Man Flu
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''Man flu'' is a colloquial term referring to the perception that men experience more severe symptoms when afflicted with the
common cold The common cold, or the cold, is a virus, viral infectious disease of the upper respiratory tract that primarily affects the Respiratory epithelium, respiratory mucosa of the human nose, nose, throat, Paranasal sinuses, sinuses, and larynx. ...
or flu-like illnesses. Primarily British, it is frequently used in a self-deprecating manner. This term has sparked both public interest and scientific inquiry into potential sex differences in the experience of respiratory illnesses.


Origins and cultural impact

The term 'man flu' is believed to have originated in the 1990s, with the earliest known use found in a message posted on the
Usenet newsgroup A Usenet newsgroup is a repository usually within the Usenet system for messages posted from users in different locations using the Internet. They are not only discussion groups or conversations, but also a repository to publish articles, start ...
misc.health.diabetes in 1999, as documented by the
Oxford English Dictionary The ''Oxford English Dictionary'' (''OED'') is the principal historical dictionary of the English language, published by Oxford University Press (OUP), a University of Oxford publishing house. The dictionary, which published its first editio ...
. Since then, the term gained recognition in popular culture and became the subject of discussions surrounding the perceived severity of symptoms experienced by men during respiratory illnesses. An open-access poll featured in '' Nuts'' magazine in 2006 brought attention to this notion, although it was widely criticized as unscientific. The poll reported that men reported longer recovery times from flu-like illnesses compared to women, with men taking an average of three days to recover, while women recovered in 1.5 days. A poll conducted for a
painkiller An analgesic drug, also called simply an analgesic, antalgic, pain reliever, or painkiller, is any member of the group of drugs used for pain management. Analgesics are conceptually distinct from anesthetics, which temporarily reduce, and in s ...
manufacturer in 2008 suggested that such exaggeration is just as prevalent in women. The concept of 'man flu' has sparked controversy, notably in a
Boots A boot is a type of footwear. Most boots mainly cover the foot and the ankle, while some also cover some part of the lower calf. Some boots extend up the leg, sometimes as far as the knee or even the hip. Most boots have a heel that is clearl ...
advertisement featuring the tagline "when he’s ill and you don’t have time to be – get cold and flu products for just 99p at Boots." This ad ignited debate about
gender stereotypes A gender role, or sex role, is a social norm deemed appropriate or desirable for individuals based on their gender or sex. Gender roles are usually centered on conceptions of masculinity and femininity. The specifics regarding these gendered ...
and perceptions of illness in popular culture.


Scientific inquiry

While initially dismissed as a cultural trope, the notion of 'man flu' has prompted scientific investigation into potential
physiological Physiology (; ) is the science, scientific study of function (biology), functions and mechanism (biology), mechanisms in a life, living system. As a branches of science, subdiscipline of biology, physiology focuses on how organisms, organ syst ...
differences between men and women in their response to viral infections. One study, published in 2009, investigated the effects of the
bacterium Bacteria (; : bacterium) are ubiquitous, mostly free-living organisms often consisting of one biological cell. They constitute a large domain of prokaryotic microorganisms. Typically a few micrometres in length, bacteria were among the ...
''
Listeria monocytogenes ''Listeria monocytogenes'' is the species of pathogenic bacteria that causes the infection listeriosis. It is a facultative anaerobic bacterium, capable of surviving in the presence or absence of oxygen. It can grow and reproduce inside the ho ...
'' on genetically modified
mice A mouse (: mice) is a small rodent. Characteristically, mice are known to have a pointed snout, small rounded ears, a body-length scaly tail, and a high breeding rate. The best known mouse species is the common house mouse (''Mus musculus' ...
. While the study did not pertain to cold or flu viruses, but rather to a bacterial disease, it gained widespread attention and was misinterpreted by various media outlets, including ''
The Daily Telegraph ''The Daily Telegraph'', known online and elsewhere as ''The Telegraph'', is a British daily broadsheet conservative newspaper published in London by Telegraph Media Group and distributed in the United Kingdom and internationally. It was found ...
'', as supporting the existence of 'man flu' in humans. Subsequent research has yielded more nuanced insights into the interplay between sex,
hormone A hormone (from the Ancient Greek, Greek participle , "setting in motion") is a class of cell signaling, signaling molecules in multicellular organisms that are sent to distant organs or tissues by complex biological processes to regulate physio ...
s, and
immune response An immune response is a physiological reaction which occurs within an organism in the context of inflammation for the purpose of defending against exogenous factors. These include a wide variety of different toxins, viruses, intra- and extracellula ...
s. According to researchers at the
University of Cambridge The University of Cambridge is a Public university, public collegiate university, collegiate research university in Cambridge, England. Founded in 1209, the University of Cambridge is the List of oldest universities in continuous operation, wo ...
, evolutionary factors may have led women to develop more rigorous
immune system The immune system is a network of biological systems that protects an organism from diseases. It detects and responds to a wide variety of pathogens, from viruses to bacteria, as well as Tumor immunology, cancer cells, Parasitic worm, parasitic ...
s than men due to differing reproductive strategies. In addition, a 2011 study conducted at the
University of Queensland The University of Queensland is a Public university, public research university located primarily in Brisbane, the capital city of the Australian state of Queensland. Founded in 1909 by the Queensland parliament, UQ is one of the six sandstone ...
suggests that female hormones, such as oestrogens, aid pre-menopausal women in fighting infections, but the protection is lost after
menopause Menopause, also known as the climacteric, is the time when Menstruation, menstrual periods permanently stop, marking the end of the Human reproduction, reproductive stage for the female human. It typically occurs between the ages of 45 and 5 ...
. The
scientific community The scientific community is a diverse network of interacting scientists. It includes many "working group, sub-communities" working on particular scientific fields, and within particular institutions; interdisciplinary and cross-institutional acti ...
continues to research the validity and significance of perceived sex differences in symptom severity and immune response to viral illnesses.


2017 BMJ medical review

In the Christmas 2017 edition of ''
The BMJ ''The BMJ'' is a fortnightly peer-reviewed medical journal, published by BMJ Publishing Group Ltd, which in turn is wholly-owned by the British Medical Association (BMA). ''The BMJ'' has editorial freedom from the BMA. It is one of the world ...
'', a review of existing research highlighted significant differences in immune response and outcomes of influenza between men and women.
Epidemiological Epidemiology is the study and analysis of the distribution (who, when, and where), patterns and Risk factor (epidemiology), determinants of health and disease conditions in a defined population, and application of this knowledge to prevent dise ...
data indicated that men may have a higher risk of hospital admission and mortality from influenza compared to women. Specifically, data from 2004 to 2010 for
seasonal influenza Flu season is an annually recurring time period characterized by the prevalence of an outbreak of influenza (flu). The season occurs during the cold half of the year in each hemispheres of Earth, hemisphere. It takes approximately two days to ...
in
Hong Kong Hong Kong)., Legally Hong Kong, China in international treaties and organizations. is a special administrative region of China. With 7.5 million residents in a territory, Hong Kong is the fourth most densely populated region in the wor ...
showed a higher risk of hospital admission among adult men, and a US
observational study In fields such as epidemiology, social sciences, psychology and statistics, an observational study draws inferences from a sample (statistics), sample to a statistical population, population where the dependent and independent variables, independ ...
from 1997 to 2007 reported higher rates of influenza-associated deaths among men, even when accounting for factors such as
heart disease Cardiovascular disease (CVD) is any disease involving the heart or blood vessels. CVDs constitute a class of diseases that includes: coronary artery diseases (e.g. angina pectoris, angina, myocardial infarction, heart attack), heart failure, ...
,
cancer Cancer is a group of diseases involving Cell growth#Disorders, abnormal cell growth with the potential to Invasion (cancer), invade or Metastasis, spread to other parts of the body. These contrast with benign tumors, which do not spread. Po ...
, chronic respiratory system disease, and renal disease. Research on
influenza vaccination Influenza vaccines, colloquially known as flu shots or the flu jab, are vaccines that protect against infection by influenza viruses. New versions of the vaccines are developed twice a year, as the influenza virus rapidly changes. While thei ...
suggested that women may be more responsive to vaccination than men, experiencing more local (
skin Skin is the layer of usually soft, flexible outer tissue covering the body of a vertebrate animal, with three main functions: protection, regulation, and sensation. Other animal coverings, such as the arthropod exoskeleton, have different ...
) and systemic (bodywide) reactions, and exhibiting a better
antibody An antibody (Ab) or immunoglobulin (Ig) is a large, Y-shaped protein belonging to the immunoglobulin superfamily which is used by the immune system to identify and neutralize antigens such as pathogenic bacteria, bacteria and viruses, includin ...
response.
Testosterone Testosterone is the primary male sex hormone and androgen in Male, males. In humans, testosterone plays a key role in the development of Male reproductive system, male reproductive tissues such as testicles and prostate, as well as promoting se ...
levels in men were found to potentially play a role in their response to influenza vaccination, with men having the highest levels tending to show a lower antibody response. This lower response may contribute to the possibility that vaccinated men experience more severe symptoms compared to women, as they may not respond to vaccination as effectively. Furthermore, test tube studies of nasal cells infected with influenza revealed intriguing findings regarding the role of the female hormone
estradiol Estradiol (E2), also called oestrogen, oestradiol, is an estrogen steroid hormone and the major female sex hormone. It is involved in the regulation of female reproductive cycles such as estrous and menstrual cycles. Estradiol is responsible ...
. Exposure to estradiol reduced the immune response in cells from women but not in cells from men. Treatment with antiestrogen drugs counteracted this effect. Since flu symptoms are largely attributed to the body's immune reaction, a lessened immune response in women may translate to milder symptoms. Despite addressing significant scientific findings, the ''BMJ'' article maintained a light-hearted tone in keeping with the traditions of its Christmas edition, and as such, is not directly intended to infer the existence of man flu.


Implications for healthcare

The concept of 'man flu' has implications for
healthcare Health care, or healthcare, is the improvement or maintenance of health via the preventive healthcare, prevention, diagnosis, therapy, treatment, wikt:amelioration, amelioration or cure of disease, illness, injury, and other disability, physic ...
, particularly in ensuring equitable access to medical treatment. Research indicates that men are less inclined to seek medical attention when unwell and may underreport symptoms when they do. It's crucial to adopt evidence-based, gender-sensitive approaches to medicine to enhance diagnostics and treatment. Stereotypical portrayals of men as weak or exaggerating patients may deter them from seeking medical help, thus perpetuating
toxic masculinity The concept of toxic masculinity is used in academic and media discussions to refer to those aspects of hegemonic masculinity that are socially destructive, such as misogyny, homophobia, and violent domination. These traits are considered "toxi ...
.


See also

*
Gender bias in medical diagnosis Gender-biased diagnosing is the idea that medical diagnosis, medical and psychological diagnosis are influenced by the patient's gender. Several studies have found evidence of differential diagnosis for patients with similar ailments but of diffe ...
*
Sex differences in humans Sex differences in humans have been studied in a variety of fields. Sex determination generally occurs by the presence or absence of a Y chromosome in the 23rd pair of chromosomes in the human genome. '' Phenotypic sex'' refers to an individu ...


References

{{Reflist English-language slang Stereotypes of men