We all must have come across the phase: this is why women live longer than men. These are all over the social media, where men are performing more often than not, some experiments, without gears, just for fun, "in the name of science". The caption reads: this is why women live longer. However, is there really a science to it, other than the fact that women choose to do things more safely?

In the United States, women have a life expectancy of about 80, whereas men have 75. Women outlive men and this holds true regardless of the country women live, the money they make, and other factors. In fact, it is true for most other mammals too.

Dr Dena Dubal, a professor of neurology at the University of California, San Francisco told the New York Times, "It is a very robust phenomenon all over the world, totally conserved in sickness, during famines, during epidemics, even during the times of starvation."

But what are the reasons? These reasons are often more complicated and less established. It is important to note that only because women are outliving men does not mean they are living a better life. In fact, women tend to have shorter health spans, which means the number of healthy years in a person's life is less in women than men, confirmed Bérénice Benayoun, an associate professor at the U.S.C. Leonard Davis School of Gerontology.

As per a 2021 study titled, Sex differences in frailty: Comparisons between humans and preclinical models, found that women are more physically grail than men in old age. They are also more vulnerable, especially after menopause and are at more risk of developing cardiovascular issues and Alzheimer's disease because of age.

The key is in figuring out what makes one sex more resilient or vulnerable.

Genetics

For things which do not find easy explanations, scientists look for their answers in genes. Many research, including a 2020 study titled, The sex with the reduced sex chromosome dies earlier: a comparison across the tree of life, suggests that the XX set of female sex chromosomes may impact longevity. However, there has not been any clarity on how it affects longevity.

Another 2018 study titled, Female XX sex chromosomes increase survival and extend lifespan in aging mice, which was conducted by Dr Dubal's lab, looked at genetically manipulated mice with different combinations of sex chromosomes and reproductive organs. It was found that those with two X chromosomes and ovaries lived longest, followed by mice with two X chromosomes and testes. Mice with XY chromosomes had shorter life spans.

"There was something about the second X chromosome that was protecting the mice from dying earlier in life, even if they had testes. What if there was something on that second X chromosome that was in some ways a sprinkle of the fountain of youth," says Dr Dubal. While scientists have not yet looked at this factor in humans, Dr Dubal suggests that humans have the same hormones and sex chromosomes, and similar reproductive system that could corroborate the similar findings in people.

Hormones

Plenty research has shown that estrogen is responsible for longevity also effect on the immune system. The data also shows that before menopause, the female immune system tends to do better. In fact Dr Benayoun said that males tend to do much worse in response to infection.

Another 2017 study titled, Ages at Menarche and Menopause and Reproductive Lifespan As Predictors of Exceptional Longevity in Women: The Women's Health Initiative, found that women who experienced menopause later in life over the age 50 lived longer than those who experienced it earlier.

Lifestyle and Behavior

There are also disparity in behavioral patterns between men and women. This includes smoking, drinking heavily, which can contribute significantly to mortality. Women also have more "health promoting behavior", believe experts. Women are also more likely to socialize than men and thus it protects them from detrimental effects of social isolation and loneliness. In fact, a 2023 analysis published in Jama Network, titled, Widening Gender Gap in Life Expectancy in the US, 2010-2021, found that women are less likely to die by drug overdose or suicide.

Many women experience bloating, acidity, stomach discomfort, or constipation from time to time. These symptoms are usually linked to diet, stress, or minor digestive issues. However, these are often overlooked.

On World Ovarian Cancer Day, doctors are urging women to pay closer attention to such recurring symptoms and seek timely medical advice.

World Ovarian Cancer Day is observed every year on May 8 to raise awareness about ovarian cancer and promote early detection. This year’s theme is “No Woman Left Behind.”

According to global estimates, nearly 250,000 women are diagnosed with ovarian cancer each year, and about 140,000 die from the disease.

What Is Ovarian Cancer?

Ovarian cancer is one of the deadliest gynecological cancers and is often referred to as the “silent killer” because its early symptoms are vague and easily mistaken for common digestive or urinary issues.

It develops when abnormal cells in the ovaries grow uncontrollably and may spread to other parts of the body. Survival rates are significantly higher when detected early—around 93 per cent of women diagnosed at stage one survive at least five years, compared to just 13 per cent at stage four, according to the American Cancer Society.

Unfortunately, many cases are diagnosed at advanced stages, when treatment options are limited, and outcomes are poorer.

Early Symptoms Often Overlooked

“Ovarian cancer is commonly called a ‘silent disease’ because its early signs are vague and often resemble routine gastric issues,” Dr. Tejinder Kataria, Chairperson – Radiation Oncology, Medanta Hospital, Gurugram, told HealthandMe.

Common symptoms include:

• Persistent bloating
• Feeling full quickly or reduced appetite
• Pelvic or abdominal discomfort
• Unexplained constipation or diarrhea
• Ongoing indigestion
• Excessive gas
• Abdominal heaviness

Also read: WHO Says 6-Week Hantavirus Incubation Raises Concern, But No Epidemic Risk

One should not ignore these symptoms if they persist for more than two to three weeks.

“Many women delay seeking medical attention because these symptoms feel too common to be serious. Early evaluation through clinical examination, imaging, and blood tests can help detect the disease earlier,” Dr Kaur noted.

“The growing tumor can press on nearby organs such as the intestines or bladder, leading to digestive changes and abdominal discomfort,” she explained.

Risk Factors to Be Aware Of

The experts also highlighted several risk factors that are often overlooked, including:

• Family history of ovarian or breast cancer
• BRCA1 or BRCA2 gene mutations
• Increasing age, especially after menopause
• Reproductive history, such as late pregnancy or never having children

Why Early Detection Matters

Being aware of subtle and persistent symptoms can significantly improve outcomes. Ovarian cancer survival rates are much higher when diagnosed early, making timely medical consultation crucial.

Thalassemia, particularly thalassemia major and thalassemia intermediate, can affect fertility and pregnancy due to iron overload caused by repeated blood transfusions. In these patients, excess iron gets deposited in various endocrine and vital organs, leading to hormonal disturbances and fertility-related complications.

Patients with thalassemia major usually require regular blood transfusions for survival, sometimes every one to three months. Thalassemia intermediate patients may require fewer transfusions, but they too remain at risk of iron overload. Over time, excess iron can accumulate in organs such as the pituitary gland, thyroid, ovaries, kidneys, liver, and suprarenal glands. This iron deposition can impair hormonal function and contribute to infertility. Experts note that many patients with thalassemia major may face fertility issues because of this reason.

Pregnancy In Women Living With Thalassemia

Dr. Sunil Bichile, Hematologist, Saifee Hospital, Mumbai, said, "Although thalassemia management has improved significantly over the years, pregnancy in such patients is still considered high-risk. " Even when iron levels are properly managed, risks to both the mother and fetus may still exist. However, these complications are mainly seen in thalassemia major and thalassemia intermediate patients. Individuals with thalassemia minor generally do not face these fertility or pregnancy-related issues and can have normal pregnancies."

"Doctors also emphasise the importance of carrier screening and prenatal diagnosis. If both partners are thalassemia carriers, prenatal testing around 12 weeks of pregnancy can help determine whether the fetus has thalassemia major. Early diagnosis allows families and doctors to make informed medical decisions and helps reduce severe thalassemia cases," Dr Bichile added.

Ensuring Healthy Pregnancies In Women Living With Thalassemia

Women with thalassemia are now increasingly able to experience healthy pregnancies due to advances in medical care. However, one of the most important concerns during pregnancy in thalassemia patients is iron overload—a condition caused by repeated blood transfusions over many years. Excess iron gets deposited in vital organs such as the heart, liver, and endocrine glands, potentially leading to serious complications if not managed properly before conception and during pregnancy.

How Does Iron Overload Affect Pregnancy?

"Iron overload can significantly increase pregnancy-related risks. When excess iron affects the heart, it may lead to cardiac complications such as arrhythmias or heart failure, which can worsen during pregnancy because of the increased workload on the cardiovascular system. Iron deposition in endocrine glands may also cause hormonal imbalances, affecting fertility and increasing the risk of gestational diabetes, thyroid disorders, or difficulties in maintaining a healthy pregnancy," Dr Liza Bulsara, Pediatric Hematologist and Oncologist, Ruby Hall Clinic, Pune, explained.

Women with poorly controlled iron overload may face a higher chance of miscarriage, fetal growth restriction, preterm delivery, or complications during childbirth. In some cases, liver dysfunction caused by iron accumulation can further complicate pregnancy management. Additionally, anaemia associated with thalassemia itself may increase fatigue and reduce oxygen supply to both mother and baby if not carefully monitored.

Dr Bulsara emphasised that pre-pregnancy counselling is essential for women with thalassemia. A detailed assessment of iron levels through serum ferritin tests and MRI evaluation of the heart and liver helps doctors determine whether the body is prepared for pregnancy. Proper iron chelation therapy before conception plays a crucial role in reducing excess iron stores and improving maternal outcomes. During pregnancy, transfusion schedules, haemoglobin levels, cardiac health, and fetal growth require close multidisciplinary monitoring.

Thalassemia is a hereditary illness that hampers the production of haemoglobin, the component of red blood cells that carries oxygen throughout the body. If the production of haemoglobin is faulty or reduced, a shortage of healthy red blood cells occurs, resulting in anaemia and reduced oxygen supply to the organs.

"Thalassemia is, in fact, a collection of conditions ranging from a simple carrier state with no symptoms to a very severe disease requiring lifelong treatment. Mostly, thalassemias are classified into alpha and beta types, depending on which chain of the haemoglobin molecule is defective," said Dr Sneha Shinde, Consultant – Paediatric Haemato-Oncology, P.D. Hinduja Hospital and MRC Centre, Khar.

As per National Health Mission figures, nearly 42 million people in India are beta thalassemia carriers, and about 10,000 to 15,000 infants with thalassemia major are born every year.

What are the causes of thalassemia?

This disease is inherited from parents through genes. If both parents are carriers, their child may develop a severe type of the disease.

What are the symptoms of thalassemia?

Symptoms largely depend on the severity of the illness and can include tiredness, weakness, pale complexion, difficulty breathing, stunted growth, enlarged spleen or liver, and changes in facial bones. Most severe cases become apparent during infancy or the toddler years.

Dr Shashikant Apte, Director – Haematology, Sahyadri Super Speciality Hospital, Nagar Road, said, "Symptoms can vary from person to person. Some individuals may simply feel low on energy, while others may notice pale skin, shortness of breath, or delayed growth in children. Because these signs are common, they are often ignored or mistaken for general weakness. The majority of children with thalassemia major require blood transfusions every month for the rest of their lives to maintain haemoglobin levels above 9 gm%."

Diagnosis and Treatment

Dr Shinde explained that diagnosis comprises blood tests such as Complete Blood Count (CBC), HPLC haemoglobin electrophoresis, and genetic analyses. Mild cases may hardly need treatment, but more serious or transfusion-dependent thalassemia cases usually require regular blood transfusions along with iron chelation therapy to avoid iron overload. Besides bone marrow transplantation and newly discovered gene therapies, treatment advancements are gradually leading to better patient survival and improved quality of life.

Dr Apte said, "The positive aspect is that thalassemia can be detected with a simple blood test. Early diagnosis helps in managing the condition more effectively. Therefore, it is advisable to undergo screening for thalassemia before marriage or before planning a pregnancy, so the level of risk can be assessed. If both parents are thalassemia minor carriers, DNA testing should be conducted to identify the genetic defect and enable prenatal diagnosis during the 12th week of pregnancy. If the child is diagnosed with thalassemia major, pregnancy termination may be considered between the 14th and 16th week, based on medical advice and individual circumstances."

Prevention and Awareness

Of equal significance is the fact that thalassemia can be prevented through premarital or pre-pregnancy carrier detection and genetic counselling. Early awareness, proper diagnosis, and making informed reproductive choices are the key factors in reducing the burden of this lifelong blood disorder.

Dr Shashikant Apte, Director – Haematology, Sahyadri Super Speciality Hospital, Nagar Road, spoke about the incidence of constant fatigue and answered FAQs about thalassemia major, while sharing tips on living with it.

Why Constant Fatigue Should Not Be Ignored

Being tired every day is typically attributed to a busy lifestyle; however, it can also have underlying medical reasons. Thalassemia is one of the conditions a person is born with that can cause fatigue due to a lack of oxygen. Thalassemia is a disorder in which the proper formation of haemoglobin — the protein in blood responsible for carrying oxygen — does not occur correctly. When haemoglobin is not formed properly, the body does not receive enough oxygen, leading to frequent tiredness and weakness.

Understanding Thalassemia Major and Carrier Status

Thalassemia major is an inherited disorder, meaning it is passed down from both parents to their child. Some individuals may simply be carriers without displaying any symptoms. During each pregnancy, there is a 25 per cent chance of passing the abnormal gene to the foetus, which may result in severe complications related to thalassemia major or other conditions associated with a lack of oxygen. Therefore, it is critical to know your family’s medical history and thalassemia minor (carrier) status.

Living with Thalassemia

Dr Apte went on to say that although thalassemia is a chronic condition, there are highly effective ways to manage it with proper medical guidance. Regular medical check-ups and prompt treatment can help individuals maintain good overall health and lead a normal life.

Understanding thalassemia is the first step towards prevention and better management. Awareness allows individuals and families to make informed decisions and avoid complications before the condition becomes severe.