Dr. Kyle Sue, a family physician based in Arviat, Nunavut is shown in this undated handout image. A review of scientific literature suggests those who believe “ man flu” is more intense than the female version have some evidence to back up their views. THE CANADIAN PRESS/HO

Dr. Kyle Sue, a family physician based in Arviat, Nunavut is shown in this undated handout image. A review of scientific literature suggests those who believe “ man flu” is more intense than the female version have some evidence to back up their views. THE CANADIAN PRESS/HO

Review of scientific studies suggests ‘man flu’ may be more intense: researcher

A researcher who blended scientific review with humour is suggesting those who believe “man flu” is more intense than the female version have some evidence to back their views.

The piece was published by a Canadian physician in the December edition of the British Medical Journal.

Dr. Kyle Sue, a family physician based in Arviat, Nunavut, found studies on mice and humans going back to the 1990s suggesting flu symptoms in men are often more acute.

His study also noted that a seasonal influenza study from 2004 to 2010 in Hong Kong found men had higher rates of hospital admission, and a decade-long American observational study that ended in 2007 suggested men had higher rates of flu-related deaths in comparison to women.

The latter study held true regardless of underlying heart disease, cancer, chronic respiratory system disease, and renal disease.

“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,” Sue wrote.

The British Medical Journal’s December issue is meant to be a special issue that has peer-reviewed articles, but allows authors to use some humour, said Navjoyt Ladher, the editor who put the issue together.

“The spirit of the issue is quite light hearted and often tackles quirky subjects … But it’s real work,” she said.

In his study, Sue also notes that the term man flu has become so common that it is included in the Oxford and Cambridge dictionaries, with Oxford defining it as “a cold or similar minor ailment as experienced by a man who is regarded as exaggerating the severity of the symptoms.”

Sue writes: “Since about half the world’s population is male, deeming male viral respiratory symptoms as ‘exaggerated’ without rigorous scientific evidence could have important implications for men, including insufficient provision of care.”

Sue’s study also considered the hypothesis that testosterone may have a relationship to influenza by acting to suppress the male immune system.

He notes there are numerous potential weaknesses in the “immunity gap” theory, including that it doesn’t always consider other influences on the flu such as the rates of smoking.

“The evidence is not definitive. It’s only suggestive,” he said during an interview, in reference to the Hong Kong and American epidemiological studies.

He says another factor not considered was the influence of men tending to take longer to seek medical care than women.

The physician also cites theories that evolution plays a role in men taking more rest than women for flu, and includes one hypothesis arguing that “the increase in male sickness may be a strategy important for survival since ‘it promotes energy conservation and reduces the risk of encountering predators.”’

“Further high quality research is needed to clarify other aspects of man flu,” says Sue’s article, with possible topics including the impact of environmental conditions on flu in males.

In addition, he raises the question of whether men who have the flu are more successful at finding mates.

“In other words, can the blame for man flu be shifted to the people who select these men as sexual partners rather than the men themselves?”

In his conclusion, Sue says the idea of “man flu” and suggestions males exaggerate their suffering is potentially unjust.

“Men may not be exaggerating symptoms but have weaker immune responses to viral respiratory viruses, leading to greater morbidity and mortality than seen in women,” says the journal article.

Sue said in an interview from his clinic that he decided to do the study for a masters level class about a week after he experienced the flu.

“It seemed like a pertinent and possibly entertaining topic to look into. And when I looked into the literature I realized that there are a lot of interesting studies and nobody had actually put it together into something coherent,” he said.

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