The Man Cold: Is It Really a Thing?

A long time patient of mine requested this one. He doesn't have children, so my last newsletter that had a lot of info on kids and pregnancy didn't really relate to him, but he wanted to know if there was anything to the "man cold". He had just gotten over another miserable cold and mentioned he feels like he's dying every time he gets sick. I think we all know a guy like that. And I just happened to know that there is, in fact, research supporting this. But, how much? And why? Well, here is everything you would ever want to know about the "man cold".

We already know there are physiological differences between men and women. Turns out there are also immunological differences between them, too. Makes total sense. We have different organs, differences in our brains, differences in our hormones. Some of these differences seem to make an impact as to why men can feel "more sick" than women. I put it in quotations because feeling sick is subjective (different for each person, regardless of sex) but there are actual objective markers that we can look at. Like all health, it is personal and there is a large variance from person to person and group to group. Do I need to preface anything else? Also, a lot of the research is from COVID-19 because it is most recent and there just happens to be quite a but of it. Who would have thought?

1. The inflammatory response, or innate immunity, tends to stronger in men. In 2021, it was found that men were at higher risk of serious complication when exposed to the C19 virus. Their initial inflammatory markers and peak markers were higher even when they adjusted for a baseline. Interestingly a study in 2022, found that higher testosterone levels in women were also associated with more inflammatory markers. [On a side note here, higher testosterone levels in women is associated with a longer lifespan.] This was an even bigger study done in 2021 showing higher levels of pro-inflammatory cytokines, whereas women had higher anti-inflammatory cytokines. So interesting! It concluded saying, "Males appear to have a more robust innate immune response, and females mount a stronger adaptive immune response to COVID-19 respiratory tract infection."

2. The last article touched on this: Women have a more adaptive immune response which seems to be stronger and more effective. Testosterone seems to be a factor here, too. Testosterone was recognized as lowering the vaccination response and lowering the anti-inflammatory cytokine response. I would guess there is more than testosterone at play here (like everything else in health, we often blame/tout ONE thing, when it's actually more synergistic than that; hormones doesn't work in isolation). This 2021 research even looked at treatment for respiratory viruses in men versus women and found that women responded better. This is not an advantage when it comes to autoimmune diseases, which is why we often see them more in women than men. The other downside of women having a more robust response, is there is a higher chance of vaccine reactions.

3. Other sex hormones like estrogen also play a role. Estrogen is known to help regulate the immune system and immune cell development. Of course this would also contribute to the difference in response to illness between men and women!

4. Women have a chromosomal advantage. Turns out, having two X chromosomes means that your immune system has a "back up" system. Say what?! In addition, after pregnancy and breastfeeding, there is a very unique hormone change and immune response that leaves fetal cells in the body for the rest of your life which can potential improve the repair of tissues and possibly contribute to a longer lifespan. Men don't have access to either of these, so their immune system can and will fall a bit short of women's.

While these aren't the only reasons there is a difference between men and women when sick, they were the ones I thought were best studied and easiest to comprehend. So, the next time you meet a man who is sick with what looks like a normal cold, but says he feels like he's dying? His immune system is likely working overtime and he is feeling worse than the women in his life! Some things just aren't fair, are they? You just can't beat nature.