During middle age, women experience biological and psychological changes that can impact their health and well-being. Menopause is a major biological factor, leading to hormone deficiencies and increased risks of conditions like depression, osteoporosis, and heart disease. Symptoms of menopause vary between ethnic groups. While women experience more non-life threatening illnesses, men face more serious health issues. Stress can also weaken the immune system and increase health risks. Cognitive abilities evolve in middle adulthood, with fluid intelligence declining but crystallized intelligence and practical problem-solving improving through experience and education. Many people also develop more complex, relativistic thinking or strengthen their spiritual beliefs during this stage of life.