Sept. 5, 2008

Why Men Die Sooner

New Book Called "Why Men Die First" Explains How Men Can Close The Longevity Gap

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(WebMD)  Listen up, guys. It may be time to drop the bravado and consider these sobering statistics:

Coronary artery disease (CAD) is three times higher among men who are clinically depressed.

Male suicides outnumber female suicides in every age group.

Homicide and suicide are among the top three causes for death among males between the ages of 15 and 34.

By the age of 85, women outnumber men in the U.S. 2.2 to 1; this rises to 3 to 1 if they reach their 90s.

These are just a few of the realities examined in Why Men Die First: How to Lengthen Your Lifespan, a new book by Marianne J. Legato, MD, that focuses on the biological, cultural, and personal reasons that men's life span in the U.S. lasts an average of six years less than women's.

Male mortality is shorter in part, Legato says, 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," Legato says. "Men have been tremendously neglected and it doesn't have to be that way."

Men's medical challenges owe a great deal to cultural conditioning. The rules are set shortly after birth, Legato says: Suck up the pain, don't be a wimp, show no weakness, and "man up." Many men only seek medical counsel when under duress from a spouse or when their condition has deteriorated to a severe state.

"Women are able to logically ask for help," says Legato, who has long promoted the concept of gender-specific medicine. "They're hardwired in the brain and very motivated."

"The cultural reasons for not going to the doctor are killing men," she says.

How Men Can Live Longer

In her book, Legato examines and champions an end to the lack of awareness among men - and even the medical community - regarding the specific health needs of a male that could help prevent male deaths. Men, she says, deserve better and should insist on higher standards.

"Don't tolerate the current situation where men die six years before women," Legato says. "If we can conquer breast cancer and AIDS to the extent we have, we can certainly save our men."

Legato highlights the following leading factors of death in men in which men can begin to make a significant difference in their health and improve male life expectancy:

1. Speak frankly with a doctor: Leave embarrassment in the waiting room. Women are taught at an early age to be candid and open with their doctors. Symptoms that can be uncomfortable to talk about - such as erectile dysfunction - can be tied to more serious ailments such as diabetes and heart disease. Men, despite cultural tradition, should also request breast checks.

"It's a part of the body and should be examined," Legato says.

She encourages men to perform testicular self-exams in the way women are taught to check their breasts for irregularities. Although men may cringe at getting a prostate check, they are far less uncomfortable than experiencing the pain of cancer treatment.

2. Check testosterone levels: Beginning at age 30, testosterone begins to dip by 1% each year, says Legato. Lowered testosterone levels can lead to a decrease in vitality, muscle mass, ability to perform prolonged exercise, memory, concentration, and libido. Not only does this impair quality of life, it can contribute to depression, which can have a significant effect on male health, potentially increasing the risk of coronary disease. There are several treatments available - including gels, patches, and injections - that can help restore this vital hormone to proper levels.

Robert Ruxin, MD, an endocrinologist from Ridgefield, Conn., says normal testosterone loss has little correlative effect on vitality or sexuality. But there are instances when dramatic loss - more likely between the ages between of 60 and 80 - can impede quality of life.

"When it drops normally, probably not, but very low, yes," Ruxin says. "A level that drops from 800 to 500 has not been shown to have a clinical effect. Maybe from 800 to 400 can be too low."

Diabetes patients, for example, may have a greater risk of significant testosterone loss. Conversely, pituitary hormones, he says, can balance out the effects of the difference in individuals who are losing testosterone at a typical rate.

"There's a wide variation of normal."

3. Immune systems: The male immune system is not as vigorous as those of females, and men die from seven of the 10 most common infections at a higher rate, Legato says, particularly tuberculosis and sexually transmitted diseases. Sanitary sexual practices are essential, beginning with use of a condom. Men should check for updated vaccinations with their doctor when traveling to foreign countries. A tetanus shot should be administered every 10 years.

"Immunization is not finished after the second year of life," Legato says.

Proper nutrition and supplementation can also be beneficial. Despite the gender-focused attention it receives, osteoporosis also strikes men.

4. Recognize and treat depression: Male depression may be much more common than has been previously estimated. Symptoms aren't always obvious.

"We glibly state that women are twice as often depressed as men throughout the world," she says. "What they do is turn to behaviors that are semi-socially acceptable: drinking alcohol, TV watching, greater sexual exploits."

Legato is convinced the vulnerability of depression can compromise men's health in other ways, leading to increased instance of disease and greater male mortality from such conditions. It's also a common symptom of "andropause," which is marked by a decrease of testosterone in males that is similar, if less dramatic, than the effect of menopause in females. Indeed, males are also susceptible to the notorious hot flashes that have often marked the change of life for women, albeit years later.

Legato says the current medical system often prevents doctors from obtaining a proper understanding of a patient's personality and life structure. Make time to discuss any such issues with a doctor and be open to treatment. "A pill is not always the cure," Legato says. "Structured conversations can be very helpful."

While Ruxin is not convinced that andropause is a genuine male concern, others are in sync with Legato's insights on male depression.

James Korman, PsyD, ACT, director of the Behavioral Health and Cognitive Therapy Center at Summit Medical Group in New Jersey, agrees that depression in men occurs far more often than reported. He also points to cultural factors as often influencing men's reluctance to get treatment.

"Men tend to express depression differently than women," Korman says. "This can result in sleep disturbances, mood change, and sexual disinterest."

Left untreated, depression can have catastrophic results.

Regarding suicide, Korman says that while women typically make more attempts, "men are much better at completing it."

Men need to realize, Legato says, how destructive depression can be to their health and openly discuss their concerns with a doctor.

"To enjoy the day and be as viable as possible in the present is the best attitude," she says.

5. Keep a close eye on young males: The reckless nature and lifestyle of adolescents make them prime targets for injury or death. Females develop a more evolved sense of judgment and decision making at an earlier age then males. Add to that the cocktail of testosterone and other hormones and, biologically, males possess a potentially lethal internal recipe. Monitoring their activities and setting careful limits is vital. "Boys have been compared to a Porsche without brakes," Legato says. "They take risks, are idealistic, intense, and believe they're invulnerable."

6. Assess your risk for coronary disease: Coronary disease, Legato says, "takes a toll on men in their prime and leaves families bereft." It's imperative to sit down and assess the risks along with any predisposed genetic tendency and discuss these with a doctor. Have any relatives died of heart disease before the age of 60? What are your cholesterol levels? Have you experienced fainting episodes, loss of consciousness, or shortness of breath?

"We downplay this tremendously," Legato says.

Again, men aren't genetically blessed compared to women in this area. The female hormone estrogen provides women with a layer of protection that men don't naturally possess, asserts Legato. Further illustrating this: Men can begin developing signs of coronary artery disease at the age of 35, Legato says, while women don't present a risk of a heart attack similar to men until much later. Men with a family history of heart disease should alert their doctor and take proper precautions beginning in their 30s.

"It doesn't have to be that way," Legato says. "We should be turning a very critical eye on why coronary disease starts in the mid-30s."

By Don Fernandez
Reviewed by Louise Chang
© 2008 WebMD, LLC. All rights reserved.

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Add a Comment See all 78 Comments
by xmanborg September 5, 2008 4:57 PM EDT
Because Females are experts at working our last nerves and spending all our money and taking away all our toys.

That the reason !
Reply to this comment
by erasmus81 September 5, 2008 5:15 PM EDT
"Because Females are experts at working our last nerves and spending all our money and taking away all our toys." Posted by XmanBorg at 01:57 PM : Sep 05, 2008

Well......at least we''re good for something!

Reply to this comment
by jtdev1 September 5, 2008 5:20 PM EDT
Men take in all the nagging (causing stress), while women let out all the nagging (relieving stress)




Reply to this comment
by jmurrieta1 September 5, 2008 5:24 PM EDT
The generations of men that are dying now are men who took the brunt of stress in the workplace, where a$$hole bosses and money-grubbing bean counters keep them from relaxing or ever having much time off.

And the American "business leaders" have made *** sure that most workers get next to no time to themselves, to relax or recreate. It''s too important to make money for the bossman.

Now that women are entering this environment, these diseases and conditions will increase among women. Plenty of young women now smoke tobacco, plenty are spending the 60 hour weeks at the office.

Look for a major step-up in stress-related death in females over the next 20-30 years.
Reply to this comment
by xmanborg September 5, 2008 5:37 PM EDT
Thats why Men turn Gaye and have Boyfriends to get away from the Chicks so they can live longer and have money, cars and not hear the nagging.

Remember:

WOMEN ARE SWEET AS HONEY AS LONG AS THEY DONT WANT NO MONEY !
Reply to this comment
by jetlizhan September 5, 2008 5:38 PM EDT
the guys are dying off younger because that gene they discovered this week that prevents them from being faithful is KILLING THEM!!! just too much activity!
LOL!
Reply to this comment
by xmanborg September 5, 2008 5:39 PM EDT
WOMEN ARE SWEET AS HONEY AS LONG AS THEY DONT WANT NO MONEY !
Reply to this comment
by jamesetling September 5, 2008 5:47 PM EDT
The best longevity booster for men is to never get married. All that nagging, demanding, and fault finding is hard on a man''s cardiovascular system. A single man''s home is quiet and peaceful. If the bed hasn''t been made and there are dirty dishes all over the kichen.......its OK.
Reply to this comment
by bm6005 September 5, 2008 5:53 PM EDT
Because they want to!!!
Reply to this comment
by jcb63 September 5, 2008 6:11 PM EDT
I really get fed up with the way women and so called enlightend males (many of whom are only trying to decrease their own guilt about their mistakes or inadequacies with women by including the rest of us in their stuff) saying that men are weaker than women. Look people, there is very little difference in the strength of men vs women and I have just had enough of our society building women up at the expense of men. We have different physical abilities and neither one is less than the other.

I agree with the suggestions in the article and with some of the mistakes that men make with their health but I have just plain had it with people suggesting that men are the weaker ***. Women didn''t like and it wasn''t true when we were saying it about them and the same holds true for men so could you please refrain from these comments that seem to have become so compulsary over the last 40 years.
Reply to this comment
by txgrouch2006 September 5, 2008 6:34 PM EDT
Why do men die sooner? WOMEN.

Men die from stress. Women can''t live without it. It''s easier to cause stress than it is to escape from it.

WOMEN WIN.
Reply to this comment
by txgrouch2006 September 5, 2008 6:36 PM EDT
We die off earlier becuase it''''s the only way to get away from women that''''s perminent..:)
Posted by guyfrompa49 at 03:22 PM : Sep 05, 2008

Why is it? We spend the first half of our lives trying to get a woman; then we spend the rest of our lives trying to get away from her.
Reply to this comment
by erasmus81 September 5, 2008 6:50 PM EDT
"I don''''t know how I''''m still alive." Posted by sillywilly4 at 03:00 PM : Sep 05, 2008

I don''t know either. If you said those things about me, you would already be dead.:)
Reply to this comment
by erasmus81 September 5, 2008 6:51 PM EDT
"WOMEN ARE SWEET AS HONEY AS LONG AS THEY DONT WANT NO MONEY !"

I must be especially sweet then.

Reply to this comment
by erasmus81 September 5, 2008 6:54 PM EDT
I think all you men that are *******'', just haven''t found the RIGHT woman yet. They aren''t ALL the same.
Reply to this comment
by myopinion381 September 5, 2008 6:54 PM EDT
notelatu: What exactly does your post have to do with the article? If you want to rant about politics, take it to the right place. Some of us don''t care!
Reply to this comment
by erasmus81 September 5, 2008 6:57 PM EDT
"They aren''''t ALL the same." posted by ME.

Now take me for instance. I might cut off your price possession if you did me wrong, but other than that, I''m pretty easy to get along with.:)
Reply to this comment
by erasmus81 September 5, 2008 6:59 PM EDT
Oops, "price" should be "prize".
Reply to this comment
by mandylou4u September 5, 2008 7:02 PM EDT
If guys are so unhappy with women, why be around them? Every heard of hook.ers? You don''t have to take them home or hear their b.itchin''! 80 percent of your health is your hapiness. If you''re not happy, change it, man or woman.
Reply to this comment
by vechibless September 5, 2008 7:15 PM EDT

'' .. i like how people ''won''t give you the time of day'' unless you at least try to look and act like a starving slaving tortured mangled raped baked african war baby, but i do think they are being a tiny bit over zealous and cruel by leaving so many other alternatives ''out of the loop'' .. ''
Reply to this comment
by sepa2 September 5, 2008 7:16 PM EDT
Most of the precariuos (but essential) work are done b men. This is the the reason
Reply to this comment
by sociald63 September 5, 2008 7:25 PM EDT
cause we watch too much poorn
Reply to this comment
by republic1776 September 5, 2008 7:29 PM EDT
We are taught to buck up and be a man.
We spend our lives working like dogs to buy woman, shinny things that are over priced.
Pocket books and shoes that cost hundreds of dollars.
Wonder why most women are democrats?
Reply to this comment
by sepa2 September 5, 2008 7:30 PM EDT
And unlike women, who have fought hard to have their specific health needs validated and addressed, men haven''t demanded equal treatment.
Breast cancer gets more than 50% of the research money for all cancers
Reply to this comment
by republic1776 September 5, 2008 7:32 PM EDT
sepa2,
I don''t have a problem with that.
Reply to this comment
by republic1776 September 5, 2008 7:33 PM EDT
sepa2,
I bet more money is spent on "Gucci wear" than on Cancer
Reply to this comment
by wl7bzh September 5, 2008 7:46 PM EDT
Fifty percent of marriages end in divorce. Half of the remaining 50% or 25% are miserable. The last 25% are lying through their teeth.

So why don''t women die sooner than men? Easy, the larger majority of them are not married to other women
Reply to this comment
by haoli25 September 5, 2008 7:50 PM EDT
When HER mood starts to change, you must move quickly, the slow ones always die. lol
Reply to this comment
by lloydbest1 September 5, 2008 8:03 PM EDT
It''s all cultural. Even the percieved "weaknesses" that Dr. Legato attributes to "inherent" male fragility are culturally based. Other than s-x linked traits that have no Y-chromosone buffer, men are just as healthy, just as strong, just as resilient, just as enduring and just as capable as women. To say otherwise is to ignore the the caustic effects our "macho" culture has on our life expectancy and our quality of life.

The tera-byte volume of verifiable evidence generated in studies related to Dr. Legato''s points to nurture rather than nature. Even she is willing to concede that much....
Reply to this comment
by downtowner97 September 5, 2008 8:12 PM EDT
Q: Why do men die sooner?
A: Women.
Reply to this comment
by erasmus81 September 5, 2008 8:13 PM EDT
"When HER mood starts to change, you must move quickly, the slow ones always die." Posted by haoli25 at 04:50 PM : Sep 05, 2008

hahaha



Reply to this comment
by erasmus81 September 5, 2008 8:16 PM EDT
"We spend our lives working like dogs to buy woman, shinny things that are over priced.
Pocket books and shoes that cost hundreds of dollars."
Posted by republic1776 at 04:29 PM : Sep 05, 2008

I''m thinkin'' you men must be bad at finding the RIGHT woman.
Reply to this comment
by czmdm September 5, 2008 8:47 PM EDT
I feel sorrry for you goof balls slamming women. my wife is my best friend and is the greatest thing that ever happened in my life. If anything she tries to help me relieve stress.
Reply to this comment
by lloydbest1 September 5, 2008 9:00 PM EDT
"I feel sorrry for you goof balls slamming women. my wife is my best friend and is the greatest thing that ever happened in my life. If anything she tries to help me relieve stress." Posted by CZMDM at 05:47 PM : Sep 05, 2008

What?!?!?.......You mean there is ANOTHER one out there?! And here I thought I got the only one. Well, if there are two, there must be more! ;)
On a serious note, many of those studies I implied in my previous post indicate married men do live slightly longer than the single ones (and no, it doesn''t just seem like it, either)
Reply to this comment
by bragova September 5, 2008 9:05 PM EDT
There are a lot of angry comments here from men who feel their wives are killing or at least abusing them. Does that mean you think that single men live longer than married men? They don''t. Married men live significantly longer than single men, and happily married men live the longest of all. There are happy marriages, you know. I''ve been in one for 16 years.
Reply to this comment
by guadalcanal3 September 5, 2008 9:35 PM EDT
downtowner97...Q: Why do ''most'' women die sooner? A: Men.
Reply to this comment
by puldr September 5, 2008 10:19 PM EDT
If men are dying much earlier than women, then, obviously, it''s because the women have killed us!!!
Reply to this comment
by simplemind2 September 5, 2008 10:51 PM EDT
Boy - if this study has any merit at all - further if Mr. John McCain ever gets so lucky - then Ms. Sarah Palin''s dream might come true.
First female US President?
Eh - hope not - at least, not 4 more years of Bushit!
Amen!
Reply to this comment
by haoli25 September 5, 2008 11:02 PM EDT
and haoli25...that was funny!! Posted by sbbm


I owe it all to years of experience of moving fast and learning to keep my MALE opinions to myself!!! lol
Reply to this comment
by gce65 September 5, 2008 11:34 PM EDT
There are a lot of angry comments here from men who feel their wives are killing or at least abusing them... There are happy marriages, you know. I''ve been in one for 16 years.

Posted by bragova at 06:05 PM : Sep 05, 2008
--------

You didn''t say whether you are male or female, but give it time to go bad. Chances are it will.
Reply to this comment
by gce65 September 5, 2008 11:42 PM EDT
If guys are so unhappy with women, why be around them? Every heard of hook.ers? You don''''t have to take them home or hear their b.itchin''!

Posted by mandylou4u at 04:02 PM : Sep 05, 2008
--------

All things considered, I think hookers are a much more honest way to go about getting ***. Less expensive in the long run and better at what they do as well.
Reply to this comment
by gce65 September 5, 2008 11:46 PM EDT
Hows that joke go? Ive been married twice and they''''re both dead. My first wife died from poisoness eating mushrooms, the second one died of a concusion, she wouldn''''t eat the mushrooms.

Posted by sillywilly4 at 03:52 PM : Sep 05, 2008
------------

Here''s another old Steve Martin joke:
I was married once, but my wife died. I don''t know, I still kinda blame myself for it. We were at a party one night and there was some drinking...and we started arguing. She wanted to go home and I didn''t...so I shot her.
Reply to this comment
by gce65 September 5, 2008 11:56 PM EDT
Well, maybe in the interest of population balance and equality in longevity more men should start putting women out of their (men''s) misery!
(Of course for the sake of blah, blah, blah, I should say that''s meant only in jest. I should say that...)
Reply to this comment
by haoli25 September 6, 2008 12:03 AM EDT
There are happy marriages, you know. I''''ve been in one for 16 years. Posted by bragova



Looking over your shoulder, is she?
Reply to this comment
by gce65 September 6, 2008 12:17 AM EDT
On a more serious note to WebMD:
This advice is all fine and dandy for those people who have affordably health care, or health care at all, but you doctors never seem to want to start a conversation about health from the fact that about 40 million Americans don''t have health insurance at all. And then add to that the number who are underinsured and, while they pay a premium to an insurance company each month, they can''t actually afford to see a doctor because it will cost too much.

Face it, American medicine is a business for those who can afford it. Health in America is a commodity to be bought and sold. Government functionaries, insurance companies, lobbyists and doctors all keep it that way. And that''s the way it will probably stay for the most part.

Every other modern industrialized nation treats health care as a right, and it''s nation''s health as a collective asset to be preserved for the common good.
Reply to this comment
by alphaa10-2009 September 6, 2008 12:43 AM EDT
CBS reports, "Male mortality is shorter in part, Legato says, because males are more fragile and inherently vulnerable than females from birth."
---
Legato''s explanation is somewhat labored, to say the least. It reintroduces a dated and somewhat murky account of genetic factors supposedly responsible for difference between male and female lifespans.

While genetic research contributes to solving the puzzle, the question of lifespan difference hasn''t a pat answer from genetics, itself. In contrast, the relatively shorter male lifespan is easily explained by a factor intrinsic to female biology-- the "curse".

Menstruation is a life-long factor for women until menopause, and has a profound effect on the health and longevity of various body subsystems. The monthly renewal of erythrocytes is a virtual factory for producing a constant supply of young, viable and healthy red blood cells.

Specifically, the youthful red blood cells are very flexible, and move easily through the capillaries, assuring maximum nutrition in even the most remote and restricted regions of the body. Young red blood cells harvest and retain more oxygen in their hemoglobin than old, tired cells can.
The difference is dramatic-- we might say, it is a matter of life and death beyond age 65. Deprived of their monthlies, women rapidly fall into the syndrome common to aging males. For postponing this damage, all hail to "The Bloody Curse"!
Reply to this comment
by alphaa10-2009 September 6, 2008 1:05 AM EDT
PS-- Don Fernandez should be commended for his effort on a difficult topic. However, his treatment needs much more breadth, and not focused primarily on the viewpoint of Legato.

To use Legato is the principal foundation and framework of this piece was a critical mistake. Fernandez may be an excellent reviewer of books, but the book-- not his review-- is the content at issue.

Check out the work of Drs. Jay Rowen and/or Julian Whitaker. Rowen is a Johns Hopkins medical grad, and Whitaker is a graduate of Emory University School of Medicine. Both agree on menstruation is the most likely-- however unlikely-- "fountain of youth" for females.
Reply to this comment
by ajaxtheleast September 6, 2008 2:42 AM EDT
Men past 60 commit more suicides

because they are the ones who have

to look at women past 60.

Reply to this comment
by haoli25 September 6, 2008 2:53 AM EDT
More men die from foolishly answering the questions, ''Does this make me look fat?'' and ''You DO like my family, right?'', than from lack of periods.

Reply to this comment
by ajaxtheleast September 6, 2008 3:18 AM EDT
These "doctors" seem sure that death
is a bad thing.

Death is the only "time traveler"

Arrogance is to think that we in some form
never happened before and will never
happen again.

The distance between one spark of
conscientiousness and the next as far as
experiencing the passage of time is concerened
doesn''t exist.

You"re here, you''re gone, you''re in
your next spark of conscientiousness
on some other life-supporting body of compacted
stardust as it''s equivilent to our cockroach.

And,, knowing nothing of what went before
are quite involved with the trials
and tribulations of cockroach society.

Then again, "you", The spark of
conscientiousness you, may be what we in the
here and now consider "lucky" and "you" may
next pop up somewhere as totally superior to
what "you", your miserable spark of
conscientiousness self, is now worrying about
something that we''ve decided to call death.
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