SVT publicerar artikel som ifrågasätter om kvinnor är fysiskt svagare än män

It is well documented that the excess of mortality among men in comparison to women is mainly due to earlier appearance of cardiovascular disease. There is in the literature not much knowledge about the pathophysiology underlying the gender gap in favor of women. One has to take into consideration the genetic advantage for women of having two X-chromosomes, the suppressing effects of estrogens upon the age related cell senescence and the favorable cardiovascular effects of hormonal fluctuations in women during their reproductive period. Estrogens exert a favorable effect upon endothelial cells and hemostatic factors. Estrogens increase the expression of antioxidant enzymes by which females are better protected against oxidative damage during life and finally the age-related telomere attrition, causing endothelial dysfunction, occurs much more slowly in females compared to males. But this cannot explain the gender gap fully. Therefore, life-style and environmental influences may modify the outcome of aging. The fact that coronary heart disease is less common in premenopausal women compared to age-matched men points towards the obvious gender difference in hormones. Females experience large fluctuations of female hormones during the menstrual cycle and pregnancy till the climacteric-postmenopausal period. In literature only serum values of hormones are investigated, largely overlooking the biological effects of estrogens. Endogenous estradiol has fluctuating vasodilatory effects through nitric oxide mediated action on the endothelium. These fluctuations trigger the cardiovascular system, comparable to ‘jogging’, by increasing heart rate and cardiac output by around 1 L/min. These fluctuations are present during the menstrual cycle and pregnancy and are absent in the postmenopausal period. These endocrine-initiated biological processes, with estradiol as the chief initiator, might contribute towards a longer life-span in women in comparison to men and may explain at the same time the gender equalization in the late menopause.