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.

Marketed as a "harmless" alternative to cigarette smoking, vaping is increasingly emerging as a health concern, particularly for lung health, doctors warned ahead of World Lung Cancer Day on August 1.

Traditional cigarettes remain strongly linked to lung cancer, chronic obstructive pulmonary disease (COPD), and several other life-threatening illnesses. However, growing laboratory, animal, and population studies suggest vaping may also damage lung tissue, alter DNA, and potentially increase lung cancer risk—especially among people who both smoke and vape.

A recent study published in the peer-reviewed journal ERJ Open Research found that vaping may offer far less protection than many users believe when it comes to cardiovascular fitness, breathing efficiency, lung function, and blood vessel health in young adults.

"E-cigarettes are often advertised as a safer choice and as a way to help people quit smoking. But the evidence behind these claims is weak. We still don't fully know what long-term damage e-cigarettes can do to the lungs, including whether they can cause lung cancer," Dr. Shiba Kalyan Biswal, Head of Pulmonology at Shalby International Hospital, Gurugram, told HealthandMe.

Why E-Cigarettes May Raise Lung Cancer Risk

The vapor produced by e-cigarettes contains several harmful chemicals, including substances that can damage cells and DNA—the genetic material inside the body's cells.

Animal studies have found that mice exposed to e-cigarette vapor for about a year developed a type of lung cancer. Ingredients commonly used in e-cigarette liquids, such as propylene glycol and benzoic acid, may also irritate cells and trigger inflammation in the lungs.

"There have also been outbreaks of a serious vaping-related lung disease that has sent people to hospital with severe breathing problems. This shows that the risks of vaping can be unpredictable, especially when products are poorly regulated or contain unknown ingredients," Dr. Biswal explained.

She urged doctors to routinely ask patients about e-cigarette use, particularly those with breathing problems or those at higher risk of lung cancer.

"Since evidence suggests that e-cigarettes add to the risk for people who used to smoke, it may be worth including vaping history when deciding who needs lung cancer screening," she said.

Why Dual Users Face Even Greater Risk

According to Dr. Biswal, lung cancer risk appears to be even higher among people who use both e-cigarettes and conventional cigarettes, often referred to as "dual users."

Many smokers who turn to e-cigarettes intending to quit end up continuing to use both products rather than switching completely.

"This means they stay addicted to nicotine and may be exposed to even more harmful substances."

Lung Cancer Rising Among Young Non-Smokers

Doctors are also reporting more lung cancer cases among young people who have never smoked, particularly women.

Indoor air pollution, biomass fuel exposure, second-hand smoke, occupational hazards, and genetic susceptibility are increasingly contributing to the disease, said Dr. Akshay Budhraja, Senior Consultant and Head of Respiratory and Sleep Medicine at Aakash Healthcare.

"It's no longer just the lifelong smoker in his sixties—we are seeing younger patients, more women, and a growing number who have never touched a cigarette. Air quality, occupational exposure and genetic predisposition are all playing a bigger role than they used to, and that means our screening approach has to widen well beyond the traditional smoker profile," Dr. Budhraja said.

Experts said early detection through low-dose CT screening remains crucial for high-risk individuals. However, symptoms such as a persistent cough or breathlessness are often mistaken for pollution-related irritation or a lingering infection, leading many people to delay getting screened.

They also noted that lung cancer affects more than the lungs, with potential impacts on men's sexual health and women's reproductive health.

Lung Cancer Remains a Global Health Challenge

According to the World Health Organization (WHO), lung cancer remains one of the world's biggest public health challenges due to its high incidence and mortality. In 2024, it was the leading cause of cancer-related deaths globally, with an estimated 2.6 million new cases and 1.8 million deaths.

Lung cancer develops when abnormal cells grow uncontrollably in the lungs. Treatment depends on a person's medical history and the

stage of the disease.

The doctors stressed that avoiding tobacco remains the most effective way to reduce lung cancer risk.

"Smokers face nearly 20 times the risk of non-smokers, though the rising non-smoker caseload complicates that picture," said Dr. Budhraja. "Second-hand smoke is the third leading cause of lung cancer among non-smokers; radon gas, seeping in from soil, is the leading one, and home testing kits can catch it."

I've spent over three decades treating heart disease, and in that time, I've seen the same misunderstanding come up again and again, across different patients, different generations, different backgrounds. It's the one that delays diagnosis more than any other. Ask most people what menopause changes, and they'll talk about hot flashes, mood swings, or sleep. Ask me, and I'll tell you it changes something just as important: a woman's heart.

I believe menopause should be treated as a cardiovascular milestone, not just a reproductive one. We talk to women a great deal about bone density, hormonal symptoms, and fertility. We talk far less about what's happening quietly inside their arteries during this same period. That gap in the conversation is costing us early diagnoses. In some cases, it's costing lives.

How Estrogen Protects The Heart?

To understand why, it helps to look at what protects a woman's heart in the first place. For most of her reproductive years, estrogen acts almost like a quiet guardian in the background, keeping the endothelium — the inner lining of blood vessels — working well, and supporting the release of nitric oxide, which helps arteries stay relaxed and open. This is a big reason heart attacks are fairly uncommon in women before menopause, compared to men of a similar age.

Menopause takes that buffer away, slowly, not all at once. The shift usually starts during perimenopause, often well before periods actually stop. LDL, the harmful cholesterol, tends to rise; HDL, the protective kind, often falls. Blood pressure that used to be easy to control starts creeping higher. Arteries stiffen, insulin resistance sets in, and fat tends to shift toward the belly, carrying its own inflammatory effect on blood vessels. None of this feels dramatic on any single day. It just builds, quietly, year after year — enough that by ten to fifteen years past menopause, a woman's heart risk has often caught up to, and sometimes overtaken, a man's of the same age.

Also read: Lifestyle Genetics And Hormones: Understanding The Interplay Of Risk Factors For Ovarian Cancer

Ageing & Menopause: A Double Impact

Some argue this is simply age catching up, and that menopause gets blamed unfairly. There's truth in that — age alone stiffens arteries in everyone. But in my experience, losing estrogen compresses those changes into a much shorter stretch of time. It isn't one factor or the other; it's ageing, sped up by a hormonal shift arriving right in the middle of life.

That said, menopause alone doesn't determine a woman's future with heart disease. It sets the stage, but daily habits decide how the story plays out. Smoking, inactivity, weight around the middle, a diet heavy in processed food, unchecked blood pressure and blood sugar, chronic stress, poor sleep, and skipped check-ups all add their share. The reassuring part is that nearly everything on that list can be changed. I've watched patients shift their own trajectory with fairly ordinary steps — walking regularly, eating simply, sleeping better, getting basic tests done once a year.

Also read: Mood Swings, Anxiety & Brain Fog During Menopause? Expert Recommends Looking Beyond Hot Flashes

Heart Symptoms Women Should Never Ignore

What troubles me most in practice is how often real cardiac symptoms get mistaken for "just menopause." Chest pressure rather than sharp pain. New breathlessness during simple activity. Fatigue that doesn't lift with rest. Pain in the jaw, upper back, or between the shoulder blades instead of the classic left-arm pain. Palpitations that don't settle. A few months ago, a woman in her early fifties came to me convinced she had acidity — tightness in the chest, breathlessness on stairs, an occasional fluttering heartbeat. An angiogram showed a significant coronary blockage. "I thought heart problems were a man's disease," she told me. I hear some version of that sentence often, and it worries me every time.

My advice to patients is simple: perimenopause is the right time for an honest conversation with a doctor about the heart, not after something has gone wrong. That means a blood pressure check, a proper lipid profile, blood sugar and HbA1c testing, and a baseline ECG — with an echocardiogram, stress test, or coronary calcium score for those with added risk factors.

Menopause changes a great deal about a woman's body. Her heart is one of those things, whether she's thinking about it or not. Don't wait for a scare to start the conversation. Start it now, while there's still so much you can do.

For decades, many cancer patients in India have lived with a frightening belief — that a biopsy can make cancer spread. This misconception continues to delay diagnosis, often costing patients the opportunity for timely treatment. This is one of the most common fears I encounter in clinic.

Almost every week, someone tells me, 'Doctor, if you cut it, it will spread.' Families repeat it, neighbors reinforce it, and patients postpone the test. Actually, this concern is linked to a genuine scientific phenomenon known as needle-tract seeding. These phenomena suggest that a few tumor cells may be displaced along the path of the biopsy needle.

However, this event is extremely uncommon and should not be confused with cancer spreading. Seeding is not the same as spreading. A few displaced cells sitting in a needle track are not a metastasis.

Published studies estimate the risk of needle-tract seeding to be extremely low. A 2015 systematic review reported the overall incidence to be below one percent, while more recent reviews, including a 2024 analysis of breast needle biopsy, found no evidence that diagnostic biopsies increase cancer recurrence or reduce long-term survival.

If tumor cells are displaced during a biopsy, they are usually removed when the tumor is surgically excised. In many cases, radiotherapy, systemic treatment and the body's own immune system also eliminate these cells.

In many tier-two and tier-three cities, it takes two to three weeks to reach final report to the treating doctor. During that period, the untreated cancer continues to grow naturally. The patient does not see natural history. He sees cause and effect. The biopsy happened; the lesion grew. The conclusion writes itself — and it is wrong. This delay unintentionally reinforces the misconception that the biopsy triggered the growth, when in reality the cancer was progressing on its own.

At the same time, every tissue injury, including a biopsy, activates the body's wound-healing response, leading to inflammation and new blood vessel formation. Laboratory and animal studies suggest that this temporary inflammatory environment may favor tumor cells. However, these findings have not translated into poorer outcomes for patients. So, the fear is not irrational. It is simply misdirected, and it is mis proportioned.

The diagnosis is not the danger. The delay is. Biopsy helps precision oncology. It helps deciding the treatment approach. Without this we would be treating in the dark.

The consequences of delaying diagnosis are serious. Patients of oral cancer diagnosed while the disease is still localized have a five-year survival rate of nearly 79 per cent. Once the cancer spreads to distant organs, survival drops to around 19 per cent. Unfortunately, nearly two-thirds of oral cancer patients in India are still diagnosed at an advanced stage.