Editor’s note: In our ongoing coverage of the underrecognized — but crucial — ways that gender influences health, last month’s issue featured a story on cancers that affect men and women differently. The article below addresses the effect of gender on other common medical conditions.
Not that long ago, doctors assumed that women’s and men’s bodies reacted more or less the same way to various diseases.
Now: Through several studies, researchers have discovered that more than half of the 30,000-plus genes in the human body behave very differently in women compared with men, affecting many vital organs.
Key gender-based variations…
Gender has a significant impact on the body’s infection-fighting immunity.
Important finding: The records of 1,136 men and 1,047 women who were treated at 28 hospital emergency departments for symptoms of pneumonia showed that men tended to be significantly sicker than women when admitted and had a 30% higher risk for death up to a year after the illness (even when the data were adjusted for such factors as age and other health problems).
No one knows exactly why women are better able to fight off bacterial and viral infections, including those that cause pneumonia. One theory suggests that women’s two “X” chromosomes — compared with the “X” and “Y” chromosomes in men — may confer some level of protection against infection.
Self-defense: Everyone — and men, in particular — should be alert for symptoms of infection, including fever and fatigue, and seek prompt treatment.
Even though ischemic stroke (due to a blood clot) is slightly more common in men than in women, women account for about 60% of stroke deaths. More research is needed to determine the reasons for this higher death rate. One possible factor is that women generally suffer strokes at an older age than men.
To minimize brain damage, it’s crucial to recognize stroke symptoms. Clot-busting medication known as tissue plasminogen activator (tPA), the standard stroke treatment, should be administered within three hours of the onset of stroke symptoms (ideally, even sooner). However, female stroke victims frequently delay seeking treatment — in part because their symptoms may differ from men’s.
Stroke symptoms that are widely known to affect both sexes strike suddenly. These symptoms include numbness or weakness of the face, arm or leg — especially on one side of the body… trouble speaking or understanding… difficulty seeing in one or both eyes… difficulty walking… dizziness, loss of balance… and/or severe headache with no known cause.
Women, however, are more likely than men to have other sudden-onset stroke symptoms, such as hiccups… nausea… chest pain, shortness of breath and/or heart palpitations.
Important new finding: In a recent analysis of 18 studies, Michigan State University researchers found that women admitted to hospitals while suffering stroke symptoms were 30% less likely to receive tPA than men experiencing such symptoms.
Self-defense: Discuss your stroke risk factors with your doctor, who will advise you what to do if you experience hiccups, nausea or other symptoms that less commonly signal a stroke.
If you suffer any of the classic symptoms (even briefly) described earlier — call 911 immediately. Anyone experiencing such stroke symptoms needs a prompt evaluation at a hospital to determine whether tPA should be given.
Hip fracture is a leading cause of disability in older men and women, but men are significantly more likely than women to be placed in a nursing home and about twice as likely to die from this injury. (Men’s shorter average life expectancy may partly explain this disparity.)
Troubling finding: In a landmark study in the Archives of Internal Medicine, men hospitalized for hip fracture were found to be significantly less likely than women to receive treatment for osteoporosis (a main cause of bone fractures) at the time of their hospital discharge.
Self-defense: If you are a man with risk factors for hip fracture — such as age (over 65) and lack of physical activity — ask your doctor whether you should receive screening tests, including dual energy X-ray absorptiometry (DEXA), to assess your risk for hip fracture.
Heart disease is America’s number-one cause of death for both genders, but it actually kills more US women than men each year.
Because estrogen is believed to protect against the buildup of arterial plaque, men in their 40s are at much greater risk for a heart attack than women of the same age. When women’s estrogen levels plummet during menopause, however, their heart attack rate equals that of men.
Recent research: Evidence suggests that women often exhibit a different pattern of arterial plaque buildup than men. While men tend to develop blockages at specific points in their arteries, women often develop plaque more evenly throughout their arteries, which makes it less detectable in screening tests.
Women also get less aggressive cardiac preventive care. While women over age 45 have higher cholesterol, on average, than their male counterparts, they’re less likely to be prescribed cholesterol-lowering statin drugs — or beta-blockers (a blood-pressure–lowering medication).
Surprising disparity: While one low-dose (81 mg) aspirin per day helps protect most men against heart attack, it doesn’t give women any heart protection — but it does help protect most women (but not men) against ischemic stroke.
Women also are less likely than men to suffer classic heart attack symptoms, such as crushing chest pain, sweating and shortness of breath.
Less well-known heart attack symptoms, including pain in the jaw or shoulder, can occur in both sexes but are more common in women. Unusual fatigue for several days may precede a heart attack in women.
Self-defense: Starting at age 40, women who are concerned about heart disease (due to family history, for example, or risk factors, such as high blood pressure) should consider consulting a cardiologist who specializes in women’s cardiac health and ask which screening test for cardiovascular disease is most appropriate for them.
This neurological disorder is nearly twice as common in men as it is in women ages 75 to 84, when the majority of cases occur.
Some experts believe that men may be more vulnerable to the disease because they are more likely to have been exposed to toxins, such as pesticides, in their jobs and/or to have suffered head injuries — both of which are believed to increase Parkinson’s risk.
Self-defense: Anyone — and men, in particular — with Parkinson’s symptoms, such as slowed gait and tremor, should see a doctor — especially if one of the risk factors described above is present.
