control over how they affect you. 

Research shows that men who take proactive steps to manage their health in their 40s and beyond often maintain higher levels of physical and mental performance than those who don’t [2].

Key Points:

• Testosterone decline affects muscle mass, energy, and mood.

• Metabolic changes require adjustments to diet and exercise.

• Proactive health management becomes crucial after 40.

• Small lifestyle changes can have significant positive impacts.

Fuel for Strength: The Male Nutrition Program for Energy & Vitality

Male nutritional needs shift with age, requiring more strategic eating to maintain energy and muscle mass. Protein becomes increasingly important. 

To maintain your current muscle mass, aim for 1.2 to 1.6 grams per kilogram [3] of body weight daily, spread across meals. If you weigh 90kg, this means 144g of protein per day, ~50g of protein per meal. This helps preserve muscle mass and supports recovery from exercise. If you are actively trying to increase muscle mass, aim for up to 2 grams per kilogram of body weight. 

Having protein with every meal is a great way to keep your blood sugar stable. Protein slows down carbohydrate absorption which counteracts insulin resistance. Also, have healthy snacks readily available to keep your blood sugar steady. 

In addition to protein, bring nutrient-dense foods into your diet that provide sustained energy, such as plenty of colorful vegetables, lean proteins, healthy fats like avocados and olive oil, and complex carbohydrates.  

Hydration becomes more crucial as we age. Aim for 30-35 mL per kg of body weight daily. That means ~3L of water per day if you weigh 90kg [4].

Example Daily Menu:

Key Points:

• Increase protein intake to maintain muscle mass.

• Eat nutrient-dense foods for sustained energy.

• Stay well-hydrated throughout the day.

• Plan meals ahead to ensure balanced nutrition.

The Power of Muscle Training

Research shows that progressive resistance training (a.k.a muscle training) can reverse up to two decades of age-related muscle loss in previously sedentary adults [5]. There are two main classifications of exercises: compound exercises and isolation exercises.  Isolation exercises focus on a single muscle, like a bicep curl. Compound exercises work multiple muscle groups simultaneously. These movements give you the biggest return on your time investment. Compound exercises include squats, deadlifts, push-ups, rows, and shoulder presses. Start with bodyweight or light weights to perfect your form. Aim for 2-3 sets of 8-12 repetitions, allowing adequate rest between sets and workouts.  

Depending on the intensity of exercise, consider supplementing with 3-5g daily of creatine to supply energy to your muscles and support brain health. With resistance training, progressive improvement is key. Gradually increase weight or repetitions as you get stronger. But listen to your body and avoid pushing through pain.  The goal is sustainable progress, not short-term gains at the expense of long-term health. 

Remember, recovery becomes more important with age, give yourself 48 hours between strength sessions that are training the same muscle groups.

Key Points:

• Focus on compound exercises for efficiency.

• Perfect form before increasing weight.

• Allow adequate recovery time.

• Progress gradually to avoid injury.

Cardiovascular Health: How to Protect Your Heart

Heart disease remains the leading cause of death in men [6], but it's largely preventable through lifestyle choices.

Regular aerobic exercise strengthens your heart, improves circulation, and helps maintain healthy blood pressure. Find activities you enjoy. Cycling, swimming, brisk walking, or dancing all count as aerobic exercise. The World Health Organization recommends at least 150 minutes of moderate aerobic activity or 75 minutes of vigorous activity weekly, plus strength training for all major muscle groups twice a week [7]. 

Remember to start where you are, not where you think you should be. If you're returning to exercise after a break, begin with walking and basic bodyweight exercises. Gradually increase intensity as your fitness improves. The key is consistency over intensity. A 30-minute daily walk is better than an occasional intense workout that leaves you too sore to move.

Try combining cardio with stress management techniques. Chronic stress increases inflammation and blood pressure, contributing to heart disease. Practice deep breathing, meditation, or yoga to activate your body's relaxation response. 

Diet plays a crucial role in heart health. Emphasize foods rich in omega-3 fatty acids (fatty fish, nuts, seeds), fiber (vegetables, whole grains, legumes), and antioxidants (berries, leafy greens). Limit processed foods, excessive salt, and saturated fats.

Key Points:

• Aim for 150 minutes of exercise weekly.

• Manage stress daily.

• Choose heart-healthy foods.

• Monitor blood pressure regularly.

Preventive Healthcare: What Tests and Checkups Do You Actually Need? 

Prevention is the best defense against age-related health issues. After 40, certain screening tests become essential for early detection of potential problems. Schedule regular check-ups with your healthcare provider and don't skip these important screenings. 

Standard screenings include:

From a longevity perspective, best to also include these annually:

Keep detailed records of your test results and family health history, if possible. Track key metrics like blood pressure (aim for below 120/80 mmHg), fasting blood glucose (4.0-5.6 mmol/L), and total cholesterol (below 5.2 mmol/L). This information helps your healthcare provider identify potential risks and develop appropriate prevention strategies.

Key Points:

• Schedule regular check-ups and screenings

• Track your health metrics over time

• Maintain open communication with healthcare providersž 

• Know your family health historyž 

• Different screening options are available for colorectal cancer - discuss with your doctor which is best for you

Sexual Health and Libido: What Every Man Should Know

Sexual health is an important aspect of overall well-being throughout life. Understanding the connection between physical health, hormones, and sexual function helps you maintain a satisfying sex life.  

Both physical and psychological factors, such as relationship stress, work pressure, and anxiety can all impact sexual function. Declining testosterone levels can also affect libido and performance, but many factors are within your control.

Regular exercise, particularly strength training and high-intensity interval training, naturally boosts testosterone production. A balanced diet rich in zinc (11 mg daily [8]), vitamin D (600-800 IU daily [9]), magnesium (420 mg daily [10]) and healthy fats supports hormone production. Stress management and adequate sleep are equally important for maintaining healthy testosterone levels. 

If you're experiencing symptoms of low testosterone (fatigue, reduced libido, muscle loss, depression), hormone-boosting supplements like DHEA, zinc, magnesium, and Vitamin D should be tried to increase your body's natural production of testosterone. 

Considering hormone replacement therapy (HRT)? 

1. Only consider HRT when multiple screenings of total testosterone levels are below 8nmol/L (a minimum of two morning tests), you have symptoms which are affecting your quality of life, and you have already tried all the lifestyle interventions (exercise, hormone boosting foods, and reducing stress) with no improvement.

2. HRT can come as injectable testosterone (every 1-4 weeks), daily transdermal gels, long-acting implants (last 3-6 months), and daily patches.

3. HRT can improve sexual function, increase muscle mass, enhance energy levels, improve mood and cognitive function and improve bone density. Don't hesitate to discuss sexual health concerns with your healthcare provider. Taking testosterone as hormone therapy isn't right for everyone. Starting testosterone without a good medical reason can be harmful to your health. Many issues have simple solutions, and early intervention often prevents more significant problems.

Don't hesitate to discuss sexual health concerns with your healthcare provider. Taking testosterone as hormone therapy isn't right for everyone. Starting testosterone without a good medical reason can be harmful to your health. Many issues have simple solutions, and early intervention often prevents more significant problems.

Key Points

• Exercise and nutrition influence hormone levels

• Manage stress for better sexual health

• Communicate openly with healthcare providers

• Address both physical and psychological factors

Prostate Health: Essential Information for Men

The prostate gland is roughly the size of a walnut and plays a vital role in male reproductive health. As men age, being proactive about prostate health becomes increasingly important.  

Research shows that one in eight men will be diagnosed with prostate cancer in their lifetime [11]. Therefore, early detection is very important as it significantly improves outcomes. 

Lifestyle can significantly impact prostate health. Maintaining a healthy weight and staying physically active reduce the risk of prostate cancer.  

Eat a diet of vegetables, especially cruciferous veggies like broccoli and cauliflower. Limit red meat consumption, eat lycopene right foods like cooked tomatoes, and healthy fats, like olive oil, avocados and nuts [12].  

Vitamin D, selenium and zinc supplements are also shown to support prostate health [12]. It is very important to complete regular screening for prostate health. 

An initial PSA test should be done at age 50 for men with average risk and at 40-45 for men with high-risk [13].

What puts you at risk

1. Age (risk increases significantly after 50

2. Family history (2-3x higher risk with a first-degree relative affected

3. Ethnicity (African American men have a higher risk

4. Genetic factors (BRCA1/2 mutations

5. Lifestyle factors (poor diet, lack of exercise, smoking)

If you notice any warning signs such as frequent urination (especially at night), weak urine stream, difficulty starting/stopping, blood in urine or semen, pelvic discomfort, erectile dysfunction and/or painful ejaculation, you should consult your doctor.

Key Points

• Know your risk factors and family history „ 

• Stay physically active „ 

• Adopt prostate-healthy dietary habits „

• Follow recommended screening guidelines „ 

• Report changes in urinary function promptly „ 

• Work with your healthcare provider on a prostate health plan

Key Takeaways & Action Items

Your health journey after 40 is about making informed, sustainable choices that support long-term vitality.  Here's your action plan for optimal health:

Remember, small, consistent actions lead to significant results. Consistency trumps intensity. 

Focus on progress, not perfection, and do regular assessments to track and maintain progress.  

Don t forget to celebrate your achievements along the way. Health is a lifelong journey.

References

[1] Harman, S M et al. (2001). Longitudinal effects of aging on serum total and free testosterone levels. The Journal of Clinical Endocrinology & Metabolism.

[3] Phillips, S.M. (2004). Protein requirements and supplementation in strength sports. Nutrition.

[4] Mayo Clinic. (n.d.). Water: How much should you drink every day?

[5] Melov, S., et al. (2007). Resistance Exercise Reverses Aging in Human Skeletal Muscle. PLOS ONE.

[6] National Center for Health Statistics. (2024). CDC WONDER Database.

[7] WHO Guidelines on Physical Activity and Sedentary Behaviour. (2020). Geneva: World Health Organization.

[8] Institute of Medicine. Food and Nutrition Board. Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc Washington, DC: National Academy Press; 2001. 

[9] Institute of Medicine, Food and Nutrition Board. Dietary Reference Intakes for Calcium and Vitamin D. Washington, DC: National Academy Press, 2010. 

[10] U.S. Food and Drug Administration. Food Labeling: Revision of the Nutrition and Supplement Facts Labels. 2016.

[11] Rawla, P. (2019). Epidemiology of Prostate Cancer. World Journal of Oncology.

[12] Wilson, K.M., Mucci, L.A. (2019). Diet and Lifestyle in Prostate Cancer. Advances in Experimental Medicine & Biology.

[13] Wei, J.T., et al. (2023). Early Detection of Prostate Cancer: AUA/SUO Guideline. Journal of Urology.