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 or flu-like illnesses. Primarily British, it is frequently used in a self-deprecating manner. [1] This term has sparked both public interest and scientific inquiry into potential sex differences in the experience of respiratory illnesses. [2]

Contents

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 misc.health.diabetes in 1999, as documented by the Oxford English Dictionary. [3] 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, [4] although it was widely criticized as unscientific. [5] [6] 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. [7] A poll conducted for a painkiller manufacturer in 2008 suggested that such exaggeration is just as prevalent in women. [8]

The concept of 'man flu' has sparked controversy, notably in a Boots 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." [9] [10] This ad ignited debate about gender stereotypes and perceptions of illness in popular culture. [11]

Scientific inquiry

While initially dismissed as a cultural trope, the notion of 'man flu' has prompted scientific investigation into potential physiological differences between men and women in their response to viral infections.

One study, published in 2009, investigated the effects of the bacterium Listeria monocytogenes on genetically modified mice. [12] 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 , as supporting the existence of 'man flu' in humans. [13] [14] [15]

Subsequent research has yielded more nuanced insights into the interplay between sex, hormones, and immune responses. According to researchers at the University of Cambridge, evolutionary factors may have led women to develop more rigorous immune systems than men due to differing reproductive strategies. [16] In addition, a 2011 study conducted at the University of Queensland suggests that female hormones, such as oestrogens, aid pre-menopausal women in fighting infections, but the protection is lost after menopause. [17]

The scientific community continues to research the validity and significance of perceived sex differences in symptom severity and immune response to viral illnesses.

2017 BJM medical review

In the Christmas 2017 edition of The BMJ , a review of existing research highlighted significant differences in immune response and outcomes of influenza between men and women. [18] Epidemiological 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 in Hong Kong showed a higher risk of hospital admission among adult men, and a US observational study from 1997 to 2007 reported higher rates of influenza-associated deaths among men, even when accounting for factors such as heart disease, cancer, chronic respiratory system disease, and renal disease. [19] [20]

Research on influenza vaccination suggested that women may be more responsive to vaccination than men, experiencing more local (skin) and systemic (bodywide) reactions, and exhibiting a better antibody response. [21] [22] Testosterone 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. [23] 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. [18]

Furthermore, test tube studies of nasal cells infected with influenza revealed intriguing findings regarding the role of the female hormone estradiol. Exposure to estradiol reduced the immune response in cells from women but not in cells from men. Treatment with antiestrogen drugs counteracted this effect. [24] Since flu symptoms are largely attributed to the body's immune reaction, a lessened immune response in women may translate to milder symptoms. [25]

Despite addressing significant scientific findings, the BMJ article maintained a light-hearted tone in keeping with the traditions of its Christmas edition. [26]

Implications for healthcare

The concept of 'man flu' has significant implications for healthcare, particularly in ensuring equitable access to medical treatment and dispelling misconceptions surrounding illness. Research indicates that men are less inclined to seek medical attention when unwell and may underreport symptoms when they do. [27] Understanding the interplay between gender, biology, and societal perceptions is essential in shaping our comprehension of illness. By promoting public awareness and engaging in evidence-based dialogue, society can encourage healthier attitudes and healthcare-seeking behaviors for all genders. It's crucial to adopt evidence-based, gender-sensitive approaches to medicine to enhance diagnostics and treatment. [28] Stereotypical portrayals of men as weak or exaggerating patients may deter them from seeking medical help, thus perpetuating toxic masculinity. [29] The notion of 'man flu' should be critically examined, although further research is warranted in this area.

See also

Related Research Articles

Sex differences in medicine include sex-specific diseases or conditions which occur only in people of one sex due to underlying biological factors ; sex-related diseases, which are diseases that are more common to one sex ; and diseases which occur at similar rates in males and females but manifest differently according to sex.

<span class="mw-page-title-main">Spanish flu</span> 1918–1920 global influenza pandemic caused by the H1N1 influenza A virus

The 1918–1920 flu pandemic, also known as the Great Influenza epidemic or by the common misnomer Spanish flu, was an exceptionally deadly global influenza pandemic caused by the H1N1 influenza A virus. The earliest documented case was March 1918 in the state of Kansas in the United States, with further cases recorded in France, Germany and the United Kingdom in April. Two years later, nearly a third of the global population, or an estimated 500 million people, had been infected in four successive waves. Estimates of deaths range from 17 million to 50 million, and possibly as high as 100 million, making it one of the deadliest pandemics in history.

<span class="mw-page-title-main">Influenza vaccine</span> Vaccine against influenza

Influenza vaccines, colloquially known as flu shots, 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 their effectiveness varies from year to year, most provide modest to high protection against influenza. Vaccination against influenza began in the 1930s, with large-scale availability in the United States beginning in 1945.

<span class="mw-page-title-main">Swine influenza</span> Infection caused by influenza viruses endemic to pigs

Swine influenza is an infection caused by any of several types of swine influenza viruses. Swine influenza virus (SIV) or swine-origin influenza virus (S-OIV) refers to any strain of the influenza family of viruses that is endemic in pigs. As of 2009, identified SIV strains include influenza C and the subtypes of influenza A known as H1N1, H1N2, H2N1, H3N1, H3N2, and H2N3.

<span class="mw-page-title-main">Flu season</span> Recurring periods of 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 hemisphere. It takes approximately two days to show symptoms. Influenza activity can sometimes be predicted and even tracked geographically. While the beginning of major flu activity in each season varies by location, in any specific location these minor epidemics usually take about three weeks to reach its pinnacle, and another three weeks to significantly diminish.

<i>Influenza C virus</i> Genus of viruses in the family Orthomyxoviridae

Influenza C virus is the only species in the genus Gammainfluenzavirus, in the virus family Orthomyxoviridae, which like other influenza viruses, causes influenza.

<span class="mw-page-title-main">Influenza treatment</span> Therapy and pharmacy for the common infectious disease

Treatments for influenza include a range of medications and therapies that are used in response to disease influenza. Treatments may either directly target the influenza virus itself; or instead they may just offer relief to symptoms of the disease, while the body's own immune system works to recover from infection.

A breakthrough infection is a case of illness in which a vaccinated individual becomes infected with the illness, because the vaccine has failed to provide complete immunity against the pathogen. Breakthrough infections have been identified in individuals immunized against a variety of diseases including mumps, varicella (Chickenpox), influenza, and COVID-19. The characteristics of the breakthrough infection are dependent on the virus itself. Often, infection of the vaccinated individual results in milder symptoms and shorter duration than if the infection were contracted naturally.

Immunization during pregnancy is the administration of a vaccine to a pregnant individual. This may be done either to protect the individual from disease or to induce an antibody response, such that the antibodies cross the placenta and provide passive immunity to the infant after birth. In many countries, including the US, Canada, UK, Australia and New Zealand, vaccination against influenza, COVID-19 and whooping cough is routinely offered during pregnancy.

<span class="mw-page-title-main">Pandemrix</span> Flu vaccine

Pandemrix is an influenza vaccine for influenza pandemics, such as the 2009 flu pandemic. The vaccine was developed by GlaxoSmithKline (GSK) and patented in September 2006.

<span class="mw-page-title-main">Influenza</span> Infectious disease

Influenza, commonly known as "the flu" or just "flu", is an infectious disease caused by influenza viruses. Symptoms range from mild to severe and often include fever, runny nose, sore throat, muscle pain, headache, coughing, and fatigue. These symptoms begin from one to four days after exposure to the virus and last for about 2–8 days. Diarrhea and vomiting can occur, particularly in children. Influenza may progress to pneumonia, which can be caused by the virus or by a subsequent bacterial infection. Other complications of infection include acute respiratory distress syndrome, meningitis, encephalitis, and worsening of pre-existing health problems such as asthma and cardiovascular disease.

<span class="mw-page-title-main">Influenza-like illness</span> Medical diagnosis

Influenza-like illness (ILI), also known as flu-like syndrome or flu-like symptoms, is a medical diagnosis of possible influenza or other illness causing a set of common symptoms. These include fever, shivering, chills, malaise, dry cough, loss of appetite, body aches, nausea, and sneezing typically in connection with a sudden onset of illness. In most cases, the symptoms are caused by cytokines released by immune system activation, and are thus relatively non-specific.

<span class="mw-page-title-main">2009 swine flu pandemic</span> 2009–2010 pandemic of swine influenza caused by H1N1 influenza virus

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<span class="mw-page-title-main">Pandemic H1N1/09 virus</span> Virus responsible for the 2009 swine flu pandemic

The pandemic H1N1/09 virus is a swine origin influenza A virus subtype H1N1 strain that was responsible for the 2009 swine flu pandemic. This strain is often called swine flu by the public media. For other names, see the Nomenclature section below.

Influenza prevention involves taking steps that one can use to decrease their chances of contracting flu viruses, such as the Pandemic H1N1/09 virus, responsible for the 2009 flu pandemic.

<span class="mw-page-title-main">Influenza A virus subtype H7N9</span> Subtype of the influenza A virus

Influenza A virus subtype H7N9 (A/H7N9) is a bird flu strain of the species Influenza virus A. Avian influenza A H7 viruses normally circulate amongst avian populations with some variants known to occasionally infect humans. An H7N9 virus was first reported to have infected humans in March 2013, in China. Cases continued to be reported throughout April and then dropped to only a few cases during the summer months. At the closing of the year, 144 cases had been reported of which 46 had died. It is known that influenza tends to strike during the winter months, and the second wave, which began in October, was fanned by a surge in poultry production timed for Lunar New Year feasts that began at the end of January. January 2014 brought a spike in reports of illness with 96 confirmed reports of disease and 19 deaths. As of April 11, 2014, the outbreak's overall total was 419, including 7 in Hong Kong, and the unofficial number of deaths was 127.

Sabra Klein is an American microbiologist who is a Professor of Molecular Microbiology and Immunology at the Johns Hopkins Bloomberg School of Public Health. Her research considers how sex and gender impact the immune system. During the COVID-19 pandemic, Klein investigated why men and women have different COVID-19 outcomes.

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References

  1. ↑ "Man Flu: A Man's Illness?". ABC News Medical Unit. Retrieved 24 July 2011.
  2. ↑ Alleyne, Richard (24 March 2010). "Man flu is no myth as Swedish scientists prove men suffer more from disease". The Daily Telegraph. London. Archived from the original on 27 March 2010. Retrieved 4 November 2011.
  3. ↑ "Man Flu, N", Oxford English Dictionary, Oxford UP, December 2023, doi:10.1093/oed/1063166065 , retrieved 7 March 2024
  4. ↑ "'Man flu' really exists". Archived from the original on 5 January 2007. Retrieved 8 February 2007.{{cite web}}: CS1 maint: bot: original URL status unknown (link)
  5. ↑ Boynton, Petra (2006). "Are reports of "man flu" just Nuts?". BMJ. 333 (7578): 1128.1–1128. doi:10.1136/bmj.39041.590556.59. PMC   1661725 .
  6. ↑ Boynton, Petra (14 November 2006). "'Man Flu' – manufacturing an illness to sell a magazine". Archived from the original on 26 April 2012. Retrieved 8 February 2007.
  7. ↑ Boynton, Petra (25 November 2006). "Are reports of "man flu" just Nuts?". BMJ. 333 (7578): 1128.1–1128. doi:10.1136/bmj.39041.590556.59. ISSN   0959-8138. PMC   1661725 .
  8. ↑ "'Man flu' just as prevalent in women". The New Zealand Herald . 20 May 2007. Archived from the original on 29 September 2007. Retrieved 12 September 2011.
  9. ↑ "Boots signs comedians in festive strategy shift". www.campaignlive.co.uk. Retrieved 7 March 2024.
  10. ↑ Boots. "Here Come the Girls 'I'm Fine' TV ad". YouTube . Archived from the original on 18 April 2012.
  11. ↑ "Boots ad 'should not have been made' | Men's Health Forum".
  12. ↑ Yeretssian, G; Doiron, K; Shao, W; Leavitt, B. R; Hayden, M. R; Nicholson, D. W; Saleh, M (2009). "Gender differences in expression of the human caspase-12 long variant determines susceptibility to Listeria monocytogenes infection". Proceedings of the National Academy of Sciences of the United States of America. 106 (22): 9016–20. Bibcode:2009PNAS..106.9016Y. doi: 10.1073/pnas.0813362106 . PMC   2690057 . PMID   19447924.
  13. ↑ Alleyne, Richard (12 May 2009). "Men succumb to manflu because women have stronger immune systems, claim scientists". The Daily Telegraph. London. Archived from the original on 17 May 2009. Retrieved 23 May 2009.
  14. ↑ "media - Bad Science" . Retrieved 23 May 2009.
  15. ↑ "Man flu: real or myth?". NHS. Archived from the original on 16 February 2010. Retrieved 24 July 2011.
  16. ↑ Restif, O; Amos, W (2010). "The evolution of sex-specific immune defences". Proceedings of the Royal Society B: Biological Sciences. 277 (1691): 2247–55. doi:10.1098/rspb.2010.0188. PMC   2880154 . PMID   20335214.
  17. ↑ Carroll, Melanie L; Yerkovich, Stephanie T; Pritchard, Antonia L; Davies, Janet M; Upham, John W (2010). "Adaptive immunity to rhinoviruses: Sex and age matter". Respiratory Research. 11 (1): 184. doi: 10.1186/1465-9921-11-184 . PMC   3024249 . PMID   21194432.
  18. 1 2 Sue, Kyle (2017). "The science behind 'man flu'". BMJ. 359: j5560. doi:10.1136/bmj.j5560. PMID   29229663. S2CID   3381640.
  19. ↑ Wang, Xi-Ling; Yang, Lin; Chan, Kwok-Hung; Chan, King-Pan; Cao, Pei-Hua; Lau, Eric Ho-Yin; Peiris, J. S. Malik; Wong, Chit-Ming (15 August 2015). "Age and Sex Differences in Rates of Influenza-Associated Hospitalizations in Hong Kong". American Journal of Epidemiology. 182 (4): 335–344. doi:10.1093/aje/kwv068. ISSN   0002-9262. PMID   26219977.
  20. ↑ Quandelacy, Talia M.; Viboud, Cecile; Charu, Vivek; Lipsitch, Marc; Goldstein, Edward (15 January 2014). "Age- and Sex-related Risk Factors for Influenza-associated Mortality in the United States Between 1997–2007". American Journal of Epidemiology. 179 (2): 156–167. doi:10.1093/aje/kwt235. ISSN   1476-6256. PMC   3873104 . PMID   24190951.
  21. ↑ Furman, David; Hejblum, Boris P.; Simon, Noah; Jojic, Vladimir; Dekker, Cornelia L.; Thiébaut, Rodolphe; Tibshirani, Robert J.; Davis, Mark M. (14 January 2014). "Systems analysis of sex differences reveals an immunosuppressive role for testosterone in the response to influenza vaccination". Proceedings of the National Academy of Sciences. 111 (2): 869–874. Bibcode:2014PNAS..111..869F. doi: 10.1073/pnas.1321060111 . ISSN   0027-8424. PMC   3896147 . PMID   24367114.
  22. ↑ Beyer, W. E. P.; Palache, A. M.; Kerstens, R.; Masurel, N. (June 1996). "Gender differences in local and systemic reactions to inactivated influenza vaccine, established by a meta-analysis of fourteen independent studies". European Journal of Clinical Microbiology & Infectious Diseases. 15 (1): 65–70. doi:10.1007/BF01586187. hdl: 1765/15036 . ISSN   0934-9723. PMID   8641306.
  23. ↑ Furman, David; Hejblum, Boris P.; Simon, Noah; Jojic, Vladimir; Dekker, Cornelia L.; Thiébaut, Rodolphe; Tibshirani, Robert J.; Davis, Mark M. (14 January 2014). "Systems analysis of sex differences reveals an immunosuppressive role for testosterone in the response to influenza vaccination". Proceedings of the National Academy of Sciences. 111 (2): 869–874. Bibcode:2014PNAS..111..869F. doi: 10.1073/pnas.1321060111 . ISSN   0027-8424. PMC   3896147 . PMID   24367114.
  24. ↑ Peretz, Jackye; Pekosz, Andrew; Lane, Andrew P.; Klein, Sabra L. (1 March 2016). "Estrogenic compounds reduce influenza A virus replication in primary human nasal epithelial cells derived from female, but not male, donors". American Journal of Physiology-Lung Cellular and Molecular Physiology. 310 (5): L415–L425. doi:10.1152/ajplung.00398.2015. ISSN   1040-0605. PMC   4773846 . PMID   26684252.
  25. ↑ Shmerling, Robert H. (4 January 2018). "Is "man flu" really a thing?". Harvard Health. Retrieved 7 March 2024.
  26. ↑ "The Best of the British Medical Journal's Goofy Christmas Papers". Smithsonian Magazine. Retrieved 27 December 2017.
  27. ↑ Baker, Peter; Dworkin, Shari L; Tong, Sengfah; Banks, Ian; Shand, Tim; Yamey, Gavin (1 August 2014). "The men's health gap: men must be included in the global health equity agenda". Bulletin of the World Health Organization. 92 (8): 618–620. doi:10.2471/BLT.13.132795. ISSN   0042-9686. PMC   4147416 . PMID   25197149.
  28. ↑ Ference, Elisabeth H.; Tan, Bruce K.; Hulse, Kathryn E.; Chandra, Rakesh K.; Smith, Sean B.; Kern, Robert C.; Conley, David B.; Smith, Stephanie Shintani (January 2015). "Commentary on Gender Differences in Prevalence, Treatment, and Quality of Life of Patients with Chronic Rhinosinusitis". Allergy & Rhinology. 6 (2): 82–88. doi:10.2500/ar.2015.6.0120. ISSN   2152-6567. PMC   4541639 . PMID   26302727.
  29. ↑ Riedl, D.; Labek, K.; Gottfried, T.; Innerhofer, V.; Santer, Matthias; Weigel, B.; Dejaco, D. (December 2022). "Man flu is not a thing – Gender-specific secondary analysis of a prospective randomized-controlled trial for acute rhinosinusitis". Journal of Psychosomatic Research. 163: 111047. doi:10.1016/j.jpsychores.2022.111047. PMID   36228432.
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