As winter rolls into town, so does the flu and all its miserable symptoms.
Yet, doctors and women alike have long noticed that men tend to bemoan those symptoms more than women. The phenomenon even has a name: the "man flu."
So, are men just whiny wimps?
No, a new analysis out of Canada suggests, because respiratory illnesses may indeed hit men harder than women.
According to study author Dr. Kyle Sue, "there are already many physiologic differences between men and women, so it makes sense that we could differ in our responses to cold and flu viruses as well."
Sue is a clinical assistant professor in family medicine with the Health Sciences Centre at Memorial University of Newfoundland.
"The evidence in current studies points towards men having weaker immune systems than women, especially when it comes to common viral respiratory infections," Sue explained. "Men are more susceptible to them, symptoms are worse, they last longer, and men are more likely to be hospitalized and die from the flu."
To compare how flu symptoms manifest among both women and men, Sue reviewed a number of studies involving both animals and humans.
One investigation out of Hong Kong suggested that when the flu strikes, adult men face a greater risk for being admitted to the hospital than their female peers. Another American study also found that, all things being equal, men seem to face a higher risk for actually dying from the flu than women.
Still another investigation indicated that in the face of both the flu and other respiratory illnesses, men face a higher risk for developing complications than women.
What's more, several mouse studies suggested that hormonal differences between men and women may actually offer women greater protection from the full brunt of flu symptoms. Other patient-based studies similarly indicated that the onset of a flu may trigger a stronger immune response among women than men, blunting the full impact of symptoms.
And yet another study found that women tend to develop a stronger reaction to the flu vaccine than men, perhaps because higher testosterone levels among men tend to suppress the overall immune response, the review team suggested.
The analysis was published Dec. 11 in the BMJ.
Sue acknowledged that more research is needed. But he suggested that the findings to date indicate that the "man flu" has some basis in reality.
"Men are regularly stereotyped to exaggerate cold and flu symptoms," Sue noted. "That's how the term 'man flu' became so commonly used internationally, regardless of differences in culture," he said. "[But] from my clinical work, personal experiences and my social circles, I've seen men suffer worse from colds and flus. In other words, be less functional."
And Sue added that if the underpinnings of "man flu" are real, it could mean that flu treatment may have to be tailored to address gender differences.
"Medically treating both genders exactly the same will do both genders a disservice," Sue said. "We already screen men earlier for cardiovascular diseases because they are more susceptible. Why should it be so controversial for men to suffer worse from colds and flus?"
Dr. Ebbing Lautenbach, chief of the division of infectious diseases at the University of Pennsylvania's Perelman School of Medicine, said the latest analysis "does a nice job of reviewing how much real data there are to back up these commonly held impressions." He wasn't involved with the review.
Still, Lautenbach stressed that the analysis does not prove that a "man's response to a respiratory infection is, in fact, worse than a woman's and, if so, by how much. Much more work needs to be done to figure out whether differences exists and, if so, what biological mechanisms might explain them."
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