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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.
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.
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.
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.
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The biological landmarks that occur in a woman’s life include many factors and menopause is one of them. Menopause is usually identified with changes in menstrual cycle, hormone levels, hot flashes and even emotional health. Nevertheless, this stage of a woman’s life is also characterized by some other things and needs to focus on woman’s cardiovascular system.
Heart problems have long been considered as the problem that concerns mostly men. Nevertheless, today it is known that cardiovascular diseases still kill more women than anything else and take the lives of almost one-third of all women in the world.
Until menopause, estrogen gives the cardiovascular system a number of advantages. It maintains the proper state of the blood vessels and assists in cholesterol regulation and proper vascular functioning. But when the woman gets into menopause, the drop of oestrogen level can cause various internal alterations. They include the increase of LDL cholesterol level, the decrease of HDL cholesterol level, elevated blood pressure, metabolic alterations and abdominal fat accumulation.
All those alterations will increase the chance of getting cardiovascular diseases, such as coronary artery disease, stroke and heart failure. According to the American Heart Association, the women become at greater risk for cardiovascular diseases after going through the process of menopause.
Also read: Is Controlling BP Enough After a Brain Bleed? Doctors Explain How to Prevent Another Stroke
On the other hand, women may suffer from various symptoms that are associated with heart disease but differ from those in men. For instance, fatigue, breathlessness, nausea, lightheadedness, jaw pain, back pain or arm pain can sometimes go unnoticed and are misdiagnosed.
Therefore, awareness and medical consultation are vital. Health checkups, blood pressure and cholesterol monitoring, living healthy, eating healthy and individualized medical advice can greatly help in decreasing risks in the future.
Also read: Preeclampsia May End With Pregnancy. Your Heart Risk May Not
Treatment for menopause should not be restricted to treating symptoms; it should include care during the entire period of health transition.
Every woman's individual health requirements and guidance through various phases of life should be in accordance with her health needs.
Menopause should never be seen as a deteriorating process but as a turning point where women can assess the state of their health and adopt preventative measures for their healthcare.
Ahead of World Heart Day, the issue of women’s heart health should go beyond just treating heart diseases and focus on preventive measures. It is not only about asking: “how do we treat heart disease in women?” It is also about asking: “how do we detect risk factors and help each woman protect her heart during one of the most critical periods in her life?” For when women understand what is going on in their body, they get the ability to make the right decisions about their health.
By Dr. Anupama Gangwal, Senior Consultant – Obstetrics and Gynaecology, Cocoon Hospital, Jaipur
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Polycystic ovarian syndrome (PCOS), now renamed polyendocrine metabolic ovarian syndrome (PMOS), can begin during adolescence and affect metabolic health, fertility and mental health, AIIMS experts said.
Speaking at a press conference in Delhi, the experts discussed PCOS risk factors, diagnosis in teenagers and the role of lifestyle management.
Obesity and sedentary habits can increase risk, but irregular periods or polycystic-looking ovaries on ultrasound do not automatically mean PCOS. Menstrual irregularity and ovarian changes can be normal during adolescence, making accurate diagnosis important.
Irregular periods are common in the first year after menstruation begins. Dr. Rajni Sharma, Professor, Division of Pediatric Endocrinology, Department of Pediatrics, AIIMS, said: “It is normal and physiological.”
However, persistent irregularity should be evaluated.
“But if they are irregular even after one year, like their duration is coming in between, duration more than 45 days up to 3 years, or after menarche, after 3 years up to 35 days cycle, or less than 21 days cycle, or less than 8 times per year cycles, or their gap is more than 3 months, then we should think that they are irregular and they should be investigated,” she said.
Also read: Why Rebranding PCOS As PMOS Could Mark A New Era In Women’s Health
Ultrasound is not routinely used to diagnose PCOS in adolescents because polycystic-looking ovaries can be normal during this stage, Dr. Rajni said.
Dr. Renu Sharma, Child Psychologist, Department of Psychiatry, AIIMS, said such findings can also cause unnecessary anxiety.
“Many times, many families come out of fear because there is a polycystic appearance in an ultrasound.”
Some girls may have PCOS-like features without meeting the diagnostic criteria and may instead be considered at risk.
“We call it at risk of PCOS. At this stage, it is best to focus on diet and lifestyle.”
Family history, obesity, type 2 diabetes and lifestyle factors can increase PCOS risk, Dr. Rajni said.
“Especially if there is type 2 diabetes, obesity, all these things are there, or mother, or her aunt had PCOS, then the risk increases.”
Poor diet and physical inactivity can also contribute.
“They are not eating fiber, fruits, vegetables. And they are consuming more junk food. And, one is, sedentary activity,” she said.
However, PCOS can also occur in girls with normal weight. “Many normal girls can also have it. Normal weight girls.”
Facial and body hair can affect self-image and self-esteem in adolescent girls with PCOS, Dr. Renu said.
“These young adolescent girls suffering from PCOS have very significant psychosocial issues," said the expert, adding that anxiety and depression are very common.
They also develop some eating disorders such as anorexia or bulimia, she said, noting that the adolescent's "self-perception, or self-concept, starts becoming negative.”
Lifestyle management is an important part of managing PCOS risk and symptoms. Dr. Vandana recommended healthier food choices and regular physical activity.
“You can make a lot of things at home, with good healthy ingredients.”
“Second, in general, you should eat more salads. You should eat more colorful fruits and vegetables, so we talk about this.”
She also stressed the importance of avoiding a sedentary lifestyle, and stressed the need for "one hour of physical activity of moderate to vigorous level daily".
“This means that, while doing that activity, you are not able to talk normally. If you can talk normally, then it means that the activity is not of moderate to vigorous level.”
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Most women who've had preeclampsia remember it as something that happened during pregnancy. The blood pressure spiked, doctors kept a close watch, the baby arrived, and everything went back to normal.
Case closed, or so it seems. But there's a quieter part of this story that doesn't get told nearly enough - what preeclampsia might mean for a woman's heart years down the line.
It's a condition that can happen after the 20th week of pregnancy, when blood pressure rises sharply and starts putting pressure on organs like the kidneys or liver. During preeclampsia, the lining of blood vessels - the endothelium - becomes inflamed and doesn't relax and dilate the way it normally should.
This is the same vessel dysfunction we see in the early stages of coronary artery disease, just decades ahead of schedule. Doctors usually catch it through routine checks - protein in the urine, sudden swelling, or blood pressure readings that don't sit right.
Once the baby is delivered, blood pressure almost always comes back down. That "return to normal," though, doesn't mean the story is over.
Also read: Vitamin D & Pregnancy: Could Vitamin D Deficiency Increase Risk Of Premature Birth?
Think of preeclampsia as an early stress test that the heart didn't quite pass. It is associated with increased risk of hypertension in future and also increase the risk of heart failure, stroke and cardiovascular diseases. And this isn’t a risk that shows up only in old age, in some cases, death happens within the first 10 years after pregnancy.
The risk of heart failure also increases by four-fold and the risk of coronary heart disease by two folds in patients with preeclampsia. The risk of ischemic heart disease and hypertension is elevated too. The risk increases further if preeclampsia occurred early in pregnancy, during multiple pregnancies, or alongside other factors like obesity or a family history of heart disease.
It highlights the importance of life law monitoring of cardiovascular rest factors in a woman who has history of preeclampsia.
Also read: PMOS Isn't Just About Periods Or Pregnancy: Why Women Need To Think Beyond Fertility
Once the baby is here, attention naturally shifts entirely toward the newborn - and a new mother's own follow-ups tend to fall away quietly, usually right after that standard six-week check. That's the gap, we need to close in postpartum care. Women with a preeclampsia history should regularly monitor their blood pressure, cholesterol and blood sugar, and actually bring these numbers up during the consultation.
None of this means preeclampsia guarantees heart disease down the road. It just means the risk picture has shifted, and that's worth knowing. Staying active, eating well, keeping weight in check, and staying away from smoking helps reduce the risk.
More obstetricians and cardiologists are starting to treat preeclampsia as something to track for life, not just for nine months. That shift in thinking could end up protecting a lot of hearts long after the pregnancy itself is over.
By Dr Waseem Farooqui, Consultant, Interventional Cardiology, Cardiac Care, Medanta Hospitals, Noida
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