You don’t need a man to tell you man flu is real, although he still will. And now health advocates are agreeing with us: nutritionist Jenna Hope, author of the new book How to Stay Healthy, is perhaps the most recent to argue that men really do suffer more than women when they’re ill. “When we look at the evidence we find that the female immune system is actually stronger than the male immune system,” she told the Times. Women have higher levels of progesterone and oestrogen, she says, which tend to support the immune system, while men have higher levels of testosterone, which suppresses immunity.
But when we talk about man flu, are we really talking about an increased sensitivity to symptoms, or just a decreased ability to stop going on about them? The term “man flu” has always suggested exaggeration, not least because the illness in question is almost never flu; it’s usually just a cold.
The distinction seems important. If the hypothesis is that men suffer more than women when they’re under the weather, then I’ve never experienced anything that would allow me to argue in favour of it. If the contention is that men make an unnecessarily big deal out of a few relatively minor symptoms, then I’m living proof of its truth. I’ve been doing that all morning.
The most often cited evidence of the existence of man flu is a 2017 British Medical Journal review that found a number of studies suggesting men have a weaker immune response to viral respiratory infection, resulting in longer lasting illness and symptoms. But your immune response is what makes you feel bad in the first place – it’s what makes your throat ache and your nose run. A stronger immune system could arguably make you feel worse in the short term.
It’s just as easy to find evidence to suggest man flu is a myth: a 2022 study into symptoms of acute rhinosinusitis (an illness that often gives rise to accusations of man flu) showed that although women recovered faster than men, women generally reported worse symptoms at the beginning of the illness.
In the end, there was little overall difference between the sexes in self-reported symptoms, assessed using the 22-question sino-nasal outcome test, otherwise known as SNOT-22. “The hypothesis of a ‘man flu’ should be disregarded,” wrote the study’s authors.
I think the real difference between the sexes is not about how severe they find the symptoms of a particular illness, but how interesting they find them. No matter how terrible my wife feels, she will generally run out of things to say about a bad cold after two or three days. I, on the other hand, will still have plenty to say on day eight. By day 10, if I’m lucky, I will be coming down with something else.
I’m not suffering more than my wife, or for longer; I’m just suffering more presently. There’s nothing like a bad cold to enhance my normally limited ability to live in the moment, to lie back and think only: ow. People talk about being in touch with their feelings. Is this not what they mean?
It may still be true that men don’t often talk about their feelings with each other, but we do talk about our symptoms, frankly and openly. At this time of year, we speak of little else.
Covid robbed us of the satisfactions of man flu for a time. When a virus features a range of symptoms that run from barely perceptible to death, it takes some of the joy out of comparing notes. Future studies may yet show that man flu is only a state of mind, but to me it’s more than that – it’s a way of life.
Tim Dowling is a Guardian columnist
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