Have you heard of the phenomenon of “man flu”—when a man suffering from a common cold or virus exaggerates the severity of his illness? While women may joke that “man flu” is a fabrication to score extra time on the couch, there is a cohort of scientists who hypothesize that it may be the real deal. Last month, a doctor and professor at Memorial University of Newfoundland in Canada took an in-depth look at actual research into “man flu.”

“Tired of being accused of overreacting, I searched the available evidence to determine whether men really experience worse symptoms and whether this could have any evolutionary basis,” author Dr. Kyle Sue wrote.

What did he find? In a review of the evidence, Sue found some data indicating that men experience viral symptoms differently than women do.

For starters, a series of studies in mice and human cells demonstrate that females have higher immune responses compared to males and that female hormones help to suppress viral symptoms.

In addition, there is some evidence in human studies that men and women respond differently to viral infections. Data from seasonal flu outbreaks in Hong Kong between 2004 and 2010 show that men with the flu had higher rates of hospitalization compared to women. And an observational study of men and women in the U.S. from 1997 to 2007 found that men were significantly more likely to die from their illness compared to women, regardless of other health conditions such as heart disease, lung disease, and cancer.

In addition, the author reports on a study published in 1993 found that health care providers underrate men’s symptoms and are more likely to attribute symptoms to women.

With data hinting that “man flu” may be a real biological phenomenon, the author explores potential reasons. For example, from an evolutionary perspective, when males experience worse symptoms, it may promote “energy conservation and reduces the risk of encountering predators.” Other scientists have noted that males may be more likely to use their metabolic resources for other purposes, such as growth and reproduction, instead of building immunity.

The author concludes: “The concept of man flu, as commonly defined, 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.”

Does the evidence back that up for certain? No. But there may be enough data to give the man in your life a pass—and an extra cup of tea—the next time he’s lying on the couch complaining of a cold.

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