Man flu is real

[David Baxter PhD]

Canadian doctor says there's evidence the 'man flu' is actually real
By Kas Roussy,CBC News
December 11, 2017

Men experience harsher cold and flu symptoms than women

Just in time for flu season, a new article in the Christmas issue of the British Medical Journal explores the science behind a debate that has annoyed sniffling, coughing men and infuriated women for years.

Is the "man flu" an actual medical condition? Do men suffer from worse flu symptoms than women?

Or, are men simply whinier than women and act sicker when they have a bug? Adding insult to injury for men, the term "man flu" has made it into the Oxford Dictionary: "A cold or similar minor ailment as experienced by a man who is regarded as exaggerating the severity of the symptoms."

Dr. Kyle Sue, a clinical assistant professor in family medicine at Memorial University in St. Johns, decided to study the available research to see if he could settle the debate with science.

His conclusion? There's evidence, albeit limited, that the man flu is actually nothing to sneeze at.

"I think the symptoms are real," Sue said. "And they're worse."

For the Canadian doctor, it was all about the science ? but it was personal, too.

"I've been criticized for exaggerating my symptoms when I had the flu," he told CBC News from Arviat, Nunavut, where he's the community's only doctor. "I thought. You know what? This would be an interesting topic to look into." (Read Dr. Kyle Sue's study in the BMJ)

In the journal, he points out that no scientific review has examined whether the term man flu "is appropriately defined or just an ingrained pejorative term with no scientific basis."

"Since about half of the world's population is male, deeming male viral respiratory symptoms as 'exaggerated' without rigorous scientific evidence could have important implications for men," he wrote.

Most of the studies he found involved mice, and several of them showed female mice have stronger immune responses than males.

A study that isolated cells from 63 healthy people and infected the cells with a common virus found the cells from women had a stronger immune response than those from men.

Other findings included:

• A seasonal flu study from 2004-10 in Hong Kong found men had a higher risk of hospital admission.
• A U.S. observational study from 1997-2007 showed men had higher rates of flu-associated deaths compared to women.
• Women are more responsive to vaccination than men.
• In an unscientific survey, men suffering from a flu reported taking more time off from work than women.

'Benefit of the doubt'
He says the studies actually point to men having weaker immune systems than women.

"Testosterone is a hormone that actually acts as an immunosuppressant. Whereas estrogen works in the opposite direction. They stimulate the immune system," he told CBC News. "So men with higher testosterone actually end up being more susceptible to viral respiratory and tend to get them worse."

Sue admits the evidence is limited, particularly since much of it involved mice. He says more higher-quality research needs to be done to determine conclusively whether man flu is an actual medical phenomenon.

Nevertheless, he says, the available evidence does suggest men suffer more with the flu than women.

"The whole point of doing this article is to prove that men are not wimps," he said in an interview. "Actually, we are suffering from something we have no control over ... [We] should be given the benefit of the doubt rather than being criticized for not functioning well during the flu or the common cold."

But, in keeping with the cheerful spirit of the season ? and with tongue firmly planted in cheek ? Sue also wrote about the benefits to having a "less robust immune system." In times of illness, it allows men to conserve their energy by lying on the couch or not getting out of bed.

"Perhaps now is the time for male-friendly spaces, equipped with enormous televisions and reclining chairs, to be set up where men can recover from the debilitating effects of man flu in safety and comfort."

 

[David Baxter PhD]

Is "man flu" really a thing?

Is “man flu” really a thing?
by Robert H. Shmerling, MD, Harvard Health Blog
January 3, 2018

This one got by me. I’d never heard of “man flu” but according to a new study of the topic, the term is “so ubiquitous that it has been included in the Oxford and Cambridge dictionaries. Oxford defines it as ‘a cold or similar minor ailment as experienced by a man who is regarded as exaggerating the severity of the symptoms.’”

Another reference called it “wimpy man” syndrome. Wow. I’d heard it said (mostly in jest) that if men had to carry and deliver babies, humankind would have long ago gone extinct. But wimpy man syndrome? I just had to learn more.

What is man flu?
As commonly used, the term man flu could be describing a constitutional character flaw of men who, when felled by a cold or flu, embellish the severity of their symptoms, quickly adopt a helpless “patient role,” and rely heavily on others to help them until they recover. Another possibility is that men actually experience respiratory viral illnesses differently than women; there is precedent for this in other conditions. Pain due to coronary artery disease (as with a heart attack or angina) is a good example. Men tend to have “classic” crushing chest pain, while women are more likely to have “atypical” symptoms such as nausea or shortness of breath. Perhaps the behavior of men with the flu is actually appropriate (and not exaggerated), and based on how the disease affects them.

Here are the highlights from the study:

• Influenza vaccination tends to cause more local (skin) and systemic (bodywide) reactions and better antibody response in women. Testosterone may play a role, as men with the highest levels tended to have a lower antibody response. A better antibody response may lessen the severity of flu, so it’s possible that vaccinated men get more severe symptoms than women because they don’t respond to vaccination as well.
• In test tube studies of nasal cells infected with influenza, exposure to the female hormone estradiol reduced the immune response when the cells came from women, but not in cells from men. Treatment with antiestrogen drugs reduces this effect. Since flu symptoms are in large part due to the body’s immune reaction, a lessened immune response in women may translate to milder symptoms.
• In at least one study reviewing six years of data, men were hospitalized with the flu more often than women. Another reported more deaths among men than women due to flu.
• A survey by a popular magazine found that men reported taking longer to recover from flu-like illnesses than women (three days vs. 1.5 days).

Taken together, these findings suggest that there may be more to “man flu” than just men exaggerating their symptoms or unnecessarily behaving helplessly. While the evidence is not definitive, they suggest that the flu may, in fact, be more severe in men.

If it’s true that men get sicker with the flu, why?
Some have suggested that early man evolved to require more prolonged rest while sick to conserve energy and avoid predators. In more modern times, the advantage of a longer recovery time is less clear beyond the obvious. When you don’t feel well, it’s nice to be taken care of. Of course, that’s true for women as well.

The bottom line
Diseases can look different in men and women. That’s true of coronary artery disease. It’s true of osteoporosis, lupus, and depression. And it may be true of the flu. So, I agree with the author of this new report, who states “…the concept of man flu, as commonly defined, is potentially unjust.” We need a better understanding of how the flu affects men and women and why it may affect them differently.

Until then, we should all do what we can to prevent the flu and limit its spread. Getting the flu vaccination, good handwashing, and avoiding others while sick are good first steps. And they’re the same regardless of your gender.