In the battle of the sexes, health is one area where women are perceived to come out on top. We live five per cent longer, reaching an average age of 83 in the UK, compared to 79 for men.
We’re also less likely to get cancer: around 182,000 women are diagnosed each year, compared to 193,000 men. And we face a lower risk from heart disease, accounting for just one third of the 2.3 million cases in the UK.
However, this isn’t the full picture. Women face a higher risk of obesity, osteoporosis and poor gut health, while cancer rates are rising three-times faster in women than men.
Here are five issues women suffer more from than men – and what to do about it.
1. Weight gain from ‘normal’ portion sizes
In a recent article published in The Lancet, obesity researchers note that prepared food – from supermarket ready meals and sandwiches to chocolate bars and restaurant meals – generally comes in one standard portion size that has been calibrated to meet an adult man’s calorie requirements.
“Portions in many places are too large,” says Professor Naveed Sattar, the government’s obesity tsar and co-author of the paper. “[Food manufacturers] do this to create a sense of value for money – sugar, refined carbohydrates, fat and salt are cheap to add to foods.”
However, this is a problem for women who need around 25 per cent fewer calories than men, meaning they are routinely over-eating simply by having a standard serving.
As excess calorie intake is the main driver of rising obesity rates, it puts women at risk of the health problems that come with being overweight or obese, such as type 2 diabetes, heart disease and some cancers.
It fights against our British instincts not to clear our plates – a hangover of the “waste not, want not” wartime mentality – but doing so when it comes to standard portion sizes means women are routinely eating more calories than needed “contributing to gradual but progressively greater average adiposity [fat] gain than in men”, Prof Sattar and colleagues write.
“Obesity levels in 1980 were around six per cent,” he notes. “Nowadays, it’s nearly 30 per cent in some parts of the UK and rapidly rising in younger women.”
The solution
The ideal solution is for supermarkets, restaurants and other food outlets to offer at least two portion sizes, with the smaller option being around 25 per cent smaller and being more suited to the energy needs of women, Prof Sattar says. “An option for a smaller portion should be there – it will help many women but also smaller adults, older people and younger boys and girls,” he says.
In the meantime, it pays to be more mindful of portion sizes, and when it comes to buying prepared, pre-packaged food, not feeling pressured to finish it all.
2. Osteoporosis
“Osteoporosis is a condition where people lose bone density, so their bones become more fragile,” says Katherine Brooke-Wavell, a professor in skeletal physiology, exercise and ageing at Loughborough University.
Women are more at risk of developing the condition, accounting for eight in 10 cases. “The reason it’s more prevalent in women is that oestrogen is really important to bone health and oestrogen production declines during the menopause, contributing to bone loss,” she says.
“Low bone density doesn’t cause any pain and there are no symptoms until you actually break a bone,” Prof Brooke-Wavell explains. While it can lead to hip and vertebral fractures that have a severe impact on daily life, it’s possible to have osteoporosis but for it not to cause any problems, if you don’t break a bone, she says.
The solution
While medications, such as bisphosphonates, can help to maintain bone density and reduce the risk of suffering a fracture, exercise also has a major role to play, Prof Brooke-Wavell says.
During weight training, for example, the muscles pull on the bones, stimulating them to become stronger. “Our bones adapt to what we do, just like our muscles, and can actually change shape and size,” Prof Brooke-Wavell says. “Bone adaptation is just slower and more subtle than muscle growth.”
“It’s especially important for women to do these exercises because they face a higher risk of osteoporosis and have lower bone and muscle mass to begin with,” she says.
“If you start around the menopause, you can counteract some of the loss of bone strength. But studies have shown that people in their 80s can substantially increase their muscle strength and bone density, so you’re never too old.”
As you get older, exercises to strengthen the muscles that keep the spine upright, such as a chin tuck (sitting upright and looking forward, moving the chin back towards the spine and holding it for a few seconds), can maintain spine posture.
“That’s important because, as we get older, our muscles get weaker and we tend to curve forwards, which puts force on the front of the spine, increasing the risk of fracture, and it also affects balance, increasing the risk of a fall,” she says. It is also important to try to avoid bending forwards or twisting when lifting – try to bend at the hips instead.
Other exercises can help to prevent fractures by reducing the risk of falls in older people. “Targeted balance and lower leg strengthening exercise programmes have been found to reduce the risk of falling,” she says. “Fall prevention exercises can be tailored to each person’s abilities and classes are available in much of the UK. Tai Chi has also been shown to improve balance.”
3. The health impact of alcohol
It’s not a surprise that alcohol does our health no favours but, due to physiological differences in women, we’re much more at risk from the negative effects of wine, beer and spirits than men.
“Women have proportionally less water, more fat and less of the enzyme [called dehydrogenase] that breaks alcohol down than men,” says Dr Nicole Lee, an adjunct professor at the National Drug Research Institute at Curtin University in Australia.
Together, it means alcohol stays in women’s systems for longer, increasing the length of time our organs – especially the liver and brain – are exposed to it, she explains. The result is that both the short-term problems caused by alcohol, like poor sleep, and long-term risks, like a higher risk of cancer and poor mental health, are amplified in women more than men, Dr Lee says.
The solution
“Sometimes it’s hard to tell what’s just normal ageing and what’s alcohol related,” she says. “So if you’ve moved into midlife and find you are not feeling great, think about having a break – like three to six months – to disentangle normal hormone changes and alcohol exacerbated changes.
“If you want to be healthier and improve your wellbeing in the short and long-term, it isn’t necessarily about quitting, it’s understanding how alcohol impacts you personally. You don’t have to be dependent or be experiencing problems to make changes.
“A lot of women are pleasantly surprised when they cut back – their sleep improves and mood and energy come back. It’s really about being mindful. Do some experiments for yourself – take a break for a few months and see what happens.”
In the UK, it is advised to drink no more than 14 units per week (around seven glasses of wine, seven pints of beer or 14 shots) on a regular basis but there is no distinction between advice for men and women.
“It’s because the guidelines are focused on risk of dying from an alcohol-related illness, not day to day health and wellbeing,” Dr Lee notes. “They are the upper limits and I always suggest everyone try and stay as far under the guidelines as is feasible for them.”
4. Certain cancers
While around 10,000 more men are diagnosed with cancer each year than women, rates of the disease are rising faster in women. Over the last few years, cases in men have risen by five per cent, while increasing 17 per cent amongst women.
“There are several different factors contributing to this all of which relate to changing lifestyles,” says Sarah Allinson, professor of cancer biology and genome stability at Lancaster University.
One is the increase in obesity among women. “Obesity is a risk factor for at least 13 different cancers,” she notes. “Many, like bowel cancer, affect both men and women. However, certain hormone responsive cancers, such as of the womb or breast, can be driven by oestrogen that’s produced in fatty tissue.” These hormone effects mean women are more at risk.
“Being obese can increase their risk of cancer by as much as 40 per cent,” Prof Allinson says. “One of the most troubling features of increasing rates of cancer is that we are seeing a particular increase in people under the age of 50 who might be less on the lookout for symptoms of the disease.”
The solution
Women can be on the lookout for cancer by regularly checking their breasts for lumps and staying up to date with cervical screening, as well as being aware of the symptoms of the most common cancers, such as a persistent cough or breathlessness (lung cancer) and changes to bowel habits (bowel cancer), she notes.
To reduce their risk, women should keep a healthy weight, exercise regularly, quit smoking and minimise the amount of alcohol they consume, Prof Allinson says. “The good thing about adopting many of these healthy habits is that they not only reduce your risk of cancer, but also protect against other conditions like cardiovascular disease,” she adds.
5. Poor gut health
Gut-related symptoms, such as abdominal pain, bloating, diarrhoea and constipation are “significantly more common in women than in men”, says Dr Federica Amati, head nutritionist at ZOE. They are often a result of functional gastrointestinal disorders (FGIDs) – the collective term given to more than 30 conditions, including irritable bowel syndrome (IBS).
The reason, in part, is down to biology. “Women tend to have slower gastric emptying (the time taken for food to leave the stomach) and colonic transit (the time taken for food to move through the large intestine). This is alongside heightened visceral sensitivity (a higher sensitivity to pain in internal organs),” she explains.
The hormones oestrogen and progesterone influence these aspects of our gut health, she says. They fluctuate during the menstrual cycle, pregnancy and menopause, which can alter symptom severity, bloating and abdominal pain.
However, psychological factors also play a role. “Women experience higher rates of anxiety, depression and somatisation [physical symptoms as a result of stress], all of which are closely linked to FGID symptom severity,” Dr Amati says. “Stress is a particularly powerful driver, activating neuroendocrine and immune pathways that worsen gut symptoms.”
The solution
Lifestyle and diet changes can help, Dr Amati notes. “Regular meals, adequate hydration and moderating caffeine and alcohol intake are consistently recommended,” she says. “Adjusting fibre intake, often prioritising soluble fibre [found in oats, apples and beans] over insoluble fibre [found in whole grains, cauliflower and green beans], can improve symptoms for many people with IBS.”
Exercise, sticking to a regular sleep schedule and getting stress under control, she adds, can all improve gut health.