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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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When we think of perimenopause, irregular periods, hot flashes and mood changes usually come to mind. But the transition to menopause is not limited to the menstrual cycle. Behind the scenes, changing ovarian hormones—particularly fluctuating and eventually declining estrogen—can influence body composition, insulin sensitivity, cholesterol levels, bone health and cardiovascular risk.
For many women, these metabolic changes begin years before their final menstrual period.
A common concern during perimenopause is: “I haven’t changed my diet, so why am I gaining weight around my abdomen?”
Ageing itself contributes to gradual loss of muscle mass and changes in energy expenditure. At the same time, the menopausal transition is associated with a shift in fat distribution, with a greater tendency to accumulate visceral or abdominal fat.
This matters because visceral fat is metabolically active. An increase in abdominal fat can be associated with insulin resistance, abnormal cholesterol levels and a higher risk of metabolic disease. So, the change in waist circumference may sometimes tell us more about metabolic health than the number on the weighing scale alone.
Also read: After Menopause, These Breast Changes Shouldn’t Be Ignored
Estrogen interacts with several pathways involved in glucose and fat metabolism. During midlife, changes in body composition, reduced physical activity, sleep disturbance and hormonal changes can collectively make insulin sensitivity less favourable.
This does not mean every woman going through perimenopause will develop diabetes. However, women who already have risk factors—such as overweight or obesity, prediabetes, a history of gestational diabetes or a strong family history of type 2 diabetes—should be particularly mindful.
The menopausal transition can also be accompanied by unfavourable changes in the lipid profile, including changes in LDL cholesterol. Cardiovascular risk increases with age, and menopause is an important time to reassess risk factors such as blood pressure, glucose, cholesterol, smoking, physical activity and body composition.
Women often spend years focusing on reproductive health while overlooking these equally important metabolic markers.
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Midlife is also an important period for protecting muscle and bone. Declining estrogen after menopause accelerates bone loss, while ageing contributes to loss of muscle mass.
Resistance training therefore becomes especially valuable. Adequate protein intake, regular weight-bearing exercise, sufficient calcium and vitamin D, good sleep and avoiding smoking can support healthier ageing.
Perimenopause should not be viewed as a disease, nor should every symptom or kilogram gained in midlife automatically be blamed on hormones. Instead, it is an opportunity for a metabolic health check.
Women should discuss appropriate screening for blood pressure, blood glucose or HbA1c, lipid profile, weight and waist circumference monitoring , DEXA scan for bone health, depending on their individual risk factors.
Most importantly, don’t wait for menopause to start thinking about metabolic health. The perimenopausal years can be an important window to build muscle, improve fitness, optimise nutrition and identify metabolic risk early.
Perimenopause is more than a change in periods—it is a transition in whole-body health. Understanding these changes early can help women enter the next phase of life stronger, healthier and better prepared.
(By Dr. Seema Daksh, MBBS, MD (Internal Medicine), DM (Endocrinology), Consultant Endocrinologist,Kailash Hospital, Greater Noida)
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Loud habitual snoring is often dismissed as a nuisance or simply a part of sleeping. For some people, it may be an early warning sign of obstructive sleep apnoea, a condition in which breathing repeatedly slows or stops during sleep. When left unaddressed, sleep apnoea can quietly strain the heart and blood vessels, increasing the risk of blood pressure, irregular heart rhythms, heart attack and stroke.
Snoring happens when relaxed tissues in the throat vibrate as air moves through a narrowed airway. Not everyone who snores has a problem and occasional snoring is common. However loud and regular snoring, especially when a bed partner notices pauses in breathing, choking or gasping should not be ignored. It may indicate sleep apnoea, where the airway collapses repeatedly during sleep.
Each time breathing stops, oxygen levels drop. The brain briefly wakes the body up to restart breathing. Most people do not remember these interruptions but their body feels the effects. Over time, this cycle can disturb sleep, raise blood pressure, increase inflammation and put pressure on the cardiovascular system.
Also read: ‘Godzilla’ Drug Retatrutide Reverses Sleep Apnea In 1 In 4 Diabetes Patients
Sleep apnoea is increasingly recognised as a risk factor for stroke. It can worsen hypertension. Contribute to atrial fibrillation, an irregular heartbeat that raises the likelihood of a stroke. The concern becomes greater in people who already have conditions such as diabetes, obesity, high cholesterol or a family history of heart disease.
For them, untreated sleep apnoea may add to the strain on the heart and blood vessels. A landmark study by the All India Institute of Medical Sciences (AIIMS) New Delhi estimates that roughly 104 million Indians suffer from Obstructive Sleep Apnea (OSA), with about 47 million cases classified as moderate to severe.
There are also signs that should prompt a conversation with a doctor. Waking up unrefreshed despite spending hours in bed, feeling excessively sleepy during the day, experiencing morning headaches, and struggling to concentrate or becoming unusually irritable can all be linked to poor-quality sleep caused by sleep apnoea. If snoring is accompanied by any of these symptoms a sleep study may be recommended to confirm whether it is snoring or a more serious breathing disorder.
The reassuring part is that sleep apnoea is treatable. Depending on its cause and severity, doctors may suggest weight management where relevant, avoiding alcohol and sedatives close to bedtime, treating congestion, changing sleep position, using an oral appliance or undergoing CPAP therapy, which keeps the airway open during sleep.
The message is not to worry about every snore but to take loud snoring seriously particularly when it comes with breathing pauses or daytime tiredness. Early diagnosis can improve sleep, energy and overall quality of life while helping reduce long-term risks to the heart and the brain.
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Perimenopause is often described as a transition marked by hot flashes, mood swings and irregular periods. Because these changes are common, many women simply accept them as an inevitable part of ageing. But the years around menopause are also an important turning point for cardiovascular health.
The connection is partly hormonal. As ovarian function changes, oestrogen levels fluctuate and eventually decline. Oestrogen has several favourable effects on the cardiovascular system, including effects on blood vessels, cholesterol metabolism and vascular function. Its decline does not suddenly “cause” heart disease, but it can coincide with changes in blood pressure, cholesterol, body fat, glucose metabolism and vascular health that collectively increase cardiovascular risk.
Not every symptom during perimenopause is cardiac. Hot flashes, night sweats, sleep disturbance, anxiety and palpitations are common. However, new, severe or unusual symptoms deserve attention—particularly in women who have cardiovascular risk factors.
Chest discomfort is one symptom that should never automatically be attributed to menopause. Women may experience coronary disease differently from the classic crushing chest pain often described in men. Pressure, tightness, burning or discomfort in the chest, upper abdomen, back, jaw or arms may occur. Breathlessness, unusual fatigue, nausea, sweating or light-headedness can also accompany cardiac problems.
Similarly, repetitive palpitations should not simply be labelled as hormonal. Perimenopausal fluctuations, stress, poor sleep and hot flashes can increase awareness of the heartbeat, but persistent rapid or irregular heartbeats, particularly when associated with dizziness, fainting, chest discomfort or breathlessness, warrant evaluation.
Increase in Blood pressure is another important warning sign. Hypertension is often silent, and women may discover it incidentally during this period. Repeated elevated readings should be assessed rather than attributed to stress.
Oestrogen influences the endothelium—the inner lining of blood vessels—and contributes to healthy vascular function. During the menopausal transition, hormonal fluctuations and eventual oestrogen decline occur alongside changes in lipid metabolism and body composition.
LDL cholesterol may rise, while HDL and triglyceride patterns can also change. Fat distribution often shifts towards the abdomen, even without a dramatic change in overall body weight. Muscle mass may decline and insulin resistance can increase.
Blood pressure may also rise with age. Sleep disruption, reduced physical activity, stress and changes in diet can further compound these effects.
It is important, however, not to think of menopause as a single switch that suddenly transforms a woman from low-risk to high-risk. Traditional risk factors like obesity, diabetes, smoking etc can increase the risk profile. Menopause is better understood as a period when existing risk factors may become more apparent or begin to accelerate.
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The menopausal transition provides an excellent opportunity for a cardiovascular “health audit.”
Know your numbers. Blood pressure, fasting glucose or HbA1c, lipid profile and weight/waist circumference should be assessed according to individual risk. A woman with diabetes, hypertension, kidney disease, premature menopause or a strong family history of premature coronary disease may require more intensive assessment.
Keep moving. Regular aerobic activity combined with resistance training is particularly valuable. Brisk walking, cycling, swimming or similar activities can be complemented by strength training two or more times a week. Physical activity helps control blood pressure, glucose, weight and cholesterol while preserving muscle mass.
Pay attention to diet. A heart-healthy dietary pattern should emphasise vegetables, fruits, legumes, whole grains, nuts, seeds and appropriate sources of protein, while limiting highly processed foods, excess sugar, refined carbohydrates, trans fats and excessive salt. Alcohol should be limited.
Do not smoke. Smoking substantially increases cardiovascular risk, and stopping at any age provides meaningful benefit.
Protect sleep and manage stress. Insomnia and night sweats are common during perimenopause, but persistent sleep deprivation can adversely affect blood pressure, glucose regulation, appetite and overall cardiovascular health. Treating significant sleep problems is therefore part of cardiovascular prevention—not simply improving.
Menopausal hormone therapy (MHT) should not be viewed as a treatment for preventing heart attacks. Its cardiovascular effects depend on factors such as age, timing relative to menopause, the formulation used, route of administration and a woman’s underlying cardiovascular and thrombotic risk.
For women with troublesome menopausal symptoms, the decision about MHT should therefore be individualised after discussing benefits, risks and alternatives with an appropriately qualified clinician. Hormone therapy should not be started solely for cardiovascular protection.
Perhaps the most important message is that perimenopause should not be regarded simply as a collection of symptoms to be endured. It is also an opportunity to identify cardiovascular risk.
The hormonal transition is natural. Cardiovascular disease is not inevitable. Recognising this window as an opportunity for prevention can help women enter the postmenopausal years with a healthier heart—and with a clearer understanding that caring for cardiovascular health is an essential part of healthy ageing.
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