Is “man flu” really a thing?

Robert H. Shmerling, MD

Faculty Editor, Harvard Health Publishing

Follow me on Twitter @RobShmerling

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.

Comments:

  1. lI

    I think and I’m not a doctor but my Opinion, I think women have stronger immune systems. For these reason is, the monthly cycle, also women can bare children and our body’s have to be tip top shape for for children. I’m not saying we don’t get sick be we know what pain is and our body is always are the defensive side most of our lives and all the stress we have especially now in the 21st Century. Women are sometimes the head of the house hold or have to have a full time job, also bare children, and be the care taker. Women body are under a lot of stress and attacked but i’m not saying men aren’t I’m just giving my Opinion on why women.

  2. AJ

    Doctor Dr.Omar, you sir sound like a very intellectual, caring and observant doctor. I only wish our ” Western Medical Society” had a greater number of medical professionals that were observant and caring as you sound. About me.
    I am a 60 year old male. I was born and raised in the Midwest. I was very very active growing up and my parents made sure we ate healthy all be it by the standard Midwest diet. As a young lad several times a year I would become very sick. Unfortunately I never out grew said sickness. At least twice a year usually during a changing weather season I fall prey to sickness ie. sever respiratory illness. The advent of the modern annual flu shot has helped however, I always end up with a sever case of sinusitis.

  3. Carl

    Aha! We knew it!! However, this would have more validity if authored by a woman doctor…. 😉

  4. Cheryl

    We have had multiple office discussions about man flu. The reaction is split down the middle. The women believe it’s a myth and the men believe it’s totally true. I appreciate the comments and will share them with our group. They are sure to keep the discussion going! Thank You!

  5. J. Manson

    “women are by nature ‘nurturers’ – by nature? or by nurture? We can’t assume it’s by nature, as nothing is purely biological. We are social creatures influenced by our psychosocial environment as much as by biology. It is simplistic to think otherwise, however convenient.

    Training and socialisation (including reward for behaviour that’s sex appropropriate and punishment for ‘unwomanly’ behaviour such as being uncaring) is effective in influencing behaviour.

    Thankfully many people develop beyond Pavlovian responses.

    • J. Manson

      Apologies to all for any confusion. This was supposed to be a reply to SteveO, but somehow it ended up in the wrong place. My error

  6. J. Manson

    We don’t actually know if men and women have different symptoms. We only know that they REPORT different symptoms. What people feel comfortable to report is as much a social issue as a medical one.

    There is also the issue of how to describe symptoms, a difficult issue for most people who have no prior experience of a particular feeling. Usually prompted by doctors with suggestions or options, what’s reported is often an interactive agreement, rather than an objective individual report. If doctors are not happy with the description, they prompt for different information to satisfy themselves. There is shaping of responses to suit.

  7. martha moore

    LOL>

  8. Pilar Holik

    It is true men deal with illnesses very differently than women. I know because I have a father, a husband and a son. I also have worked in a very male dominated field. In my experience, men will deny any health problems even when they are serious. They won’t see a doctor or ask for help. This is very true at the work place and if the men are in a position of authority such as a father or a boss. Before my husband became a father he would admit not to be feeling well or accepting comfort from me. After my son was born there was a radical change in my husband and his health. He does not admit feeling ill or he won’t see a doctor’s help. He does not take care of himself. He has become my father. My parents had the biggest fights because my father would not go to his scheduled medical appointments. My father had cancer he needed to keep these appointments. My son, when not feeling well seeks the comfort of mom and the helpof a doctor. However, as he has become older he hides the fact he is sick. If he gets hurt playing sports he would do anything to hide the fact he is hurt and he won’t accept any help until the match or game is over. On the other hand women don’t have a problem admitting we are sick. We go to a doctor we seek solutions to feel better and we are more proactive. I have the feeling these are both cultural and biological differences between the sexes.

    • azure15

      I think it’s a mistake to generalize so much about either sex/gender. Not ALL women are fine w/being sick or admitting to being sick. For years, I rarely admitted to feeling ill because I got one of two responses (or both), that I was being an annoyance by having (deliberately apparently) gotten sick/using as an excuse to miss a class or (2) you must go see a MD, now!!!!
      whether or not it was something a MD could do anything about. I learned to keep quiet. As a single person, I pretty much take care of myself, except in a few situations (out patient surgery, asking a friend to drive me to/from the surgery location).

      I’m female.

      Known a number of women who would not admit to being ill because they had too much to do: jobs, children to take care of, possibly a spouse as well. They might, at some point, admit to not feeling all that great, but they kept going anyway.

      Some men, if they become ill, expect to be waited on (although they may not do that for anyone else).

  9. Sylvia

    I worked for nearly two decades in Human Resources, in a company with several thousand employees, blue collar to professional. An empirical observation is that while women were generally more likely to call out sick–perhaps just to stay home with a sick child–men were more likely to ignore severe symptoms until they became serious. Men certainly didn’t complain about their illnesses at work, the way women do. Maybe at home they whine, but not at work. A guy will lose consciousness or even drop dead before admitting to chest pain, for example. Women like the attention of being ill, getting attention for aches and pains from other women, talking about their health problems. Men are NOT doing that. They will not get that sort of positive sympathy from other men. The idea of the “man flu” is something women with husbands like to believe perhaps–but as a woman who had to deal with sick employees of either sex, and a range of sexualities–the “man flu” wasn’t a workplace problem. Dealing with substance abuse, mental health issues, excess weight, chronic illnesses–men tended to ignore these problems in themselves. That was true “man flu.”

    • J. Manson

      A few massive generalisations in your comments, that are disproved by facts. Whilst your observations are valid, they are not the whole story.

      1) Not all women like attention when they’re sick. Some hide away, but of course you don’t see them so perhaps they’re not factored into your observations.

      2) Some men do seek out attention and talk a lot about their ailments when they’re sick, but perhaps you don’t see that either. Many of us do.

      3) Like some men, some women are too busy to pay attention to their ailments or prefer to avoid dealing with them.

      This is the problem with personal anecdotes. They’re usually based on insufficient data. Lack of scientific methodology leads to myths that others believe, especially if there are stories to which others relate. This can create false divisions between people, based on their category and insufficient knowledge – called stereotypes.

      • Dr.Omar

        It should be noted that Sylvia qualified her assessment of at least one factor by saying “while women were generally more likely to call in sick…”, with “generally” being the operative term here.

        By being so overly critical of other opinions, you tend to overreach in your attempts to sound convincing. And as a result, your post loses all of its intended value. As an example, you first suggest that she might not see the women who hide emotions, well, because they hide theirs is fair enough, but you try and echo that by suggesting that some men do seek out attention but that she might have missed that too. As ifnshe is missingnthe obvious and the hidden and yet you know all that exists.

        Lastly, and anecdotal as it may be, her observations are based upon her “near two decades in Human Resources, in a company with several thousand employees, blue collar to professional”, which, if this were a study, the depth, breadth and scope of her data would more than likely satisfy the strictest of standards. Whereas your opinions are mere statements that you support through your use of a speculative “perhaps” based upon data you collected, sample size: “zero”.

  10. Anthony jaggi

    I love the blogs and find them intetesting

  11. Kathleen

    The idea that anyone recovers from flu symptoms in 1.5 days is absurd. Clearly the women are downplaying their experience.

  12. FRWebb

    True for women as well, he says of the possibility that men like to be cared for when Feeling ill.
    The difference being, who is there to take care of the average woman with a bad cold? In many if not most households, research confirms that Mom is still up and doing, nursing Dad and the kids and cooking and cleaning and probably going to work at a wage earning job regardless of her own symptoms.
    So, there’s liking a bit of downtime and coddling, and who wouldn’t? And then there’s feeling entitled to it. Which in our culture is still pretty much a guy thing.

    • SteveO

      May I suggest that the reason that there is a perception of “entitlement” to be cared for when sick comes about because women are by nature “nurturers”. And because of this, they choose to take care of their children and/or husbands when they are sick. This only causes the children and/or husbands to expect this same treatment the next time they’re sick. A Pavlovian response, if you will. Or, the women are just enablers! LOL!