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The Man Cold: Myth, Mystery or Medical Reality? · Meaningful Medicine with Novant Health

• 0:04
  Joey Wahler (Host): Is it real or imagined?
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  We're discussing the subject of man colds.
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  Our guest is Dr.
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  Van Williamson.
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  He's a family medicine physician.
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  This is Meaningful Medicine, a Novant Health podcast bringing you
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  access to leading doctors who answer questions they wish you would ask.
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  From routine care to rare conditions, our physicians offer tips on
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  navigating medical decisions and building a healthier future.
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  Thanks so much for joining us.
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  I'm Joey Wahler.
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  Hi there, doctor.
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  Welcome.
• 0:35
  Van Williamson, MD: Thank you for having me.
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  Host: Great to have you aboard.
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  So, I saw you chuckling there when I introduced the topic.
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  So, it begs the question to get us started, what is the man cold and the
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  science behind men actually experiencing colds differently than women?
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  Because for me, this is a new one, but you're the one that went
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  to medical school, of course.
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  Van Williamson, MD: Yeah.
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  And I don't know that we had a topic in medical school or a test
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  specifically devoted to the man cold.
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  But maybe as a long term sufferer of colds out of proportion to what my wife
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  has, maybe I'm an expert in that field.
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  But, you know, the common social myth of a man cold is that men may have worse
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  symptoms or just exaggerate them more when they have the same respiratory illnesses
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  as women and it's often a comparison between a husband and wife or partners
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  on how they react to said infection.
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  Host: So that being said, are men in general, would you say more
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  susceptible to any particular illnesses, or is it mostly this myth when it
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  comes to how they handle colds?
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  Van Williamson, MD: So, I think it's both in the sense that there is some
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  biological evidence of a hormonal effect from sex hormones, which estrogen
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  higher in women, testosterone higher in men, impacting our innate immunity.
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  And so, there is a biological basis for some of this.
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  And I think there's also some evidence that the development of a fetus of a
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  male will potentially have slower or different development of lungs so that at
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  fetal age, their lungs are not as mature.
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  So, that can make infant males more susceptible with certain infections.
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  And so, we see that with hospitalization rates for common infections like
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  RSV, higher rates in boys between three months and two years of age
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  compared to girls at the same age.
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  And that may be due to some of the genetic factors and hormonal
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  developmental factors in utero.
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  And so, other factors that play a role later in life as we said in the term
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  man cold and with the role of estrogen providing women with perhaps a better
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  innate immunity and a better response helps keep them free of certain—or
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  not free of viral illnesses—but have reduced viral infection rate for
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  respiratory illness and perhaps reduce severity of those illnesses as well.
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  Host: Well, you mentioned hormones there, Doctor, like testosterone, et
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  cetera, impacting the immune system.
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  And so, how do they actually impact it and affect response
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  to infections and the like?
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  Van Williamson, MD: Yeah.
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  So, that's a great question and there's a very detailed answer by people who are
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  much smarter than me who can give you all the nuances of the immune system.
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  But there are different types of immunity.
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  And so, when you have an innate immunity that can respond in general to
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  infections, and then you have antibodies that can get ramped up when exposed
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  to certain infections to fight those.
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  And so, the quicker the immunity or immune system is able to
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  respond, often the better it's able to clear out an infection.
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  And so, some of the role of estrogen receptors is actually to kind cue up the
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  immune system and make it more responsive to those infections like viruses.
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  And so, that's where we see the difference between response in women
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  and men as they would have more estrogen and more testosterone.
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  And testosterone does not necessarily convey that same type of immune response.
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  Host: How about the way in which lifestyle factors, sleep, diet, stress
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  perhaps, how do those affect how men get sick or recover from common illnesses?
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  Van Williamson, MD: Yeah, that's a great question.
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  So, lifestyle is always a factor.
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  And so, sleep definitely plays a role.
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  And there have been some studies relatively small studies that I
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  looked at were less than 200 people where they actually inoculated people
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  with rhinovirus; controlled studies who were healthy, exposed them to
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  the virus and then measured the likelihood of getting that infection
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  within five to seven days afterwards.
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  And those who slept less than seven hours, particularly those who slept less
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  than five hours a night, were at much higher risk for getting an infection.
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  And I think most of us can say subjectively there's times that
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  we're really busy not sleeping as well, we seem to be more apt to
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  get sick and kind of more run down.
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  So yeah, there's evidence that sleep plays a major role.
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  Obviously, as you said, stress psychosocial stress or physical stress
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  even can disrupt that sleep and make us less likely to be able to respond
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  and to also slow our immune response.
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  Sleep is vitally important.
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  Host: So that being said, Doctor, in terms of evidence-based strategies men can use
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  to recover faster from colds or perhaps even prevent them better in the first
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  place, aside from what you've mentioned already, is there any remedy that maybe
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  gets overlooked that you'd like to remind us of here that can play a big role?
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  Van Williamson, MD: Yeah, that's a great question.
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  So, the prevention can be challenging during seasons where there's a
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  high prevalence of respiratory viruses in the community.
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  And so, you know, my personal strategy would be to, you know, stay away from your
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  young children and not go into preschools, but I don't know how realistic that is.
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  Well, hand hygiene is typically the number one intervention, washing our hands
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  several times a day if we are, you know, in an environment or around other people
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  or large groups of people who may be sick.
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  But it doesn't have to be with antibacterial soap.
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  I mean, just simple soap and water because again, we're talking about respiratory
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  viruses and not bacterial illnesses.
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  That's generally the best method of prevention.
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  Of course, if we have some sort of immune system dysfunction, whether we're on a
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  medication that suppresses our immune system or another condition, and that
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  makes you higher risk for complications of illness, then it's probably good
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  to wear a mask when you're in close quarters, especially if you're flying
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  or somewhere where you're in a contained space for a long period of time, to reduce
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  your inhalation of certain particles.
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  Host: Now, you hit on something there that I want to delve into a little bit more:
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  young kids in school catching stuff from classmates and then bringing it home.
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  We hear about this all the time.
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  I am still getting over a viral bug of some sort that I've had for
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  weeks now, quite possibly caught through our daughter soon to be
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  four years old, who is now in pre-K.
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  What can I do to protect myself against that, if anything?
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  Maybe sanitizing their hands when they come home?
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  Is there anything you can do between when they leave school and come home
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  to try to cut down on the chances.
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  Van Williamson, MD: Yeah.
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  Certainly having the children wash their hands when they get home from school.
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  If there's a water bottle they've taken to school or some other utensil
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  make sure we're washing that off.
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  During seasons where you know there might be sniffles and cough and
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  congestion, just being cognizant of, you know, those times where we might
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  be more likely to share germs whether that's—you know, at meal times is
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  commonly a place because of course we're eating and drinking and talking.
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  And so, yeah, it'd be nice if you could just spray your children
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  down before they come into house and get rid of all the germs.
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  But I think you have to find that solution.
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  Host: How about this?
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  I don't think we need science, Doctor, to tell us that one trait
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  that's male-oriented is we tend to just try to kind of fight through
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  when we don't feel well, right?
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  Try to brush it off try to be manly—not all of us, but many of us.
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  So, when should men take a seemingly mild illness seriously and seek medical care?
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  Where's that line?
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  Van Williamson, MD: Most of us—and a lot depends on our baseline state
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  of health—but most of us if we get a common viral respiratory illness,
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  it's going to be nagging and nuisance for seven to 10 days, then our body
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  will fight it off and clear it out.
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  But your symptoms are getting progressively worse after that time
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  especially if you wake up with night sweats or fevers or progressive shortness
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  of breath, that can be a concerning sign that we developed secondary
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  pneumonia that needs to be evaluated by medical provider, potentially have
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  X-ray imaging, additional lab work, usually just some imaging, an exam,
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  and diagnosis will help, because that's where you really want to escalate care.
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  That's where people tend to be sick.
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  In rare circumstances, viruses can impact other parts of the body and
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  cause inflammation around the heart or thyroid gland or things like that.
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  But yeah, I would say if we're not getting better in 7 to ten days or
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  getting progressively worse, then it's very important to seek care.
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  Host: Speaking of other parts of the body, a couple more questions for you.
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  One being, aside from colds, what would you say from your experience day-to-day
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  are the top health issues men do tend to overlook, and how can lifestyle
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  changes help in that regard there?
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  Van Williamson, MD: Yeah, that's a great question.
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  And as a primary care physician, that's central to the way I operate and need
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  to think on a daily basis to make sure that we have a common ground of
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  what's important to the patient and also important to me as the physician
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  for concerning health conditions.
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  And so, I think mental health is a big one.
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  That's one that men tend to shrug off more or to not acknowledge to the
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  same degree perhaps than women do.
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  And that's not true for everybody, but I think that plays a significant role
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  in people's health as we've already gone back to the stress and sleep
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  deprivation increase in risk of illness.
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  But mental health is a big one.
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  I read something really surprising recently that I think in the UK in
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  2025, they said that suicide was number one cause death of men under
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  age of 50 and that just blew me away, you know, that that is the case.
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  So, I think mental health is a big
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  Another one that we may not tend to take as seriously are cancer screenings
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  Women tend to start cancer screening at earlier ages specifically cervical
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  cancer screen and mammography.
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  It's more ingrained into them to do that.
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  For men, the most important what I would say is to go ahead start getting
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  your colorectal cancer screenings at appropriate age, which now 45
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  for the average risk person because that's actually number cause of
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  cancer deaths in men less than 50 in this country is colorectal cancer.
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  So, I think, those two are very important to me, mental
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  heath and colorectal cancers.
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  Host: And finally, in summary here, Doctor, speaking of prevention
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  and screenings that seem to be stressed more than ever nowadays,
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  how about prostate health as well?
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  Because the prostate as well as the colon, when it comes to screening,
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  getting it done on a regular basis can literally be the difference
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  between life or death, right?
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  Van Williamson, MD: Absolutely.
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  That's a great point to make, is that having it done on a regular
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  routine basis and not just, you know, once every five years or once
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  in a blue moon is vitally important.
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  And so, there are certain biomarkers for prostate cancer that we like to trend.
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  And if those are changing, that's a concerning trend and might lead us
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  to do some more advanced imaging, like an MRI of the prostate or
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  refer to a urologist for biopsy.
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  And then, with cardiovascular health, exact same as kind of knowing when
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  your risk factors start to change.
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  Is that an increase in blood pressure?
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  Is it an increase in cholesterol or blood sugar?
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  Other things that we know that contribute to development of
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  coronary artery disease over time.
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  So, that's the importance of regular routine screening testing, is to make sure
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  that we're aware of the risk factors and trending those over time and intervening
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  before the problem really occurs.
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  Host: Better safe than sorry for sure.
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  Van Williamson, MD: Absolutely.
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  Host: Well, we trust you're now more familiar with man colds and other perhaps
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  more realistic men's health issues.
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  Doctor, valuable information.
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  Thanks so much again.
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  Van Williamson, MD: My pleasure.
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  Thank you for having me.
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  Host: Absolutely.
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  And to find a physician, please visit novanthealth.org.
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  For more health and wellness information from Novant Health experts,
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  please visit healthyheadlines.org.
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  Thanks so much again for being part of Meaningful Medicine,
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  a Novant Health podcast.