Some recent research suggests a physiological basis for the oft-mocked “man flu” but Stat News reports that there’s still little evidence that men’s symptoms are worse than women’s.

More extensive evidence undercuts the notion of man flu. The most important is that immune organs such as the thymus as well as immune cells such as macrophages all have receptors for testosterone and estrogens, so those sex hormones can affect the immune system. In general, testosterone suppresses it slightly while estrogens rev it up, including by increasing the production of microbe-killing antibodies and inflammation-causing proteins. Result: When women catch a virus, their immune systems flood the zone.

That might suggest that men are doomed to be more miserable when they have a flu or other viral infection, as their immune systems take a lackadaisical approach to fighting it. But no. “People think that when we get sick it’s the virus that causes our symptoms, but often those symptoms are from the immune response,” said biologist Sabra Klein of Johns Hopkins Bloomberg School of Public Health. “Cells clogging our airways, proteins causing inflammation, fever, and chills — that’s all immune response to a flu virus. And it is more common in females than males for those responses to go on too long and to be too intense. Testosterone [tamps down] the immune response, so you don’t get the exaggerated response” that intensifies symptoms.

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