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If a typical day finds you blasting your headphones, shouting over the din at dinner, and blaring the TV, this will come as no surprise: "Hearing loss is now a growing epidemic among women in their 30s and 40s," says Douglas Backous, MD, medical director of the Center for Hearing and Skull Base Surgery at the Swedish Neuroscience Institute in Seattle. Even in the quietest places, we can face unrelated issues, like infection, vertigo, and congestion. All ears now? Follow our guide to caring for and protecting this key organ.
RELATED: Famous Celebrities with Hearing Loss
Problem No. 1: Hearing loss
The lowdown: This isn't a concern just for drummers and construction workers. "Even having earbuds at full blast while you're running every day can cause permanent damage over time," says Eric Smouha, MD, director of otology and neurology at Mount Sinai Hospital in New York City. "Intense exposure to sound causes wear and tear on the hair cells in your cochlea."
What it feels like: Conversations are muffled; you may notice that you're asking people to speak more slowly or repeat themselves. "If you turn the TV volume up so high that others complain about the noise, that's a red flag," says Barry Hirsch, MD, director of the division of neurotology at the University of Pittsburgh Medical Center.
Rx: See your doctor. The first step is to check your ears–—wax may simply be blocking sound waves from entering your ear canal. Otherwise, you'll be referred to an audiologist for a hearing test. "If you have trouble hearing sounds above 25 decibels [dB], it's considered hearing loss and needs to be thoroughly evaluated," says Sarah Sydlowski, PhD, an audiologist at the Cleveland Clinic. While there's no way to reverse noise-induced hearing loss, mild forms can be treated with an assistive listening device. If your loss is more pronounced, you'll need a hearing aid.
For people who are not a candidate for hearing aids, personal sound amplification products (PSAPs) have improved challenging situations like hearing conversations in noisy places. You might want to consider a product like Bose Hearphones, conversation-enhancing headphones that can help take the edge off background noise.
To keep your hearing healthy, use earplugs whenever you're in a noisy situation—–say, a concert or football game. "And when you're listening to tunes, keep the volume at the halfway point," Sydlowski says.
RELATED: Is Loud Music in Workout Classes Bad for Your Ears?
Problem No. 2: Pressure changes
The lowdown: You know that awful ear pop (the one your kids shriek about) as the plane you're in starts to descend? It has a fancy name—–barotrauma. "The air pressure in your middle ear is usually the same as the air pressure outside your body," Dr. Hirsch explains. But when you're landing, the cabin pressure increases. "The outside pressure pushes your eardrum inward," he says. Your Eustachian tubes—–which connect your middle ear to the back of your nose and throat—–regulate air pressure, but they can't always react quickly enough. The result: serious discomfort. (When a plane goes up, the reverse happens; it's a lot less likely to cause pain.) These symptoms can get worse if you have a stuffed-up schnoz from a cold.
What it feels like: Mild to moderate pressure or pain in your ear, along with stuffiness.
Rx: Take a big yawn, chew gum, or suck on a hard candy. "These actions pull the muscles that open your Eustachian tubes and equalize the pressure," Dr. Hirsch says. Alternatively, try the Valsalva maneuver: Pinch your nostrils shut, close your mouth, and force air into the back of your nose, as if you're blowing it. If you have a full-fledged cold, use a drugstore decongestant nasal spray, such as Afrin, and pop a decongestant pill like Sudafed before you fly.
RELATED: Why Nature Sounds Help You Relax, According to Science
Problem No. 3: Tinnitus
The lowdown: Up to 20% of people under age 50 are plagued by tinnitus—–ringing in the ears. It's usually a symptom of an underlying condition, such as hearing loss or an ear injury. "One theory about the cause: When hair cells in the inner ear are damaged by a trigger like loud noise, random electrical impulses are generated, which the brain perceives as ringing," Sydlowski says. Other possible culprits include high blood pressure (which can restrict blood flow to ears), stiffening of the bones of your inner ear (a condition called otosclerosis), jaw joint problems (TMJ), and certain medications, such as the antibiotic erythromycin and the anti-malaria med quinine.
What it feels like: A ringing, buzzing, or hissing sound that may vary from a low roar to a high-pitched squeal. You may hear it in one or both of your ears, and it can either be constant or come and go.
Rx: If you experience tinnitus after being exposed to a loud noise, wait a day or two to see if it subsides. But if it doesn't, visit an audiologist. Treating the cause or going off the offending meds should make symptoms disappear.
RELATED: 5 Mistakes You're Making Cleaning Your Ears
How infections start
While kids are much more prone to them than we are, middle ear infections—–which usually develop after fluid builds up there after a cold—may be on the rise in adults, says Dr. Backous. "I see this more and more in my practice," he notes, "probably because there's more particulate matter in the air on account of pollution and smoking that can trigger infections."
That said, the most common kind of ear infection in grown-ups is an outer ear infection, aka swimmer's ear. It's typically caused by water left in your ear after a swim, but "it can also be caused by sticking cotton swabs in your ear, which damages the thin layer of skin lining your ear canal," says Sean McMenomey, MD, professor of otolaryngology at New York University. Prevent them by refraining from putting swabs or even fingers deep into your ears. If you swim, rinse your ears out afterward with a mixture that's 50% rubbing alcohol and 50% white vinegar–—use a baby syringe to squirt it in.
RELATED: Got Ringing in Your Ears? Here's How to Cope With Tinnitus
How you hear
1. A source of sound sends vibrations, or sound waves, into the air.
2. The waves funnel through the ear opening, go down the external ear canal, and strike your eardrum, making it vibrate.
3. The vibrations are passed to the three small bones of the middle ear.
4. The bones transmit the vibrations to the cochlea, which contains tubes filled with fluid. Inside the tubes, tiny hair cells pick up the vibrations and convert them into nerve impulses.
5. These impulses are delivered to the brain via the auditory nerve.
6. The brain interprets the impulses as sound (music, voice, a car horn, etc.).
To get our top stories delivered to your inbox, sign up for the Healthy Living newsletter

If a typical day finds you blasting your headphones, shouting over the din at dinner, and blaring the TV, this will come as no surprise: "Hearing loss is now a growing epidemic among women in their 30s and 40s," says Douglas Backous, MD, medical director of the Center for Hearing and Skull Base Surgery at the Swedish Neuroscience Institute in Seattle. Even in the quietest places, we can face unrelated issues, like infection, vertigo, and congestion. All ears now? Follow our guide to caring for and protecting this key organ.
RELATED: Famous Celebrities with Hearing Loss
Problem No. 1: Hearing loss
The lowdown: This isn't a concern just for drummers and construction workers. "Even having earbuds at full blast while you're running every day can cause permanent damage over time," says Eric Smouha, MD, director of otology and neurology at Mount Sinai Hospital in New York City. "Intense exposure to sound causes wear and tear on the hair cells in your cochlea."
What it feels like: Conversations are muffled; you may notice that you're asking people to speak more slowly or repeat themselves. "If you turn the TV volume up so high that others complain about the noise, that's a red flag," says Barry Hirsch, MD, director of the division of neurotology at the University of Pittsburgh Medical Center.
Rx: See your doctor. The first step is to check your ears–—wax may simply be blocking sound waves from entering your ear canal. Otherwise, you'll be referred to an audiologist for a hearing test. "If you have trouble hearing sounds above 25 decibels [dB], it's considered hearing loss and needs to be thoroughly evaluated," says Sarah Sydlowski, PhD, an audiologist at the Cleveland Clinic. While there's no way to reverse noise-induced hearing loss, mild forms can be treated with an assistive listening device. If your loss is more pronounced, you'll need a hearing aid.
For people who are not a candidate for hearing aids, personal sound amplification products (PSAPs) have improved challenging situations like hearing conversations in noisy places. You might want to consider a product like Bose Hearphones, conversation-enhancing headphones that can help take the edge off background noise.
To keep your hearing healthy, use earplugs whenever you're in a noisy situation—–say, a concert or football game. "And when you're listening to tunes, keep the volume at the halfway point," Sydlowski says.
RELATED: Is Loud Music in Workout Classes Bad for Your Ears?
Problem No. 2: Pressure changes
The lowdown: You know that awful ear pop (the one your kids shriek about) as the plane you're in starts to descend? It has a fancy name—–barotrauma. "The air pressure in your middle ear is usually the same as the air pressure outside your body," Dr. Hirsch explains. But when you're landing, the cabin pressure increases. "The outside pressure pushes your eardrum inward," he says. Your Eustachian tubes—–which connect your middle ear to the back of your nose and throat—–regulate air pressure, but they can't always react quickly enough. The result: serious discomfort. (When a plane goes up, the reverse happens; it's a lot less likely to cause pain.) These symptoms can get worse if you have a stuffed-up schnoz from a cold.
What it feels like: Mild to moderate pressure or pain in your ear, along with stuffiness.
Rx: Take a big yawn, chew gum, or suck on a hard candy. "These actions pull the muscles that open your Eustachian tubes and equalize the pressure," Dr. Hirsch says. Alternatively, try the Valsalva maneuver: Pinch your nostrils shut, close your mouth, and force air into the back of your nose, as if you're blowing it. If you have a full-fledged cold, use a drugstore decongestant nasal spray, such as Afrin, and pop a decongestant pill like Sudafed before you fly.
RELATED: Why Nature Sounds Help You Relax, According to Science
Problem No. 3: Tinnitus
The lowdown: Up to 20% of people under age 50 are plagued by tinnitus—–ringing in the ears. It's usually a symptom of an underlying condition, such as hearing loss or an ear injury. "One theory about the cause: When hair cells in the inner ear are damaged by a trigger like loud noise, random electrical impulses are generated, which the brain perceives as ringing," Sydlowski says. Other possible culprits include high blood pressure (which can restrict blood flow to ears), stiffening of the bones of your inner ear (a condition called otosclerosis), jaw joint problems (TMJ), and certain medications, such as the antibiotic erythromycin and the anti-malaria med quinine.
What it feels like: A ringing, buzzing, or hissing sound that may vary from a low roar to a high-pitched squeal. You may hear it in one or both of your ears, and it can either be constant or come and go.
Rx: If you experience tinnitus after being exposed to a loud noise, wait a day or two to see if it subsides. But if it doesn't, visit an audiologist. Treating the cause or going off the offending meds should make symptoms disappear.
RELATED: 5 Mistakes You're Making Cleaning Your Ears
How infections start
While kids are much more prone to them than we are, middle ear infections—–which usually develop after fluid builds up there after a cold—may be on the rise in adults, says Dr. Backous. "I see this more and more in my practice," he notes, "probably because there's more particulate matter in the air on account of pollution and smoking that can trigger infections."
That said, the most common kind of ear infection in grown-ups is an outer ear infection, aka swimmer's ear. It's typically caused by water left in your ear after a swim, but "it can also be caused by sticking cotton swabs in your ear, which damages the thin layer of skin lining your ear canal," says Sean McMenomey, MD, professor of otolaryngology at New York University. Prevent them by refraining from putting swabs or even fingers deep into your ears. If you swim, rinse your ears out afterward with a mixture that's 50% rubbing alcohol and 50% white vinegar–—use a baby syringe to squirt it in.
RELATED: Got Ringing in Your Ears? Here's How to Cope With Tinnitus
How you hear
1. A source of sound sends vibrations, or sound waves, into the air.
2. The waves funnel through the ear opening, go down the external ear canal, and strike your eardrum, making it vibrate.
3. The vibrations are passed to the three small bones of the middle ear.
4. The bones transmit the vibrations to the cochlea, which contains tubes filled with fluid. Inside the tubes, tiny hair cells pick up the vibrations and convert them into nerve impulses.
5. These impulses are delivered to the brain via the auditory nerve.
6. The brain interprets the impulses as sound (music, voice, a car horn, etc.).
To get our top stories delivered to your inbox, sign up for the Healthy Living newsletter

Flat abs aren't just for teenagers, models, or Olympic athletes. Learn how to get a flat stomach with these expert tips.
When You're In Your 20s...
In theory, these should be flat-ab glory years. Though your metabolism starts to drop by 1 to 2 percent when you cross from your teens into your twenties (that means, if you're burning 2,500 calories a day in your teens, you'll burn 25 to 50 fewer calories a day in your twenties, which is why most people gain an average of 1.2 pounds per year at this age), it's still high, says endocrinologist Scott Isaacs, M.D., the author of Hormonal Balance. You're also continuing to churn out large amounts of hormones, like estrogen (this peaks in your late teens or early twenties), which guides your body to store fat in the hips, butt, and breasts instead of the midsection, and growth hormone, which releases fat from its stores in the body so it can be delivered to your muscles for energy, Dr.Isaacs says.
RELATED: You Asked: Can You Lose Weight Just from Your Stomach?
This is particularly true if you consume a lot of carbs. A recent study in the Journal of Nutrition revealed that large amounts of processed carbs (the higher-carb participants in the study were eating 55 percent carbs, 18 percent protein, and 27 percent fat) raise the body's level of insulin, which prevents fat from being unlocked from abdominal fat stores and burned off. Another factor: "Many twentysomethings haven't hit their fitness stride yet; they're doing too much steady-state cardio and not enough strength training and cranking out old-school crunches, a particularly ineffective combination for chipping away at belly fat," says Holly Perkins, a strength-and-conditioning specialist and the author of Lift to Get Lean.Still, even with all this in your favor, four years of keg parties and late-night pizza may have left you with a post grad gut, and those poor eating and drinking habits have a tendency to linger just about as long as your student loan payments. "After graduation, people tend to spend more time sitting at a desk, and this sedentary lifestyle can lead to more weight gain, especially if you're still drinking a lot and not keeping close tabs on your diet," Dr.Isaacs explains.
How to get a flat stomach: Start by shifting your eating habits away from college carbo-loading. (Read up on these healthy beer options if you want to cut down without making your weekend drink-free.) "Help keep insulin at a healthy level by following a moderate-carb diet, in which most of your carbs come from nutritious unprocessed sources like whole grains, beans, fruits, and vegetables," says nutritionist Lisa Young, Ph.D., the author of The Portion Teller. The participants in the Journal of Nutrition study who were given a moderately low-carb diet (43 percent carbs, 18 percent protein, and 39 percent fat) lost 11 percent of their abdominal fat after eight weeks, compared with those on a low-fat, higher-carb diet, who lost only 1 percent ab fat. And because the goal is to burn flab, you need to choose calorie-incinerating workouts.
RELATED: The 7 Best Ab Exercises That Are All Over Pinterest
"It's important to incorporate steady-state cardio, interval training, and strength training," Perkins says. She recommends doing two 35- to 40-minute steady-state cardio sessions a week at a pace that's about a 7 out of 10 on the intensity scale; two 30-minute interval workouts (go for two minutes at moderate intensity followed by two minutes at an almost-all-out pace) to maximize growth-hormone secretion and fat burning; and two days of strength training to build lean muscle mass, which ups your calorie burn. Any type of strength training will be effective, as long as the program gets progressively harder (more weight, more reps) so that you continue to challenge your body. If you're not up for sweating six days a week, you can double up and do the strength training on your cardio or interval days. "Twentysomethings still have metabolism and hormones on their side, so they just need to develop a definitive fitness strategy that includes a balance of cardio and strength training to kick-start their burn and firm," Perkins says. (Want to work out your way to better abs? Try the best ab exercises of all time.)
When You're In Your 30s...
For many women, their thirties are the time to have babies. Pregnancy can cause your rectus abdominis muscles (your front-and-center six-pack muscles) to stretch to the point of separation, a painless condition called diastasis recti, which Brazilian researchers found affected 68 percent of women above the belly button and 32 percent below, when measured at up to eight weeks postpartum. "The muscles usually move back together on their own," says Mary Jane Minkin, M.D., a clinical professor of obstetrics, gynecology, and reproductive sciences at the Yale School of Medicine. "In extreme cases, surgery may be needed to repair the separation." Otherwise, you're probably just dealing with some leftover fat and ab muscles that became stretched out during pregnancy.
RELATED: The One Thing Venus Williams Adds to Her Ab Workouts for a Rock-Solid Core
That doesn't mean they can't snap right back, but it takes some effort. Luckily, you still have a respectable metabolism in your thirties. (Want to pump it up anyway? Eat these 5 foods to boost metabolism.) While it drops another 1 to 2 percent from the first small dip in your twenties during this decade, that's not really going to catch up to you for another decade or so. Estrogen levels can start to drop for some women in the late thirties as fertility diminishes, but less estrogen isn't an issue until you are well into your forties. And you can still cash in on your growth hormone production for now too.
How to get a flat stomach: Getting your pre-baby belly back requires a two-pronged approach: You need to melt the flab that's covering your abs and strengthen your stretched-out muscles. Trainer Sara Haley, the creator of the Expecting More pre- and postnatal exercise DVD programs, suggests the following time-saving high-intensity routine, which has you moving fast enough to keep your heart rate up to torch calories and incorporates moves designed to tone and tighten your whole core; these exercises are safe for those with diastasis recti, as long as it's not severe.
After warming up, do each of the following moves for one minute: high knees (run in place), plank squats (start in a plank, then jump feet forward and pop up into a squat), knee repeaters (get into a low lunge, clasp hands over your head, and bring your back knee up to your chest while simultaneously bringing your hands down to meet the knee; do one minute per leg), and dead bugs (lie faceup on the floor with your legs raised, knees bent at a 90-degree angle, arms raised toward ceiling, and flex your feet as if you're pushing something away with them while focusing on pulling your belly button into your spine). Rest for one minute, then repeat the circuit two more times; cool down. As much as you may want to throw a crunch into the bunch, don't. "Crunching and twisting movements can make any separation worse because they repeatedly open and close the abdominal muscles," Haley says.
RELATED: 5 Crazy-Effective Crunch Variations
And while juggling work, kids, and a relationship doesn't leave a lot of time for slumber, make sure you get as much shut-eye as you can (shoot for seven to nine hours per night), because sleep deprivation jacks your level of the stress hormone cortisol, which encourages ab-fat storage. If you have kids keeping you up at night, sneak in an afternoon snooze. A Penn State study found that a two-hour afternoon nap can offset the effect that a bad night's sleep can have on cortisol. "Even a short nap—if only for a half hour—may have a small beneficial effect," Dr. Isaacs says.
When You're In Your 40s...
Levels of sex hormones, including estrogen, begin to dip at this age. "Until now, the estrogen receptors' influence on fat deposition in the breasts, hips, and butt have been more powerful than the receptors controlling how much fat is stored inside and outside the abs. As estrogen declines in your forties, the receptors in the abdomen begin to exert more power, so you start to preferentially gain weight there," says Pamela Peeke, M.D., the author of Fight Fat After Forty. Not only does metabolism drop by another 1 to 2 percent from when you were in your thirties—one study found that people can lose as much as 8 percent of their calorie-burning muscle mass from age 40 to 50 if they haven't been taking preventive steps—but growth hormone is also dwindling (one University of Virginia study found that there's about half as much at 45 as there is at 25).
RELATED: Jennifer Lopez Shows Off Her Ridiculous Abs in a Post-Workout Selfie: 'We Never Quit'
How to get a flat stomach: There's not much you can do on your own about the loss of estrogen, but a surefire way to boost growth hormone is to go hard at the gym. "Moderate- to high-intensity programs with multiple sets, high reps, short rest intervals, and exercises that target multiple large muscle groups at one time produce substantial acute growth hormone responses," says Nicholas Ratamess, Ph.D., a professor of health and exercise science at the College of New Jersey, who suggests working out intensely at least three times a week for 30 minutes. A review of research in the Journal of Applied Physiology found that in 25- to 43-year-old women, regular high-intensity aerobic exercise resulted in a twofold increase of growth hormone release over 24 hours.
As for muscle loss, it's somewhat preventable. "If you're staying physically active and lifting weights, you should be holding on to about the same muscle mass you had in your thirties," Dr. Peeke says. Research in the journal Physician and Sportsmedicine suggests that cardio can also be effective at helping you pack on muscle or maintain it. The study found that intense aerobic exercise (running, biking, or swimming four to five times a week) reduced muscle loss in athletes ages 40 and up, because regular exercise stimulates protein synthesis (repair and maintenance of muscle) and boosts muscle mass and strength. You can also help build and maintain muscle mass by eating 50 to 60 grams of high-quality protein a day; a nice mix of sources could include a cup of cottage cheese, Greek yogurt, legumes, and a piece of fish or chicken. Finally, no need to get discouraged: Keep in mind that you can start reversing age-related ab issues at any time in life. "If you exercised in your twenties and thirties, your forties will be a breeze," Dr.Peeke says. "The great news is that you can start in your forties and start seeing long-lasting results—it's never too late."
To get our top stories delivered to your inbox, sign up for the Healthy Living newsletter
This article originally appeared on Shape.com.

Flat abs aren't just for teenagers, models, or Olympic athletes. Learn how to get a flat stomach with these expert tips.
When You're In Your 20s...
In theory, these should be flat-ab glory years. Though your metabolism starts to drop by 1 to 2 percent when you cross from your teens into your twenties (that means, if you're burning 2,500 calories a day in your teens, you'll burn 25 to 50 fewer calories a day in your twenties, which is why most people gain an average of 1.2 pounds per year at this age), it's still high, says endocrinologist Scott Isaacs, M.D., the author of Hormonal Balance. You're also continuing to churn out large amounts of hormones, like estrogen (this peaks in your late teens or early twenties), which guides your body to store fat in the hips, butt, and breasts instead of the midsection, and growth hormone, which releases fat from its stores in the body so it can be delivered to your muscles for energy, Dr.Isaacs says.
RELATED: You Asked: Can You Lose Weight Just from Your Stomach?
This is particularly true if you consume a lot of carbs. A recent study in the Journal of Nutrition revealed that large amounts of processed carbs (the higher-carb participants in the study were eating 55 percent carbs, 18 percent protein, and 27 percent fat) raise the body's level of insulin, which prevents fat from being unlocked from abdominal fat stores and burned off. Another factor: "Many twentysomethings haven't hit their fitness stride yet; they're doing too much steady-state cardio and not enough strength training and cranking out old-school crunches, a particularly ineffective combination for chipping away at belly fat," says Holly Perkins, a strength-and-conditioning specialist and the author of Lift to Get Lean.Still, even with all this in your favor, four years of keg parties and late-night pizza may have left you with a post grad gut, and those poor eating and drinking habits have a tendency to linger just about as long as your student loan payments. "After graduation, people tend to spend more time sitting at a desk, and this sedentary lifestyle can lead to more weight gain, especially if you're still drinking a lot and not keeping close tabs on your diet," Dr.Isaacs explains.
How to get a flat stomach: Start by shifting your eating habits away from college carbo-loading. (Read up on these healthy beer options if you want to cut down without making your weekend drink-free.) "Help keep insulin at a healthy level by following a moderate-carb diet, in which most of your carbs come from nutritious unprocessed sources like whole grains, beans, fruits, and vegetables," says nutritionist Lisa Young, Ph.D., the author of The Portion Teller. The participants in the Journal of Nutrition study who were given a moderately low-carb diet (43 percent carbs, 18 percent protein, and 39 percent fat) lost 11 percent of their abdominal fat after eight weeks, compared with those on a low-fat, higher-carb diet, who lost only 1 percent ab fat. And because the goal is to burn flab, you need to choose calorie-incinerating workouts.
RELATED: The 7 Best Ab Exercises That Are All Over Pinterest
"It's important to incorporate steady-state cardio, interval training, and strength training," Perkins says. She recommends doing two 35- to 40-minute steady-state cardio sessions a week at a pace that's about a 7 out of 10 on the intensity scale; two 30-minute interval workouts (go for two minutes at moderate intensity followed by two minutes at an almost-all-out pace) to maximize growth-hormone secretion and fat burning; and two days of strength training to build lean muscle mass, which ups your calorie burn. Any type of strength training will be effective, as long as the program gets progressively harder (more weight, more reps) so that you continue to challenge your body. If you're not up for sweating six days a week, you can double up and do the strength training on your cardio or interval days. "Twentysomethings still have metabolism and hormones on their side, so they just need to develop a definitive fitness strategy that includes a balance of cardio and strength training to kick-start their burn and firm," Perkins says. (Want to work out your way to better abs? Try the best ab exercises of all time.)
When You're In Your 30s...
For many women, their thirties are the time to have babies. Pregnancy can cause your rectus abdominis muscles (your front-and-center six-pack muscles) to stretch to the point of separation, a painless condition called diastasis recti, which Brazilian researchers found affected 68 percent of women above the belly button and 32 percent below, when measured at up to eight weeks postpartum. "The muscles usually move back together on their own," says Mary Jane Minkin, M.D., a clinical professor of obstetrics, gynecology, and reproductive sciences at the Yale School of Medicine. "In extreme cases, surgery may be needed to repair the separation." Otherwise, you're probably just dealing with some leftover fat and ab muscles that became stretched out during pregnancy.
RELATED: The One Thing Venus Williams Adds to Her Ab Workouts for a Rock-Solid Core
That doesn't mean they can't snap right back, but it takes some effort. Luckily, you still have a respectable metabolism in your thirties. (Want to pump it up anyway? Eat these 5 foods to boost metabolism.) While it drops another 1 to 2 percent from the first small dip in your twenties during this decade, that's not really going to catch up to you for another decade or so. Estrogen levels can start to drop for some women in the late thirties as fertility diminishes, but less estrogen isn't an issue until you are well into your forties. And you can still cash in on your growth hormone production for now too.
How to get a flat stomach: Getting your pre-baby belly back requires a two-pronged approach: You need to melt the flab that's covering your abs and strengthen your stretched-out muscles. Trainer Sara Haley, the creator of the Expecting More pre- and postnatal exercise DVD programs, suggests the following time-saving high-intensity routine, which has you moving fast enough to keep your heart rate up to torch calories and incorporates moves designed to tone and tighten your whole core; these exercises are safe for those with diastasis recti, as long as it's not severe.
After warming up, do each of the following moves for one minute: high knees (run in place), plank squats (start in a plank, then jump feet forward and pop up into a squat), knee repeaters (get into a low lunge, clasp hands over your head, and bring your back knee up to your chest while simultaneously bringing your hands down to meet the knee; do one minute per leg), and dead bugs (lie faceup on the floor with your legs raised, knees bent at a 90-degree angle, arms raised toward ceiling, and flex your feet as if you're pushing something away with them while focusing on pulling your belly button into your spine). Rest for one minute, then repeat the circuit two more times; cool down. As much as you may want to throw a crunch into the bunch, don't. "Crunching and twisting movements can make any separation worse because they repeatedly open and close the abdominal muscles," Haley says.
RELATED: 5 Crazy-Effective Crunch Variations
And while juggling work, kids, and a relationship doesn't leave a lot of time for slumber, make sure you get as much shut-eye as you can (shoot for seven to nine hours per night), because sleep deprivation jacks your level of the stress hormone cortisol, which encourages ab-fat storage. If you have kids keeping you up at night, sneak in an afternoon snooze. A Penn State study found that a two-hour afternoon nap can offset the effect that a bad night's sleep can have on cortisol. "Even a short nap—if only for a half hour—may have a small beneficial effect," Dr. Isaacs says.
When You're In Your 40s...
Levels of sex hormones, including estrogen, begin to dip at this age. "Until now, the estrogen receptors' influence on fat deposition in the breasts, hips, and butt have been more powerful than the receptors controlling how much fat is stored inside and outside the abs. As estrogen declines in your forties, the receptors in the abdomen begin to exert more power, so you start to preferentially gain weight there," says Pamela Peeke, M.D., the author of Fight Fat After Forty. Not only does metabolism drop by another 1 to 2 percent from when you were in your thirties—one study found that people can lose as much as 8 percent of their calorie-burning muscle mass from age 40 to 50 if they haven't been taking preventive steps—but growth hormone is also dwindling (one University of Virginia study found that there's about half as much at 45 as there is at 25).
RELATED: Jennifer Lopez Shows Off Her Ridiculous Abs in a Post-Workout Selfie: 'We Never Quit'
How to get a flat stomach: There's not much you can do on your own about the loss of estrogen, but a surefire way to boost growth hormone is to go hard at the gym. "Moderate- to high-intensity programs with multiple sets, high reps, short rest intervals, and exercises that target multiple large muscle groups at one time produce substantial acute growth hormone responses," says Nicholas Ratamess, Ph.D., a professor of health and exercise science at the College of New Jersey, who suggests working out intensely at least three times a week for 30 minutes. A review of research in the Journal of Applied Physiology found that in 25- to 43-year-old women, regular high-intensity aerobic exercise resulted in a twofold increase of growth hormone release over 24 hours.
As for muscle loss, it's somewhat preventable. "If you're staying physically active and lifting weights, you should be holding on to about the same muscle mass you had in your thirties," Dr. Peeke says. Research in the journal Physician and Sportsmedicine suggests that cardio can also be effective at helping you pack on muscle or maintain it. The study found that intense aerobic exercise (running, biking, or swimming four to five times a week) reduced muscle loss in athletes ages 40 and up, because regular exercise stimulates protein synthesis (repair and maintenance of muscle) and boosts muscle mass and strength. You can also help build and maintain muscle mass by eating 50 to 60 grams of high-quality protein a day; a nice mix of sources could include a cup of cottage cheese, Greek yogurt, legumes, and a piece of fish or chicken. Finally, no need to get discouraged: Keep in mind that you can start reversing age-related ab issues at any time in life. "If you exercised in your twenties and thirties, your forties will be a breeze," Dr.Peeke says. "The great news is that you can start in your forties and start seeing long-lasting results—it's never too late."
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This article originally appeared on Shape.com.

There's waking up early to work out... and then there's waking up to work out at 4 a.m. (If you're not a morning person, you just died at the thought alone.) Truth: It takes a special type of person to wake up at the crack of dawn for a sweat session. But with the end of the year sneaking up and the holiday season in full swing, your work calendar and social schedule are about to blow up. If you're a strictly-sweat-at-night kind of girl, now might be the time to embrace the morning workout. It doesn't have to be before the sun rises, but consider signing up for a 7 a.m. class at your go-to studio, and you might come away with a new favorite instructor. (Not to mention, science says waking up earlier can change your life.)
Not sure how to get started? Below, seven women who get up nearly every day at 4-in-the-freaking-morning share how they find the energy to break sweat while we sleep—without hating their lives or falling asleep at the office.
RELATED: How to Motivate Yourself to Go to the Gym on Cold, Dark Days
"I keep my alarm in my bathroom."—Macy Vonderschmidt, 22
After graduating from college, I realized I had absolutely zero motivation or energy to lift or run after a full day of work. So I started experimenting with what it would be like to get it out of the way super early. It took me about a month to adjust, but my biggest tip? Put your phone out of reach. I keep my phone in my bathroom, so when the alarm goes off I'm FORCED to wake up and get out of bed to turn it off. (Also try this snooze-proof Red Bull alarm app.) I would say 95 percent of the time that works for me—and the other 5 percent? I cozy back up in bed. Because sometimes it's just not happening—and that's okay. I feel amazing coming into work knowing that my workout is already done, I'm caffeinated, and have taken my dog for a nice walk. Then, I can use the rest of the day to focus on everything else in my life.
RELATED: This Gym Makes It Hard to Breathe for a Better Workout—So I Tried It
"It's when nothing can get in the way of my workout."—Kayla Coffey, 28
I work out in the morning because nothing gets in your way at 4 or 5 a.m. except yourself. Not family, not partners, not work, not chores. The first couple of weeks I was tired, but I just did it. After a few weeks, I was able to get up earlier and earlier without hesitation. It helped me develop discipline that's carried over into the rest of my life. My advice: Stick with it for at least two weeks by signing up for early morning classes with a cancellation fee, finding a morning accountability buddy, writing down your goals, packing your bag the night before, and drinking water first thing in the morning. Trust me, there's no better feeling than being done your workout at 6 a.m. before the world is even out of bed.
RELATED: 5 Reasons Mornings Are the Best Time to Work Out
"I remind myself that it's the only chance I have for my WOD."—Ella McDaniels, 24
Five days a week, I'm up for CrossFit by 4 a.m. I work at a hospital, so my hours are really unpredictable. If I don't get it done right away, there's a really good chance I'd miss the afternoon or night classes. It was hard getting up that early at first, but I never regretted it and noticed that I felt better throughout my day. So I kept doing it again and again and again. My advice is to give your body time to adjust to getting up and working out so early. It may be hard at first, but stick with it, and you'll be glad you did. Oh, and go to bed early!
"I count down from three when my alarm goes off."—Rachel Turner, 24
As a busy mom and business owner, sometimes the only possible way I can get a workout in is if I do it at 4:30 a.m. before my son wakes up. It's not ideal, and there are some days I definitely hit snooze too many times and miss my chance. (If you can relate, you need to read this: Fit Moms Share How They Really Make Time for Workouts) To help the wake-up process, I use the three, two, one rule; when I hear my alarm I count down from three and get up, no matter what. (And that means no scrolling through my emails!) My biggest piece of advice is to pick a form of exercise you actually like. It's way easier to get up when you're not dreading the workout. Whether I'm doing a 10-minute AMRAP, yoga, or a longer workout, movement makes my body feel more grounded, focused, and empowered throughout the day.
"I put a coffeemaker with a timer in my bedroom."—Stef Bishop, 34
Honestly, when I first started to get up early, it was a nightmare for two full weeks. (Also see the super-relatable struggles of this fitness Instagrammer who tried to become a morning person.) Then I began to settle into a routine and saw the benefits—physically and mentally. The key to my success is preparation. I make sure my clothes were packed the night before and that my food is ready to grab from the refrigerator. I keep water by my bed and drink it as soon as my alarm goes off. That way, if I try to press snooze, I won't be in bed for long before my bladder gets me out from under the sheets. I even go as far as putting a coffeemaker with a timer in my bedroom. It may seem strange to others, but it gets me up and sweating before the sun rises. With everything planned like that, I can get out of my house within 15 minutes of waking up. (Take a closer look at many fitness trainers' morning routines, too.)
If you're just getting started, try planning your workout the night before, enlisting a friend to train with you in the a.m. Place your alarm across your bedroom, and put some tunes on as soon as you wake up to get you moving.
"I get up because if I don't, I won't be able to move the rest of the day."—Sonya Marie Reis, 30
I get up because my body and my health rely on it. I have rheumatoid arthritis, lupus, fibromyalgia, and two other autoimmune diseases. Two years ago, I got so sick that I couldn't walk on my own most days, and had to use a cane or a walker. It took a while for me to recover and re-learn how to walk again, and some days it's still hard. I wake up to exercise really early because if I don't, it's hard for my body to move fluidly the rest of the day. Getting out of bed when you're exhausted and it's freezing outside is tough, but I tell myself "now or never" and repeat it like a mantra. For me, it's true: If I put it off, I really will never feel my best later. (Here's a whole list of morning mantras to get you started.)
"I never let myself think about how early it is."—Christine Cody, 27
Waking up early to work out used to sound like the worst possible idea to me. I couldn't imagine why anyone would do it—that is until I tried it. It took about five days before I fell in love. So, I started working out at 5 a.m. before work four or five days a week, and I'll never go back. Now, when I skip a morning workout, I can clearly feel myself dragging. My biggest piece of advice is to don't think. The more time you give yourself to think about what you're about to do (get out from under the covers), the more likely you'll be to keep snoozing and "start tomorrow."
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This article originally appeared on Shape.com.