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‘Man flu’

Fact or fiction? Faculty of Medicine researcher says 'fact'


By Virginia Middleton

Cold and flu season is upon us and, for half of the population, there is a collective worry about being inflicted with a debilitating illness known as “man flu.”

From Internet memes to product commercials, “man flu” is viewed as a man’s exaggerated response to their cold or flu symptoms.

Scientific basis?

While “man flu” often becomes a lighthearted jab at the male gender once flu season hits, Dr. Kyle Sue, a clinical assistant professor in the Discipline of Family Medicine in the Faculty of Medicine, has examined research that indicates the ailment may in fact exist.

His research, published in the Christmas 2017 edition of the British Medical Journal (BMJ) is receiving a lot of international attention — from Britain to L.A. and many places in between.

“Surprisingly, there are actually many studies already on this topic, from mouse studies to test tube studies to human studies,” said Dr. Sue. “No scientific review has examined whether the term “man flu” is appropriately defined or just an ingrained pejorative term with no scientific basis.”

Hormonal differences

Research shows that higher estrogen levels are associated with stronger immune responses, lower viral levels and more immune markers in the blood, while higher testosterone levels do the opposite.

This difference stops at menopause when estrogen levels fall in women.

“The current evidence suggests that men may have a weaker immune system than women, resulting in worse and more prolonged symptoms when faced with the common cold or flu,” said Dr. Sue.

Dr. Kyle Sue in  Iqaluit, Nunavut.
Photo: Submitted

However, this stronger immune system isn’t always a good thing for women.

When it comes to autoimmune diseases, where the immune system attacks the body’s own cells, women are found to be more vulnerable.

“When it comes to pandemic infections, like the Spanish Flu of 1918 or H1N1,” said Dr. Sue, “women’s immune systems have been shown to overreact, creating a so-called “cytokine storm” that overwhelms the body, leading to worse illness and more death.”

While the research is suggestive, it is not proven enough to be deemed definitive by the scientific community.

More research is needed to examine other differences between men and women, like smoking and drinking rates, or willingness to see a doctor in a timely manner.

Evolutionary origins

Dr. Sue says that some research findings suggest the immune differences between men and women to be based in evolution.

While men were viewed to be responsible for hunting (often dangerous) animals, testosterone’s effect of increasing physical strength and aggressive behaviour makes sense.

“When looking at the hunter-gatherer role, a man wouldn’t be hunting while not thinking straight or low energy or out of strength.” — Dr. Kyle Sue

With that in mind, when faced with a common infection, says Dr. Sue, it also makes sense that men are completely debilitated from it — removing them from the imminent danger altogether.

“When looking at the hunter-gatherer role, a man wouldn’t be hunting while not thinking straight or low energy or out of strength. They could instead retreat home where it’s presumably safer.”

Noting that the topic is not necessarily a serious one, Dr. Sue jokes that the concept of a “man cave” may not be too far-fetched.

“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.”

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