Aging Differences By Sex And Gender
Women live longer than men. Why? There have been several theories, including estrogen protection against cardiovascular disease, a less risky lifestyle, and a willingness to seek preventative medical care. These factors may explain lifespan differences in some cases, but are unlikely to explain a persistent difference between men’s and women’s lifespans.
The biggest factor affecting how men and women age and why they age differently is sex hormones. Testosterone levels slowly decline over a man’s lifespan, while estrogen drops suddenly at menopause. Researchers are exploring gender-based differences in how the immune system works and how hormones may affect the brain, bone, and heart.
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Women outlive men in almost every society around the globe. A recent report from the U.S. Census Bureau reviews life expectancies since 1960 and projects them through 2060. Projected life expectancy by 2060 is expected to increase to 85.6 years. Women are still expected to live longer than men, though men are closing the gap by 3.4 years.
Women have lower mortality rates but higher rates of physical illness and disability. Women seem to be more robust than men. Men die at a higher rate from nearly every major cause of death than women. Potential reasons may include:
- More active immune function
- Protective effect of estrogen
- Having a second X chromosome
- Reduction in growth hormone and insulin-like growth factor cascades
- Reduced oxidative stress
Each of these hypotheses has some support, but it is weak. The theory with the best support is that women have a longevity advantage because of their second X chromosome. In many cases, a mutation in one copy of the genetic code can be compensated for by having a second copy.
Some theorize that women outlive men because women focus more on maintaining their health by choosing healthier nutrition, engaging in physical activity, and developing a stronger social network. There are many opportunities for age management.
Hormonal differences may also affect how men and women age. Fat can be stored either around organs or under the skin. Visceral fat stored around abdominal organs is metabolically active and has a more direct blood supply route to the liver. Men tend to have more visceral fat, and women have more subcutaneous fat. Visceral fat increases the risk of cardiovascular disease.
Women go through a more abrupt transition in terms of sex hormone declines. Menopause marks when estrogen and progesterone levels are below a critical threshold. Testosterone, a sex hormone with both androgenic and anabolic effects, declines more slowly in men, starting in their late 30s. Not all men have a measurably low testosterone level. Less than one-fourth do.
Women experience many changes associated with sexual health due to the abrupt drop in estrogen and progesterone associated with menopause. Some of these changes include:
- Vaginal dryness and pain
- Hot flashes
- Night sweats
- Mood swings
- Brain fog
- Thinning hair
- Difficulty sleeping
- Increased risk for urinary tract infections
- Weight gain
- Mood changes
Men experience a more gradual decline in sex hormones and, therefore, do not go through the male equivalent of menopause. However, this does not mean that men do not experience any effects from declining sex hormones. When testosterone levels decline below a critical threshold, men may experience the following symptoms:
- Mood changes
- Abdominal weight gain
- Loss of libido
- Decreased muscle mass
- Decreased bone density
- Erectile dysfunction
- Decreased ejaculate volume
- Breast discomfort
- Decreased energy
As projected lifespan increases, men and women are expected to spend a longer percentage of their lifespan living with the effects of decreased sex hormones. As a result, many people choose to use supplements or prescription medications to treat or reverse some of the sexual health symptoms associated with aging.
Sexual health screenings are important for everyone. If you are sexually active, talk to your healthcare provider about chlamydia, gonorrhea, and syphilis screening. Ask your doctor about breast, ovarian, uterine, and prostate cancer screening.
One in five adults over age 55 likely experience some mental health concern. Decreased social interaction, restrictions on physical independence, and living with chronic diseases can affect your mental health as you get older. Depression, dementia, and anxiety are more common in people over age 60. Substance misuse and abuse may increase. Social isolation and loneliness can increase depression and the risk of suicide. Older men have the highest suicide rate of any age group.
Mental health conditions, such as depression and anxiety, are treatable. If you are concerned about your mental health, call your healthcare provider. If you have thoughts of harming yourself, reach out for help.
The National Suicide Prevention Lifeline can be reached 24 hours daily at 800-273-8255.
Osteoporosis is a decrease in bone density that can increase your risk for fractures. Hip and spine fractures are the most common and debilitating. Estrogen is bone protective, so osteoporosis risk increases after menopause. Other risk factors for decreased bone density include:
- Poor diet
- Medical conditions
- Excessive alcohol intake
- Family history
Osteoporosis screenings are recommended for women over age 65 and men over age 70. Postmenopausal women under the age of 65 with risk factors for osteoporosis should also talk to their doctor about bone density screening.
Loss of muscle strength, mass, and tone is a known change associated with aging. For example, muscle mass declines at a rate of 3% to 8% per decade after the age of 30. The decline is even faster after age 60. This is mostly attributable to declines in sex and growth hormones. Muscle is broken down more quickly than it is built up, resulting in a decline in muscle mass. Decreased muscle mass and strength increase the risk of falls and disability.
Declines in hormones and genetic predisposition are important factors determining how your muscles are expected to change with aging. However, many lifestyle factors can help prevent muscle loss, including:
- Choose physical activity over a sedentary lifestyle. Resistance exercise can help build muscle.
- Increase your protein intake as part of a well-balanced diet.
- Work with your doctor to manage chronic diseases that may limit your mobility and ability to exercise.
- Ensure your diet includes excellent sources of vitamin D, creatine, and omega-3 fatty acids.
Engaging in regular physical activity and consuming a nutritious diet can help tip the balance in favor of building, or at least maintaining, muscle mass and strength. Nutrients and supplements can support optimal muscle function and enhance performance.
Aging can have a significant impact on the nervous system. How aging affects your attention, memory, awareness, perception, and learning depends on your genetic predisposition, history of chronic illness, and environmental factors such as how much you stimulate your brain by trying new activities.
There are several ways that aging affects the nervous system, including:
- Slower information processing
- Trouble focusing on more than one activity at the same time
- Changes in working memory
- Decreases in brain size
In one study, researchers using MRI found that men had a steeper decline in brain volume than women, even without cardiovascular risk factors such as high blood pressure. Good nutrition and increased physical and mental activity can support brain function.
Nootropics are supplements and medications that can boost brain performance. One well-known nootropic is caffeine. Many others may support cognitive health and enhance cognitive performance.
Both men and women experience hair loss with aging, along with graying hair. Male and female pattern hair loss is non-scarring hair loss in a predictable pattern that can start as early as puberty. Free testosterone in the bloodstream is converted to dihydrotestosterone (DHT) outside the testes. Male pattern hair loss has several contributing hormonal and genetic factors, including increased 5-alpha reductase activity, increased androgen receptors, and increased DHT production. The relationship between androgen levels and female pattern hair loss is less clear.
Finasteride blocks the activity of 5-alpha reductase, decreasing DHT production by up to 60% to 70%. Finasteride increases overall hair count, but treatment must be continued to maintain hair regrowth,
Body composition also changes with aging. Declines in sex hormones set the stage for increasing fat mass and decreasing muscle mass. But, increases in physical activity can combat these changes. As you exercise, your body composition changes, gaining muscle and reducing fat mass. These changes strengthen your cardiovascular and respiratory systems, which makes gains in physical strength and endurance easier.
If you are concerned about changes you are experiencing as you get older, contact one of the medical professionals at Invigor Medical to learn about potential treatment options.