Why Men Have a Shorter Life Expectancy and What to Do About It

These are difficult times for everyone, but especially men. Compared with women, men have lost more jobs in this recession and are struggling to get back on track in an increasingly competitive work environment while balancing ever-mounting pressures and responsibilities at home. Compounding these stresses are the inherent health disadvantages men face that have wedged five years in life expectancy between the sexes. The average woman lives to the ripe old age of 81, but the average man lives only to age 76. Moreover, in every age group, men are more likely than women to die, with the leading causes of death for men in the US including heart disease, cancer, injuries, chronic obstructive pulmonary disease, infections such as flu and pneumonia, and suicide.

Yes, times are tough, but it’s time that the tough… men, that is… get going so they can live longer and healthier lives. Women have done a great job of joining together in assorted advocacy groups that help protect and advance their issues. Men, however, have not created the same support structure. This is a shame because, in truth, men face unique challenges and would benefit from collective efforts to address their particular health needs.

HOW MEN CAN LENGTHEN THEIR LIVES

I spoke to Marianne J. Legato, MD, professor of clinical medicine at Columbia University and author of Why Men Die First: How to Lengthen Your Lifespan, about men’s unique challenges. She explained to me that the combination of genetics, physiology and the way our society conditions and trains men to behave has resulted in “unique fragilities” that include a weaker immune system, earlier onset of coronary artery disease (CAD) and a tendency to tough it out and not admit to pain or emotional difficulties. Consequently men are less proactive than women when it comes to their physical and mental health, resulting in missed opportunities to catch illnesses in their earlier stages, when they can be effectively treated. Moreover, in these stressful times, many men are not admitting to or recognizing their own feelings of depression, which itself is a risk for serious illness.

Dr. Legato offered some suggestions on what specific steps men can take to lengthen their lives.

1. Bolster Your Immune System

Generally speaking, the male immune system has a less vigorous response to diseases and infections, leaving men more vulnerable to heart disease; colorectal, lung and liver cancers, melanoma; and infectious diseases such as influenza and pneumonia. Because this somewhat weaker immune system is hardwired, Dr. Legato told me that it becomes even more important for men to make lifestyle choices that help them stay strong and healthy.

2. Prevent Early Onset of Heart Disease

Men tend to develop CAD about 10 to 20 years before women, often in the prime of their lives — in fact, the symptoms can appear in men as early as the mid-30s and they are also likely to die from it at younger ages. Blame hormones — estrogen helps protect women from CAD until they are well into midlife by elevating levels of high-density lipoprotein (HDL) and keeping blood vessel walls relaxed, whereas in men, testosterone is thought to increase low-density lipoprotein (LDL — the so-called bad cholesterol), which, if it oxidizes, raises risk of heart disease and stroke.

Dr. Legato advises men to get an annual screening for CAD, which should include a careful assessment of their risk factors, starting with a baseline in their 20s. Tests should include an electrocardiogram… a test for inflammatory markers identifying factors that can contribute to serum cholesterol damage of vessel walls… and a cholesterol panel, paying particular attention to the ratio of good HDL to triglycerides and HDL to LDL. Also important: Follow an anti-inflammatory lifestyle, eating nutritious foods (including plenty of fruits and vegetables and not too much animal protein), exercising regularly and getting sufficient omega-3 fatty acids, either by eating fish twice weekly or taking fish oil supplements.

3. Get Early Cancer Screenings

Cancer is the other main killer of men in middle and older age, said Dr. Legato. Early detection is the key to surviving the three most common (and lethal) cancers in men — prostate, lung and colon. To screen for prostate cancer, Dr. Legato recommended digital rectal exams beginning at age 45, followed by an ultrasound of the prostate when necessary. For lung cancer, those at high risk (smokers, men with a history of exposure to radon) should have annual or biannual chest X-rays. All men should begin colon cancer screening at age 45 and even earlier for those with family history of the disease.

4. Recognize and Treat Depression

Unlike women, who tend to express their emotions and have broader social networks to get help, men often struggle silently, holding in their feelings. The result, said Dr. Legato, is an “under-recognized epidemic of depression, which leaches the color out of men’s lives.” Depressed men tend to neglect their health, smoke more, self-medicate with alcohol and other drugs and exercise less. Heart disease is three times higher among men who are clinically depressed. Finally, depression sometimes leads to suicide, which is four times more likely in men compared with women.

One step that men who suspect they’re suffering from depression can take is to ask their doctor to check testosterone levels, as both high and low levels can cause symptoms of depression. Low testosterone negatively affects energy, muscle mass, ability to perform prolonged exercise, memory, concentration and libido. High testosterone can cause restlessness, aggressive behavior and a general sense of dispiritedness. There are several different forms of treatment, including gels, patches and injections, to help restore testosterone to clinically functional levels.

It’s also important to talk about your feelings and concerns with friends or family and, if that’s not very helpful, seek professional counseling.

5. Reduce Stress

While stress can be motivating and challenging, it can also be physically and mentally exhausting. Strategies for stress management recommended by Dr. Legato include making a list of the factors that cause stress in your life, prioritizing those you can work on and crossing out the ones that you can’t control. She says it is important to steal a few hours away from your busy day for just yourself. Figure out what helps you decompress — maybe the aromatherapy or morning walk with friends through the neighborhood that your wife finds helpful isn’t your style, but here’s your excuse to go fishing… take the dog for a spirit-boosting run… or find a men-only yoga class or martial arts program that incorporates meditative exercise (such as Hatha Yoga, Tae Kwon Do or Tai Chi). Anything you can do to make life better will likely help make it longer, too.