why is it that women live longer than men?

'We're like little babies when we're ill but we won't see a doctor.' He said it. Lucy O'Brien on men, women and health

Richard had a lump under his arm for three years before he had it checked out. Luckily it was benign, but "I didn't go for so long because I was worried." Women tend to monitor their health, and this is further encouraged by health education campaigns such as the forthcoming Breast Cancer Awareness Month. Men, however, can be lax. they tend to be unaware of screening programmes for potential killers and are reluctant even to register with a GP, let alone visit one. This reluctance is reflected in current statistics: in Britain, men are almost twice as likely to suffer heart disease as women; for every woman that dies of cervical cancer this year, five men will die of prostate cancer; a woman's average life expectancy at 79; the male average is 73.

"Men are expected to carry on and not report illness, so they're twice as likely as women to die before 65," says Graham Rogers of the Frenchay Health Trust. "Men have sudden deaths, which could have been avoided if detected early enough. Testicular cancer, for instance is 90 per cent curable in the initial stages. There is a lack of awareness - most men don't even know where their prostate gland is."

Is this, as some in the men's movement would have it, a result of government neglect, of resources being diverted away from men and towards women? In part, says Rogers: "The rise in mediation of women's health issues has diverted attention from men's specific health needs, making men invisible. They have a right to be heard."

Macho attitudes, however, also play a part. "I had a slipped disc," says Trevor, "but instead of going to the doctor I ploughed on bravely with Nurofen. I ended up in hospital with a collapsed disc, which is permanent rather than temporary. It was my own fault." It is, he admits, "the male health paradox. We're like little babies when we're ill, yet never go to the doctor because it's not a masculine thing to do."

Not surprisingly, such a difference in attitudes causes conflict in relationships, with the woman assuming the caretaking or "nagging" role when her partner is ill. "My boyfriend had a terrible cough for three months. He was very worried, hacking away in this irritating manner, but when I said, go to the doctor, he'd make light of it. It drove me mad," says Gill, 28.

There is evidence, though, of a shift in attitudes. In the past few years, new men's magazines like Men's Health and XL have highlighted medical issues, and titles such as Go, Esquire and FHM now dedicate pages to health advice. Many employers, too, now provide a medical check-up as a perk. "Our company offered it, so I had one just on the off-chance after I got married," says Michael, a 36-year-old merchant banker. Tests showed he had contracted hepatitis C, a potentially incurable virus. A former heavy drinker, he has since radically changed his lifestyle, and is responding positively to treatment. "I never used to go to the doctor unless I was really ill, so I don't know what would have happened had I not had the check up. It doesn't bear thinking about."

Communication seems to be the key. In a society where 77 per cent of suicides are men, it is critical that men express their needs. As Michael Bennett, manager of Bristol Relate, asserts: "Men are less familiar with the language of their emotions than women. You're more likely to maintain your physical health if you have the language to articulate how you feel." The more men monitor their health, the less women will have to take on that caring role, and the typical image of the man toughing it out will be a thing of the past.