LET’S HEAR IT FOR THE GIRLS! Why women really are the stronger sex
Men may boast superior muscle power, but it’s women who have the greater natural strength when it comes to health. Here’s why we really are the stronger sex…
We know that, on average, women live longer than men, but now it seems we have a built-in health advantage that goes way beyond blowing out more candles on our birthday cakes.
‘Women are better at fighting cancer and surviving famine and, crucially, have a stronger immune system,’ says scientist and physician Dr Sharon Moalem, author of a fascinating new book The Better Half.
This superior strength is apparent from birth, with more girls surviving the first year of life than boys. The reason? It’s due to X chromosomes, says Dr Moalem. ‘The X chromosome carries genes that are important in making and maintaining the immune system,’ he adds. ‘Women have one X chromosome from their mothers and one from their fathers, while men have one X from their mothers and a Y from their fathers.’
Previously, it was thought that genes on the second X chromosome were inactivated during the earliest stages of an embryo’s development, but now we know that a quarter of these genes are still active – escapees that offer a back-up service, explains Dr Moalem. ‘So, for women, who have inherited two X chromosomes in each of your cells, your cells have options,’ he adds. ‘And when the going gets tough in life, those options help you survive.’
We have another advantage, too: our hormones. Testosterone suppresses the immune system, while oestrogen makes it more aggressive. Even after menopause, when oestrogen levels decline, female cells tend to be more critical and powerful in defending against a possible attack, says Dr Moalem.
It’s too early to know the full picture, but it appears that this may be one reason why women seem to be less vulnerable to the coronavirus than men.
However, there is a price to pay for our super-aggressive immune systems. Women are far more likely to develop autoimmune diseases, which is when the immune system’s antibodies or killer T-cells mistakenly attack our own bodies – a case of friendly fire.
So how can we protect ourselves from the drawbacks inherent in our genetic make-up and what can we do to help safeguard the health of our sometimes more vulnerable menfolk?
Super immunity risks
There are more than 100 different autoimmune diseases, including type 1 diabetes, rheumatoid arthritis and thyroid disease, and 80% of those with an autoimmune disease are women, says Professor David Wraith, an international expert on autoimmunity and director of the Institute of Immunology and Immunotherapy at the University of Birmingham.
Identifying the protein that has set off the attack, which is different for each type of autoimmune disease, is the first step to finding treatments. ‘We have shown you can “silence” the attack if you administer tiny fragments of that protein so the body’s killer T-cells accept it and no longer mistake it for a harmful microbe they have to destroy,’ says Professor Wraith, who is currently leading research into developing treatments for multiple sclerosis, Graves’ disease and haemophilia.
An analogy can be made with the desensitising treatment sometimes used to treat allergies, which first inspired Professor Wraith, where tiny doses of pollen, for example, are gradually administered so the immune system acquires a tolerance.
Although the treatments operate on a similar principle, you are not more
‘Oestrogen makes the immune system more aggressive’
likely to develop an autoimmune disease if you have an allergy. Family history, however, does stack the odds in the case of some autoimmune diseases, such as lupus (which causes inflammation to the joints, skin and other organs). In other conditions, specific genes increase likelihood, for example, in rheumatoid arthritis.
It’s not all out of our hands, though. Taking simple steps to look after our health can help lessen the likelihood of developing autoimmune diseases or prompting flare-ups of existing conditions, says Professor Wraith.
Why are men more vulnerable to coronavirus?
The full picture will take time to emerge, but significantly more men are dying due to Covid-19 than women, and there are also more deaths among those of black, Asian and minority ethnic backgrounds (BAME).
While it is very early days in terms of our understanding, cautions Dr Moalem, it appears to be a particular aspect of women’s double X chromosomes that may give more protection. ‘In simple terms, the X chromosome carries a gene, which you can think of like a padlock,’ he says. ‘Viruses such as Covid-19 can unlock these padlocks and enter our cells. Women, with two X chromosomes, have two different versions of these padlocks, while men only have one.’
It might be anathema to the male psyche to think that when it comes to the hardwiring, their health just doesn’t have such good back-up data, but Dr Moalem suggests it helps for men to understand that it’s not a weakness. It’s because they’re genetically programmed to have greater muscle power, lift heavier weights and run faster that they have to be more careful about their health. ‘It helps to see it in positive terms,’ he says. ‘I tend to say that men’s bodies are like exotic sports cars that require more care, so they have to keep taking it to
the mechanic and use the right fuel. Women are much more like complex hybrid cars with greater innate endurance, and are able to travel healthily further on into the life course.’
There are other health implications. Women have only relatively recently been included in medical research trials, and sex and gender differences haven’t always been fully addressed when it comes to drugs and treatments, says Dr Moalem.
‘In terms of healthcare, we should not be treating women and men as though they are identical,’ he adds.
‘All of us have discovered more about looking after ourselves’
His health, your problem?
Urging, nagging and even threatening men to see a doctor is a role many of us recognise, but women shouldn’t have to carry the load of responsibility for health, says Alan White, emeritus professor of men’s health at Leeds Beckett University and patron of Men’s Health Forum.
‘Health is everybody’s business,’ says Professor White. ‘The stereotypical view that health is women-based and women control health is an unfair burden on them and can actually inhibit men. Take home-testing kits for bowel cancer, for example. While both some women and some men will be reluctant to use the test, in general, women are more likely to encourage a man to do the test, while a man will think his wife isn’t asking his opinion and she’s making up her own mind.’
Nevertheless, it’s still a fact that from the earliest years, girls and women are more health literate. A group of 16-year-old girls who were asked to make an appointment at the GP were perfectly able to; boys of the same age were all at sea. ‘Their mothers were more likely to make appointments for them, go with them and even speak to the GP for them,’ says Professor White.
In general, though, there’s been a huge increase in health awareness among men who respond best to factual information rather than opinion (see menshealthforum.org.uk). And health-literate men can also play a part. ‘Men talking to other men is incredibly therapeutic,’ says Professor White.
Talking to each other on every level certainly is a therapy that has sustained us all through these toughest of times. As we hopefully begin to move from Zooming to hugging each other again, all of us will have discovered more about looking after ourselves and our loved ones. We will also value anew the extraordinary powers of our complex immune systems.