The evidence for man-flu: real or fake news?
The British Medical Journal recently published an article called ‘The Science behind man-flu’. The author Dr Kyle Sue, a clinical assistant professor in family medicine at the Memorial University of Newfoundland, explored the concept of ‘man-flu’ in an attempt to learn whether men actually experience more extreme symptoms of the flu than women.
Dr Sue surveyed epidemiological records and research where women appear more responsive to viral vaccinations than men, and cited studies that indicated men have weaker immune systems than women, thus supporting the case for the existence of man-flu.
Dr Sue stated, “The concept of man flu, as commonly defined, is potentially unjust. Men may not be exaggerating symptoms but have weaker immune responses to viral respiratory viruses, leading to greater morbidity and mortality than seen in women.”
He further asserted that the behaviours often ridiculed as being synonymous with man-flu could be remnants from mankind’s prehistoric ancestors. Dr Sue wrote, “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.”
This article received wide attention in the media. To shed light on the matter, we spoke with IBMS member Dr Sarah Pitt, a virologist and lecturer in biomedical science at the University of Brighton.
Dr Pitt commented, “This is an interesting and topical systematic review of the literature concerning comparisons of male and female responses to respiratory illness. There appears to be some evidence that higher levels of testosterone may cause a weaker immune response to respiratory viruses. However most of the laboratory and epidemiological studies cited involved seasonal influenza, while ‘man flu’ refers to more mild respiratory diseases associated with viruses such as rhinovirus and coronavirus. Studies of people’s behaviour when they have a cold ( likelihood of resting, time taken to recovery) quoted in the article appear to involve observation or self-reporting on behaviour, so their objectivity can be questioned.
The author discusses possible evolutionary reasons for males having reduced immunity to colds. One idea is that hunter gatherers did not waste metabolic energy on reacting to infection when they were more likely to die from physical trauma, thus leaving them less able to fight respiratory disease. This does not account for the role that the immune response plays in symptomatic disease. Another suggestion is that hunter gatherer males rested when ill to ensure they were fully fit to successfully collect food and avoid danger.
The author acknowledges that the quality of the current evidence is not good enough to make firm conclusions and therefore further investigations seem warranted. However given that both men and women have strong opinions about ‘man flu’ based on their own experience, whether an unbiased researcher can be found is another matter.”
Is more research needed? For a fuller interview with Dr Sue, see the Guardian article.
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