Batsi Chikura

Dr Batsi Chikura is a consultant physician and rheumatologist based in Lincoln, UK. He is a member of the Royal College of Physicians (London) and a member of the British Society for Rheumatology

Are women the better sex?

Race against ageing ... Women are outliving men

IN MOST countries in the world, females live longer than their male counterparts. In the ultimate battle of longevity, women usually have the last laugh. Men may think they are indispensable, yet nature has made them disposable.

This is not unique to mankind. There is good evidence which shows that females in most animal species live longer than males.

In the industrialised world, women live five to 10 years longer than men. Women dominate the 100 years and over old age group and they constitute at least 85% of that population.

The reproductive success of mankind is so inextricably bound up with the integrity and durability of the female body and evolution has determined that man are disposable and have a statistically significant, higher likelihood of dying at all ages compared to women.

Due to cultural pervasiveness of certain societies, the population has been systematically engineered and there are more males than females in most age groups.  At present, some countries which include India (2001 census), Pakistan (1998 census) and China (2011 census) have life expectancy of males exceeding that of females. These societies have systematically ‘reduced’ the female sex by various methods.

In India it is estimated that the female foeticide (the killing of the unborn female child or induced abortion) is approximately one million per year and the mortality rate of girls is 40% higher for girls under five than boys the same age, which is divergent to the rest of the world.

If you exclude the cultural pervasiveness of certain societies, men have a statistically significant higher likelihood of dying at all ages compared to women. The perilous journey for men starts before birth. More male foetuses are naturally aborted by their mothers during early pregnancy.

At birth there are slightly more boys than girls. More boys than girls die in their first year of life. This trend persists and during subsequent years of life, mortality rates for males are higher than those for females and by the age of 25, women are in the majority.

But why do men die so young and why do women die so old? If you ask women they will tell you not to waste time brooding over the mystery of something that is very obvious: men are either stupid or do stupid things most of the time and end up dead!

In the race for the title of ‘the most stupid male’, the male black widow spiders are obvious winners; they are signatory to a deadly contract of being eaten after romance.

If you ask men, the answer is simple; women live longer because their lives are made easier by men. Men feel that they are nagged by their wives until they give up on life altogether. Young men attribute such differences to greater physical labour of men and that they are disadvantaged by their ‘provider’ role. Men basically dig their short distance to their graves whilst women take a long leisurely walk.

If we set aside the societies perceptions of such variance, is there a biological or medical explanation to this difference in longevity and is there evidence for this?

The honest truth is no one really knows why women are built to last. The causes of gender differences remain poorly understood and there is no single explanation. Research supports an interaction of biological and socio-cultural factors to account for why women live longer than men.

Experts suspect that gender differences in mortality may be influenced in part by sex hormones; the male hormone testosterone and the female hormone oestrogen.

The age related disease patterns vary between the two sexes. Women tend to get potentially lethal cardiovascular disease, like heart attack and stroke later in life, about 10 years later than men.

Men have a higher metabolic and growth rates and a longer period of sexual competence than women, which could put the body systems under prolonged pressure.

Health seeking behaviours such as going to the doctor, less alcohol and smoking in women could explain the gender difference.

The ‘macho’ perception means men are less likely to complain about illnesses and sometimes they have to be dragged kicking and screaming by their wives to see a doctor. The ‘macho’ perception is rubbed into the minds of boys from an early age when they are told by their mother to “get on with it” and “be a man”.

When men are ill, their wives may derogatively use terms such ‘Man Flu’ which is defined as ‘a crippling and debilitating disorder indiscriminately striking down male members of the human species without warning’ i.e. exaggerated illness. No wonder why men exercise their right to remain silent and suffer in silence.

It is not all doom and gloom for men. Men who survive to celebrate their 100th birthday enjoy better health than their fellow female centenarians. More women than men are bedridden and unable to walk. Women are also more likely to have a history of bone fracture due to osteoporosis (brittle bones). Although women live longer than men, they get sick more. It could be that women live with their diseases, while men die from them.

Compared to men, women live with disability, in part due to higher prevalence of non-fatal chronic conditions such as arthritis. Some women think that their disabilities in later life is due to less paid work, more hours spent in household chores, child care, helping others, fewer hours of leisure and poor sleep.

Gender equality is unfortunately catching up in this area. More women have taken on behaviours and stresses that were formerly confined to men such as smoking, drinking, partying, reckless behaviour and stressful jobs. The mortality from conditions such as heart diseases, lung cancer etc has risen in women in the past decades. The gender gap is therefore shrinking.

It is advisable for men to stop being a ‘macho’ and see a doctor when you are ill, then you may live as long as your wife. Your health is your priority, so take care of yourself.