Why is paracoccidioidomycosis more common in men?

Paracoccidioidomycosis is most common in adult men between the ages of 30 and 60 years. Skin testing indicates that the rate of infection is equal among the sexes. However, clinical disease is more common in men, with a male:female ratio of 15:1. It has been shown that this sex difference is due to the inhibitory action of estrogens on the mycelium to yeast transformation necessary for infectivity. Only 3% of cases occur in children and 10% in adolescents.