Why Men Die Earlier than Women

Why Men Die Earlier than Women

April 11, 2019 0 By Anthony Ekanem

Women generally live longer than men. In all developed countries and most developing ones, women outlive men, sometimes by a margin of up to 10 years. The gender discrepancy is most pronounced in the very old: among centenarians worldwide, women outnumber men in the ratio of about nine to one. The gender gap has widened as gains in female life expectancy have exceeded those for males.

The death rates for women are lower than those for men at all ages – even before birth.  Although boys start life with some numerical leverage, their numbers are preferentially whittled down thereafter. About 104 boys are born for every 100 girls because of the disproportionate rate of spontaneous abortions, stillbirths and miscarriages of male foetuses. More boys than girls die in infancy. And during each subsequent year of life, mortality rates for males exceed those for females, so that by age 25 women are in the majority.

The statistics above raise two questions: Why do men die so young? And why do women die so old?  Whilst researchers may not have definitive answers to the above questions, available evidence associates behavioural as well as biological differences between the sexes, differences in the effects of medical technology, as well as social and psychological factors. In spite of the evolutionary imperative, the good news is that the gap between male and female life expectancy may now be narrowing, while the bad news is that some of the convergence may be the result of women suffering from what used to be considered “male” diseases.

The diversity in worldwide longevity alone indicates that the difference in mortality between the sexes is not purely biological and that there are intervening social factors. The current range of situations actually reflects different stages of a three-part historical evolution. Women most probably have a biological advantage that allows them to live longer. Today, given the general progress in female life conditions, women have not only regained their biological advantage, but have gone much beyond it, both because they tend to engage in fewer behaviours that are bad for health than men do and because they better profit from current advances in healthcare and living conditions.

Below are some of the factors affecting male and female life expectancy.  In other words, we shall be looking at why women generally live longer than men and why men mostly die before women.

Sex Hormones

Experts suspect that gender differences in mortality patterns may be influenced at least in part by sex hormones, namely the male hormone (testosterone) and the female hormone (oestrogen).  The conspicuous peak in the sex-mortality ratio at puberty, for example, coincides with increased testosterone production in men.  Because the male hormone has been linked with aggression and competitiveness as well as libido, some researchers ascribe this spike in male mortality to “testosterone toxicity.”  Later in life, testosterone puts men at risk biologically as well as behaviourally. It increases blood levels of the bad cholesterol (known as LDL, for low-density lipoprotein) and decreases levels of the good one (HDL, for high-density lipoprotein), putting men at greater risk of heart disease and stroke.

The female hormone (oestrogen), on the other hand, has beneficial effects on cardiovascular health, lowering LDL cholesterol and increasing HDL cholesterol.  A study at the University of Washington suggests that oestrogen may exert these effects by regulating the activity of liver enzymes involved in cholesterol metabolism.

It is important to note that with the exception of this evidence regarding oestrogen therapy, the relationship between sex hormones and mortality patterns is still speculative.  Furthermore, any attempt to explain mortality patterns must include the recognition that these trends are relatively recent. Before that time, the sex-mortality ratio was constant across age groups for which data are available. The recent changes can probably be accounted for by two societal factors: improvements in obstetrical care, which have dramatically reduced women’s risks of dying during childbirth, and an increased availability of guns and cars, which has contributed to more accidental and violent deaths in young males.

Lifestyle and Behaviour

Behaviour-related fatalities are still among the most common causes of death for men and are still much higher in men than in women.  Men of this age are more than twice as likely as women to die in car accidents, for example, and almost four times as likely to take their own lives. Although death rates are higher for males than females at all ages, the difference between the sexes is more pronounced at certain stages of life. Between 15 and 24 years, for example, the male-to-female mortality ratio peaks because of a sudden surge in male deaths with the onset of puberty.  During this period, men are three times more likely to die than women, and most of the male fatalities are caused by reckless behaviour or violence.  Motor vehicle accidents are the most common cause of death for males in this age group, followed by homicide, suicide, cancer and drowning.

According to French demographer, Jacques Vallin, there are fundamental differences in lifestyles that allow women to better benefit from the general progress in health. For example, although women now participate massively in the workforce, their roles remain different and their professional activities are, on average, less prejudicial to their health. In addition, women often relate to their bodies, their health and their lives in general in a much different way than men do.

Illnesses and Diseases

Illnesses related to smoking and alcohol consumption also kill more men than women. But heart disease is the main cause of the gender gap here.  Men experience an exponential rise in the risk of heart disease beginning in their 40s; in contrast, women’s risk of dying from heart disease does not begin to increase until after menopause, and it approaches the male risk only in extreme old age.  Although the gender gap in this age group is smaller than the one described for young adults, the number of people affected by it is far greater. 

Biological Factors

If female longevity is the product of evolutionary forces, then one might wonder what physiological mechanisms have evolved to support the preferential survival of women over men. As we have mentioned, sex hormones are thought to be important factors in determining the relative susceptibilities of the genders to aging and disease.  Less obvious is the contribution that menstruation might make to longevity. 

Because of the monthly shedding of the uterine lining, pre-menopausal women typically have 20 percent less blood in their bodies than men and a correspondingly lower iron load. Because irons are essential for the formation of oxygen radicals, a lower iron load could lead to a lower rate of aging, cardiovascular disease and other age-related diseases in which oxygen radicals play a role.

In his book, Why Men Die First: How to Lengthen Your Life Span by Marianne J. Legato, male mortality is shorter in part, because males are more fragile and inherently vulnerable than females from birth.  And unlike women, who have fought hard to have their specific health needs validated and addressed, men haven’t demanded equal treatment. “It is a need that has never been addressed”. “Men have been tremendously neglected and it doesn’t have to be that way,” Legato says.

Chromosomal Factors

Chromosomal differences between men and women may also affect their mortality rates. The sex-determining chromosomes can carry genetic mutations that cause a number of life-threatening diseases. The female body has to make reserves to accommodate the needs of pregnancy and breast feeding; this ability has been associated with a greater ability to cope with overeating and eliminating excess food.

Cultural Conditioning

According to Legato, men’s medical challenges owe a great deal to cultural conditioning where men are expected to endure pains and not show weakness in any form. Many men only seek medical counsel when under duress from a spouse or when their condition has deteriorated to a severe state, while women are able to logically ask for help.

Females are tougher in utero

According to Dr. Legato, two and a half as many boys are conceived as girls, but they are so much more likely to succumb to prenatal infection or other issues in the womb that by the time they are born, the ratio is close to one-to-one. They are also slower to develop physically than girls prenatally, which means they are more likely to die due to underdeveloped lung or brain development.

Women are less likely to be daredevils

Unintentional injuries are the third leading cause of death in men, according to the CDC; for women it’s only the sixth

Women succumb to heart disease later

Heart disease is the leading killer of both men and women, but men are more likely to develop it – and die from it – as early as their 30s and 40s. Women, on the other hand, typically develop heart disease 10 years later than men. They’re protected from it until menopause, since their bodies churn out estrogen, which helps keep arteries strong and flexible, says Dr. Legato.

Women have stronger social networks

Friends make good medicine: People with strong social connections have a 50% lower chance of dying than those with few social ties, according to a 2010 study at Brigham Young University. “Most men tend to hold their stress and worries close to their chest, while women tend to reach out and talk to others,” Dr. Legato explains.

Women take better care of their health

More than a quarter (28%) of men don’t have a regular physician, and about one in five don’t have health insurance, according to the Kaiser Family Foundation (2012). Men often deny illness; they minimize symptoms because they don’t want to go to a doctor and find out something is wrong.


It is a fact of life that men enjoy certain physical advantages over women. On average, men are stronger, taller, faster and less likely to be overweight. But none of these attributes seem to matter over the long haul. For whatever the physical virtues of maleness, longevity is not among them.

So why do women live longer than men? This book attempts to answer the question from different angles and perspectives with the hope that men will do what is necessary to improve their life expectancy.