With flu season upon us, a Canadian doctor has taken it upon himself to explore whether there’s a scientific basis to the widely held idea that men exaggerate flu symptoms.
The so-called “man flu” is defined by the Oxford dictionary as “a cold or similar minor ailment as experienced by a man who is regarded as exaggerating the severity of the symptoms.”
But as family medicine professor Kyle Sue of Memorial University of Newfoundland wrote in the British Medical Journal, there has been no review of scientific research pertaining to gender differences in flu symptoms.
“Tired of being accused of overreacting, I searched the available evidence to determine whether men really experience worse symptoms and whether this could have any evolutionary basis,” Sue wrote.
His conclusion: Men may genuinely have more severe symptoms when they’re hit with the flu.
LISTEN: Dr. Kyle Sue chats about the motivation behind his investigation, and how he came to his findings.
Sue arrived at his thesis after analyzing the scientific literature and unearthing several pieces of evidence suggesting that men may actually be more vulnerable to the flu.
For example, a 10-year observational study from the U.S. found that men had higher rates of flu-related deaths compared to women, while a study from Hong Kong found that adult men were more likely to be admitted to hospital due to flu.
Sue also cited studies which found women are more responsive to the flu vaccine than men, including one which found that high testosterone levels could weaken men’s immune responses following flu vaccination.
READ MORE: The ‘man flu’ is real – viruses want to kill men more than women: study
There may even be an evolutionary reason — in a review article titled “The sicker sex,” biologist Marlene Zuk posited that the advantages of high testosterone in the male reproductive strategy may override the cons associated with immune system suppression.
“Arguments about the weaker sex notwithstanding, there is no contest about the identity of the sicker sex — it is males, almost every time,” Zuk wrote.
READ MORE: This year’s flu vaccine might only be 10% effective against predominant strain
However, Sue cautions that the available evidence is limited in scope and that more research needs to be done before anyone can come to a conclusive understanding of the “man flu.”
He says one potential study could look into whether men with strong immune systems are less successful at mating, and vice versa.
WATCH: Flu shot update
Dr. Brett Belchetz, an emergency room doctor, also warned against making wide-ranging extrapolations from Sue’s findings.
In an interview with 640 Toronto, Belchetz pointed out that existing research hasn’t established clear cause and effect.
“Did men have worse outcomes from the flu because they actually have more flus, or because men, as we know, tend to avoid treatment a lot of the time until it’s too late?” Belchetz asked. “That’s one of the things that’s not accounted for.”
Belchetz says the potential role of testosterone in weakening men’s immune systems could make for an important direction for future research, and possibly even the development of vaccines to be more effective for certain populations who don’t benefit from them as much as others.
LISTEN: Is the “man flu” real? Dr. Brett Belchetz weighs in on 640 Toronto
As for Sue, he managed to balance out the scientific theorizing with some clearly tongue-in-cheek insights into the potential advantages of exaggerating one’s flu symptoms, dubbing the common definition of the man flu “potentially unjust.”
“There are benefits to energy conservation when ill. Lying on the couch, not getting out of bed, or receiving assistance with activities of daily living could also be evolutionary behaviours that protect against predators,” he 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.”