News flash: Men and women are different.

Before you roll your eyes and laugh, this really is a bit of a novel idea—at least in the medical field. You see, for centuries, men and women were treated the same when it came to disease prevention, diagnosis, and management.

But today, we know this approach is flawed. In many cases, the same exact disease not only presents different symptoms in men and women, but the treatment that works for one sex can prove to be totally ineffective for the other.

Sadly, that difference in outcomes can lead to tragedy, but it is preventable.

Today we examine how.

How Sex Reveals Signs of Heart Disease

In no condition is the disparity in treatment outcomes more evident than heart disease.

Diseases involving the heart—heart disease, heart attacks, etc.—often present themselves very differently in men versus women. As you might expect, hormones have a lot to do with why.

Estrogen is thought to offer protection against heart disease by keeping blood vessels flexible. That’s why it’s pretty unusual for healthy premenopausal women to suffer from heart disease or a heart attack.

However, with the dramatic drop in hormone production that occurs during menopause, that layer of protection goes away. Menopause also brings about other changes that increase heart disease risk, including higher blood pressure, raised triglycerides, and elevated LDL (bad) cholesterol. As a result, women become much more vulnerable to heart disease, heart attacks, sudden cardiac death, and other serious heart issues.

To add insult to injury, women often fare worse than men, too.

One of the biggest reasons is that they rarely experience the telltale chest and arm pain that men do when they have heart attacks. And they could have heart disease but remain symptom-free for years. This means so many women end up doing the worst possible thing when suffering a serious heart event.

(They do nothing.)

If it’s hard to understand why, take a look at some of the most common symptoms of heart attack in women:

• Shortness of breath
• Weakness
• Fatigue
• Cold sweat
• Dizziness
• Nausea/indigestion/stomach pain
• Feeling of weakness/heaviness in arms

While men certainly experience a number of these symptoms during a heart attack, it’s usually in addition to chest pain—in women, chest pain is often absent.

Without this obvious sign of heart attack, many women dismiss their otherwise unremarkable symptoms as simple tiredness or overexertion.

And the last thing any woman in the throes of a heart attack should do is nothing.

Take An Ounce of Prevention to Heart

Now that you know the signs and symptoms, you know what to look for. If something doesn’t feel right, call 911 immediately.

It's also important for women to take prevention seriously. As many as two-thirds of women who die of a heart issue showed no symptoms and had no idea there was an underlying problem in the first place.

One study out of Harvard showed just how crucial of a role lifestyle plays in preventing heart disease in women. They evaluated 20 years of data on nearly 70,000 women and found that 73 percent of cardiovascular disease cases could be attributed to poor lifestyle.

However, adhering to six healthy habits—good diet, no smoking, healthy weight, regular exercise, minimal TV watching (seven hours or less per week), and limited alcohol (one or fewer drinks per day) reduced the risk of cardiovascular disease by a whopping 92 percent.

These lifestyle habits are important no matter what your age, but become even more critical post-menopause.

What Gender Reveals or Hides About the Blues

While heart disease is the biggest condition that presents itself differently in men and women, we would be remiss if I didn’t take a moment to discuss depression.

Depression has been a major topic in the news lately, due to the very unfortunate suicides of children and adults struggling with COVID-19 isolation and lockdowns.

While the vast majority of people who deal with depression don’t suffer the same fate (thankfully), research is finding that men and women do present some different symptom patterns. 

Overall, the core symptoms of depression that men and women experience are fairly similar. They include sadness, lack of motivation, sleep problems, loss of pleasure in once-beloved activities, and feelings of guilt and despair.

However, studies suggest that how men and women express many of these symptoms can vary.

For example, women tend to convey their sadness outwardly, such as through crying or talking with friends, while men hold it in. As a result, men are more prone to intense outbursts of anger or violence than women. Other characteristics of depression that are more common in men than women include:

• Alcohol or drug abuse
• Risky activity
• “Escaping” by working late or spending excessive time away from “normal” life

Sadly, this is not surprising. In our culture, women are given permission to be vulnerable and open with their emotions, yet men are expected to be strong, silent, and stoic.

It’s “normal” for a woman to cry, yet a man could be perceived as “weak” if he does the same. It’s certainly not fair, but these are the expectations we as a society place on men, and eventually, it can reach a head.

Encouraging Words From the Heart

If you or a loved one (man, women, teen, child, or senior citizen alike) is experiencing any of these signs of depression, please seek help. Psychotherapy and counseling are extremely important and beneficial, and should be the basis of depression treatment.

Additional therapies include exercise, various nutritional supplements, and even antidepressants. (While we don’t like these medications for long-term use, they can be helpful to restore balance.) Whatever you do, don’t deal with depression alone.

Similarly, stay vigilant when it comes to heart health. As we discussed, the way your body demonstrates problem signs can remain hidden, depending on the chromosome pairing.

At this point, you can't control your original design, but you can adjust your lifestyle to overcome any potential disadvantage when it comes to protecting your ticker, or your body's control center.

Take good care.

References

• Chomistek A, et al. Healthy lifestyle in the primordial prevention of cardiovascular disease among young women. J Am Coll Cardiol. 2015 Jan 6;65(1):43-51. Last accessed June 11, 2018.
• Schimelpfening N. Is depression different in males and females? 19 May 2018. Last accessed June 12, 2018.

Disclaimer: Please note the date of last review or update on all articles. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.

Last Updated: February 24, 2021
Originally Published: June 19, 2018