The Paradoxical Vulnerability of Men

Dr. Marriane Legato discusses what she believes to be one of the most interesting issues concerning men. At any age, from birth to 85 years, men die at a greater number than women. Their vulnerability in the womb is very interesting. About 250 male fetuses are conceived for every 100 females fetuses and, yet, the birthing average is a one to one ratio. So why are those male fetuses dying at a greater number in the womb? Why are they less developed than girls at birth? They're about six weeks behind their sisters when they're born. And if they're premature and have a low birth weight, they're much more likely to die than girls.

Some of the other vulnerabilities of male children occur between the ages 0 and 10. After unintentional injuries as a cause of death, the most serious cause of death for these children is suicide or murder. And this persists for men until the age of 45 when the primary cause of death becomes heart disease. And in subsequent decades it passes between cancer and heart disease.

 The message Dr. Legato takes away from these findings, is that the apparently strong, vigorous, aggressive, dominant male is actually more vulnerable from the beginning. The fact that men show signs of coronary artery disease as early as 35 is really unacceptable. There should be a "go blue for men" like there is a "go red for women".

We know women suffer from heart disease, and that it's a unique experience for women, but it's important to take that same concentration on gender and look at why men are dying. Men with coronary artery disease are usually dead by the age of 65, and this is just not "okay".

Dr. Marianne J. Legato, MD, FACP, a specialist in Gender Specific Medicine, or Women's Medicine and Men's Medicine respectively. Dr. Legato is part of the Women's Heart Foundation, an international gathering of nurse executives, civic leaders, community health directors, member hospitals, partners, providers and corporate sponsors who want something done to fight women's heart disease.

Dr. Legato promotes the inclusion of women in clinical trials of relevance to the health of both men and women. She furthers the study of biological differences in men and women, and how gender plays a role in the diagnosis and treatment of disease, all to benefit patients.


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