Men who think they are tough can end up self-sabotaging the level of medical care they receive, researchers examining why men usually do not live longer than women concluded.

"The question that we wanted to answer was, why do men die earlier than women?" said Diana Sanchez, associate professor of psychology in the School of Arts and Sciences at New Jersey's Rutgers University. "Men can expect to die five years earlier than women, and physiological differences don't explain that difference."

Sanchez and doctoral student Mary Himmelstein conducted a series of studies that examined how men's perceptions of themselves affected their health and medical care. In the first study, which was published in the journal Preventive Medicine, the researchers carried out three sets of interviews.

In the first two parts of the study, the researchers assessed men's opinions regarding masculinity and gender. Men who were more traditional were more likely to think that they had to be tough, brave and free of emotions. Their doctor preferences were also recorded. In the final part, the researchers examined how the participants interacted with either a male or female medical interviewer. A total of 546 men participated.

The researchers found that men who had a more traditional view on masculinity and gender were more likely to either ignore symptoms or delay medical treatment. They were also more likely to prefer going to a male doctor as opposed to a female one. Despite seeking out medical care, the men were not too honest about their symptoms.

"That's because they don't want to show weakness or dependence to another man, including a male doctor," Sanchez explained.

Interestingly enough, however, the researchers did find that when men with traditional views saw a female doctor, they tended to be more open and honest about their symptoms. Sanchez argued that in the presence of women, tough men might not feel vulnerable at all and, therefore, are more willing to tell the truth.

In the second study, the researchers interviewed 193 students from a large American university located in the northeast and an additional 298 people from the public. The questions were once again related to views on masculinity. The researchers found that men who had more traditional views on masculinity were less likely than women to seek out medical attention and more likely to play down their symptoms. When the researchers compared health outcomes, they found that traditional men were more likely to have worst outcomes than women and other men who did not have the same views on masculinity.

"Men have a cultural script that tells them they should be brave, self-reliant and tough," Himmelstein said. "Women don't have that script, so there isn't any cultural message telling them that, to be real women, they should not make too much of illnesses and symptoms."

This study was published in the Journal of Health Psychology.