Are boys born unhealthy?

It's not just because we love to booze, eat too much and drive too fast. It's also because we start out with some big biological disadvantages, argues Jerome Burne. 

If you want a long life, your best bet is to be born a female or, failing that, to marry one. Men may have the muscle, but whatever point in our life cycle you look at - growing foetus, risk-taking adults or fading pensioners - we are likely to pop off sooner than a woman. What is it that makes us so vulnerable? Are men really the weaker sex?

At the very beginning we outnumber the women. About 125 males are conceived for every 100 females. The reason may be that sperm bearing the Y chromosome - the one that carries the genetic switches to turn the embryo into a male - swim faster. Or it could be some sort of insurance against the disaster that happens next. Think of any problem that is likely to happen in the womb - cerebral palsy, premature birth, stillbirth, deformities - all are more common in males. In fact, at birth, by which time the male lead has been whittled down to 105 to 100, a boy's development is reckoned to be about four to six weeks behind a girl's.

Through the childhood years the carnage continues. Males notch up higher scores in hyperactivity, reading and behavioural problems, autism, clumsiness and stammering. And it gets no better as we grow up - circulation disorders, diabetes, alcoholism, ulcers and lung cancer - men are ahead in all of them. Out of the 72 major causes of death, females only have higher rates in five, including breast cancer and pregnancy. Women on average live five years longer and men are twice as likely to die before 65.

The chief suspect responsible for our reduced survival rate is the hormone that defines us - testosterone. Certainly removal of the goolies will give you about an extra 10 years of life, but you may feel that price is too high. It's a surge of testosterone in the womb around the end of the first month that stops you developing into a female. But you have to have the right amount - too little and your sperm count will be low later in life, too much and your risk of those developmental disorders soars.

Your next testosterone boost in adolescence is linked with a rise in violence and accidents. Five thousand people are severely injured in accidents every year in the UK, 75% of them men. Males also score heavily in other indicators of aggression and rebellion - four times as many take their own lives and men make up 88% of drug offenders. Testosterone has also been linked with higher blood pressure - raising the risk of heart disease - and with damping down the immune system.

The fact that the male immune system seems less aggressive than the female does at least give us one health advantage. Women are far more likely to develop illnesses caused by an over-active immune system, such as multiple sclerosis or rheumatoid arthritis. What's more, cutting back on testosterone doesn't seem a very attractive prospect. After all, the result of falling levels as we approach late middle is loss of muscle and body hair, decline in sexual desire and erections and an expansion of the midriff.

While testosterone certain extracts a penalty for the pleasures it provides, we may also lose out because of low levels of oxytocin - a largely female hormone that is currently a hot research topic. A breakthrough study published last year found the reason women are generally better at handling stress is that oxytocin gives them a natural advantage. For years we've been told that fear and anxiety trigger the hormone adrenaline as part of the fight-or-flight response. But now Professor Shelley Taylor of the University of California has found that women also produce higher levels of oxytocin when threatened.

This is the so-called 'love' hormone associated with both childbirth, bonding and orgasm. Its role in dealing with stress is to encourage women to look after any children first and then call for help. That, according to Taylor, is why women often stay calmer when stressed and are more likely to chat to a friend about it. Men do make a little oxytocin but its effect is reduced by testosterone while the female sex hormone oestrogen seems to reinforce it.

Not only is stress damaging to health in all sorts of ways in the long term - so handling it better gives women an advantage - but oxytocin could well be reason why women generally have better social networks. This matters because many studies have shown that being involved in charities or local clubs, or having friends and relatives you can turn to, all reduce your chance of developing illnesses.

Hyped up on testosterone, more stressed and with a weaker social support system, it's a wonder we last as long as we do. But there's more. New findings in genetics suggest that the male disadvantage may be rooted in our genes. Remember those faster Y chromosomes? The sperm they were competing with carried an X and since an egg has an X, a male has XY sex chromosomes while a female has XX. The fact that every cell of a woman's body has two copies of the X chromosome could be the key to secret of her longevity.

Although she has two copies, only one is used at any one time. The other is locked away like skiing clothes in the summer. To begin with, which one is silenced is quite random - some cells use the one they got from dad, others the one from mum. Very recently researchers have found as women get older their cells start to develop a preference for one or other version. The suggestion is that they are using the stronger chromosome, which could be one of the reasons they live longer.

In fact, as far as the sex chromosomes go, men are hit with a double whammy. Not only don't we have the option of choosing the higher grade version of either the X or the Y because we only get one of each, but if we get a duff one, there is also no chance of swapping. That's why we're more prone to various genetic disorders involving faulty genes on either the X or the Y, such as Fragile X syndrome, the most common inherited cause of learning difficulties.

So holding this crap hand in the poker game of life, what can we do? Well there are the familiar bits of healthy advice: Don't smoke - that can take off six years; don't do reckless things like drinking and driving or fighting on the way back from the pub; keep alcohol consumption to a reasonable level; have regular health check-ups when you are older - men famously leave things until it's too late to do much about it.

On the other hand you might well agree with novelist Kingsley Amis: 'Almost nothing is worth giving up for the sake of a few more years in a nursing home in Bournemouth.'

by Jerome Burne, a health and medical journalist who doesn't smoke and drinks in moderation but at his last check-up had a happily high testosterone level. 

Have your say about men's health

Do you think that the dice are loaded against men from the start or do you think the real problem is that we just don't care enough about our health? Or is Kingsley Amis right: what matters is the quality not the quantity of your life? Whatever your views, we'd like to hear them. All contributions will be published on malehealth.co.uk.