Gender differences in processing grief may condition men’s poorer coping with the end of a relationship following partner loss. As indicated by Wahring, Simpson, and Van Lange, men tend to rely much more than women on their romantic partners and are likely to suffer more after the relationship dissolution. We argue that this also applies to the experience of losing a partner either by death or due to dementia, occurring most often in the middle or old age.

Widowed men are relatively more vulnerable to health risks than women (Fitzpatrick, Reference Fitzpatrick1998), including higher mortality risk in the period of acute grief (Mineau, Smith & Bean, Reference Mineau, Smith and Bean2002). These results indicate that men’s adaptation to a partner loss might not be effective enough not only to manage their grief but also for their general well-being.

Ratcliffe and Byrne (Reference Ratcliffe, Byrne, Køster and Kofod2021) distinguish between emotions that are regulated by life structure (e.g., staying in a long-term relationship) and emotions that involve responding to disturbances of this life structure. We argue that the loss of a partner ends the long-term life-structure that previously regulated partners’ emotions. Importantly, the men not only lose their long-term pattern of dyadic emotional regulation but also experience the emergence of new emotions triggered by the loss. The disturbance of the previous life structure refers to the disruption of rituals and habits that used to involve the deceased or cognitively impaired partner, as well as the wider social cycle, which are considered to be critical regulatory processes (Ratcliffe, Reference Ratcliffe2019; Ratcliffe & Byrne, Reference Ratcliffe, Byrne, Køster and Kofod2021).

Wahring et al. refer to three theoretical models accounting for gender differences in the weight of the relationship with a romantic partner. In our opinion, the psychological vulnerability of men following the loss of their partner may also be explained by the fourth model – attachment theory. The profound attachment bonds are deeply encoded in the brain. Both grief and addiction activate overlapping neural circuits involved in reward and motivation (Burkett & Young, Reference Burkett and Young2012). For men who rely on romantic relationships as their primary source of emotional regulation, their emotional lives revolve around a singular dyadic bond. Therefore, losing a partner can trigger a sense of reward deprivation. This loss often signifies the end of emotional reciprocity and the breakdown of the shared daily routines that helped many men maintain emotional stability (Ratcliffe & Byrne, Reference Ratcliffe, Byrne, Køster and Kofod2021). Under stress, men are more likely to employ regulatory strategies such as suppressing their emotions, blaming themselves, and blaming others, rather than seeking emotional support (García-Fernández et al., Reference García-Fernández, Fuentes-Sánchez, Escrig, Eerola and Pastor2025). The absence of a life structure that once helped regulate emotions may result in dysphoria and symptoms resembling withdrawal. In such states, men may turn to maladaptive coping mechanisms, including substance use (Burkett & Young, Reference Burkett and Young2012). As in addiction, familiar routines can activate attachment-linked reward pathways, briefly bringing back the sense of the lost partner’s presence and intensifying grief (Burkett & Young, Reference Burkett and Young2012). These effects are particularly pronounced in the elderly men, whose social networks often tend to be smaller and in whom the relationship between low social support and depressive symptoms is stronger than in women (Hed et al., Reference Hed, Berg, Hansson, Kivi and Waern2020).

The mechanisms described above explain why regulating emotions in men might be more profoundly compromised after the death or non-death loss of their partner. This may also be explained by their exclusive reliance on female partners as confidants, the higher levels of social support received by widows compared to widowers (Eisma & Stroebe, Reference Eisma and Stroebe2021), and also by the fact that emotion regulation strategies are more diverse and flexible in women (Goubet & Chrysikou, Reference Goubet and Chrysikou2019). Overall, men tend to suppress or repress their grief-related emotions, and as a result, they are more prone to experience loneliness.

Disruption of life structure and emotional regulation becomes especially evident in ambiguous loss due to dementia; men whose wives or partners are affected often experience this loss due to progressive changes in cognition, behaviour, and communication. These changes have a profound impact on the relationship, which evolves from a partnership to a caregiving role. This change may be evident very early (even at pre-dementia stage) in the course of a neurodegenerative disease when prefrontal cortex and/or frontostriatal loops are primarily affected, e.g. in frontotemporal dementia (Johannessen et al., Reference Johannessen, Helvik, Engedal and Thorsen2017) or Huntington’s disease (Exuzides et al., Reference Exuzides, Matos, Patel, Martin, Ricker and Bega2022). However, the role changes become overwhelming at the stage of mild/moderate dementia in all cases (Colloby, Whiting, & Warren, Reference Colloby, Whiting and Warren2022). According to the ambiguous loss theory, the affected partner is still physically present but mentally absent (Boss & Couden, Reference Boss and Couden2002), which implies the loss of partnership and the emergence of new duties. Although literature on gender-related differences in different dementia syndromes is limited, men may suffer more when confronted with unfamiliar caregiving roles and their changed identity that requires reshaping their masculinity. This change in the relationship may be more challenging for men, as the intimate relationship is a more primary and core relationship for them than it is for females. Additionally, when a woman used to lead the couple’s social life and/or was independent or dominant, the male partner, who becomes a caregiver, may struggle in particular to adjust to a new role. From a practical perspective, as noted by Wahring et al., in most couples, women tend to perform a greater share of household chores. This imbalance is often greater in elderly couples. Thus, when the elderly male, who is not accustomed to various household chores, faces the loss of his partnership, caregiving duties, and all household chores, the real burden is actually tripled.

In summary, we support the idea proposed by Pena-Vargas, Armaiz-Peña, and Castro-Figueroa (Reference Peña-Vargas, Armaiz-Peña and Castro-Figueroa2021), which suggests that the capacity for emotional regulation enhances mental health in the context of grief. Rigid emotional regulation strategies in men may substantially hinder grief adaptation. In the context of both partner’s death and the ambiguous loss of a partner due to dementia, men are particularly vulnerable, and a gender-specific approach to interventions is needed.