Joey Wahler (Host): Is it real or imagined? We're discussing the subject of man colds. Our guest is Dr. Van Williamson. He's a family medicine physician. This is Meaningful Medicine, a Novant Health podcast bringing you access to leading doctors who answer questions they wish you would ask. From routine care to rare conditions, our physicians offer tips on navigating medical decisions and building a healthier future.

Thanks so much for joining us. I'm Joey Wahler. Hi there, doctor. Welcome.

Van Williamson, MD: Thank you for having me.

Host: Great to have you aboard. So, I saw you chuckling there when I introduced the topic. So, it begs the question to get us started, what is the man cold and the science behind men actually experiencing colds differently than women? Because for me, this is a new one, but you're the one that went to medical school, of course.

Van Williamson, MD: Yeah. And I don't know that we had a topic in medical school or a test specifically devoted to the man cold. But maybe as a long term sufferer of colds out of proportion to what my wife has, maybe I'm an expert in that field. But, you know, the common social myth of a man cold is that men may have worse symptoms or just exaggerate them more when they have the same respiratory illnesses as women and it's often a comparison between a husband and wife or partners on how they react to said infection.

Host: So that being said, are men in general, would you say more susceptible to any particular illnesses, or is it mostly this myth when it comes to how they handle colds?

Van Williamson, MD: So, I think it's both in the sense that there is some biological evidence of a hormonal effect from sex hormones, which estrogen higher in women, testosterone higher in men, impacting our innate immunity. And so, there is a biological basis for some of this.

And I think there's also some evidence that the development of a fetus of a male will potentially have slower or different development of lungs so that at fetal age, their lungs are not as mature. So, that can make infant males more susceptible with certain infections. And so, we see that with hospitalization rates for common infections like RSV, higher rates in boys between three months and two years of age compared to girls at the same age. And that may be due to some of the genetic factors and hormonal developmental factors in utero.

And so, other factors that play a role later in life as we said in the term man cold and with the role of estrogen providing women with perhaps a better innate immunity and a better response helps keep them free of certain—or not free of viral illnesses—but have reduced viral infection rate for respiratory illness and perhaps reduce severity of those illnesses as well.

Host: Well, you mentioned hormones there, Doctor, like testosterone, et cetera, impacting the immune system. And so, how do they actually impact it and affect response to infections and the like?

Van Williamson, MD: Yeah. So, that's a great question and there's a very detailed answer by people who are much smarter than me who can give you all the nuances of the immune system. But there are different types of immunity. And so, when you have an innate immunity that can respond in general to infections, and then you have antibodies that can get ramped up when exposed to certain infections to fight those.

And so, the quicker the immunity or immune system is able to respond, often the better it's able to clear out an infection. And so, some of the role of estrogen receptors is actually to kind cue up the immune system and make it more responsive to those infections like viruses. And so, that's where we see the difference between response in women and men as they would have more estrogen and more testosterone. And testosterone does not necessarily convey that same type of immune response.

Host: How about the way in which lifestyle factors, sleep, diet, stress perhaps, how do those affect how men get sick or recover from common illnesses?

Van Williamson, MD: Yeah, that's a great question. So, lifestyle is always a factor. And so, sleep definitely plays a role. And there have been some studies relatively small studies that I looked at were less than 200 people where they actually inoculated people with rhinovirus; controlled studies who were healthy, exposed them to the virus and then measured the likelihood of getting that infection within five to seven days afterwards. And those who slept less than seven hours, particularly those who slept less than five hours a night, were at much higher risk for getting an infection.

And I think most of us can say subjectively there's times that we're really busy not sleeping as well, we seem to be more apt to get sick and kind of more run down. So yeah, there's evidence that sleep plays a major role.

Obviously, as you said, stress psychosocial stress or physical stress even can disrupt that sleep and make us less likely to be able to respond and to also slow our immune response. Sleep is vitally important.

Host: So that being said, Doctor, in terms of evidence-based strategies men can use to recover faster from colds or perhaps even prevent them better in the first place, aside from what you've mentioned already, is there any remedy that maybe gets overlooked that you'd like to remind us of here that can play a big role?

Van Williamson, MD: Yeah, that's a great question. So, the prevention can be challenging during seasons where there's a high prevalence of respiratory viruses in the community. And so, you know, my personal strategy would be to, you know, stay away from your young children and not go into preschools, but I don't know how realistic that is.

Well, hand hygiene is typically the number one intervention, washing our hands several times a day if we are, you know, in an environment or around other people or large groups of people who may be sick. But it doesn't have to be with antibacterial soap. I mean, just simple soap and water because again, we're talking about respiratory viruses and not bacterial illnesses. That's generally the best method of prevention.

Of course, if we have some sort of immune system dysfunction, whether we're on a medication that suppresses our immune system or another condition, and that makes you higher risk for complications of illness, then it's probably good to wear a mask when you're in close quarters, especially if you're flying or somewhere where you're in a contained space for a long period of time, to reduce your inhalation of certain particles.

Host: Now, you hit on something there that I want to delve into a little bit more: young kids in school catching stuff from classmates and then bringing it home. We hear about this all the time. I am still getting over a viral bug of some sort that I've had for weeks now, quite possibly caught through our daughter soon to be four years old, who is now in pre-K. What can I do to protect myself against that, if anything? Maybe sanitizing their hands when they come home? Is there anything you can do between when they leave school and come home to try to cut down on the chances.

Van Williamson, MD: Yeah. Certainly having the children wash their hands when they get home from school. If there's a water bottle they've taken to school or some other utensil make sure we're washing that off. During seasons where you know there might be sniffles and cough and congestion, just being cognizant of, you know, those times where we might be more likely to share germs whether that's—you know, at meal times is commonly a place because of course we're eating and drinking and talking. And so, yeah, it'd be nice if you could just spray your children down before they come into house and get rid of all the germs. But I think you have to find that solution.

Host: How about this? I don't think we need science, Doctor, to tell us that one trait that's male-oriented is we tend to just try to kind of fight through when we don't feel well, right? Try to brush it off try to be manly—not all of us, but many of us. So, when should men take a seemingly mild illness seriously and seek medical care? Where's that line?

Van Williamson, MD: Most of us—and a lot depends on our baseline state of health—but most of us if we get a common viral respiratory illness, it's going to be nagging and nuisance for seven to 10 days, then our body will fight it off and clear it out. But your symptoms are getting progressively worse after that time especially if you wake up with night sweats or fevers or progressive shortness of breath, that can be a concerning sign that we developed secondary pneumonia that needs to be evaluated by medical provider, potentially have X-ray imaging, additional lab work, usually just some imaging, an exam, and diagnosis will help, because that's where you really want to escalate care. That's where people tend to be sick.

In rare circumstances, viruses can impact other parts of the body and cause inflammation around the heart or thyroid gland or things like that. But yeah, I would say if we're not getting better in 7 to ten days or getting progressively worse, then it's very important to seek care.

Host: Speaking of other parts of the body, a couple more questions for you. One being, aside from colds, what would you say from your experience day-to-day are the top health issues men do tend to overlook, and how can lifestyle changes help in that regard there?

Van Williamson, MD: Yeah, that's a great question. And as a primary care physician, that's central to the way I operate and need to think on a daily basis to make sure that we have a common ground of what's important to the patient and also important to me as the physician for concerning health conditions.

And so, I think mental health is a big one. That's one that men tend to shrug off more or to not acknowledge to the same degree perhaps than women do. And that's not true for everybody, but I think that plays a significant role in people's health as we've already gone back to the stress and sleep deprivation increase in risk of illness. But mental health is a big one. I read something really surprising recently that I think in the UK in 2025, they said that suicide was number one cause death of men under age of 50 and that just blew me away, you know, that that is the case. So, I think mental health is a big

Another one that we may not tend to take as seriously are cancer screenings Women tend to start cancer screening at earlier ages specifically cervical cancer screen and mammography. It's more ingrained into them to do that.

For men, the most important what I would say is to go ahead start getting your colorectal cancer screenings at appropriate age, which now 45 for the average risk person because that's actually number cause of cancer deaths in men less than 50 in this country is colorectal cancer. So, I think, those two are very important to me, mental heath and colorectal cancers.

Host: And finally, in summary here, Doctor, speaking of prevention and screenings that seem to be stressed more than ever nowadays, how about prostate health as well? Because the prostate as well as the colon, when it comes to screening, getting it done on a regular basis can literally be the difference between life or death, right?

Van Williamson, MD: Absolutely. That's a great point to make, is that having it done on a regular routine basis and not just, you know, once every five years or once in a blue moon is vitally important. And so, there are certain biomarkers for prostate cancer that we like to trend. And if those are changing, that's a concerning trend and might lead us to do some more advanced imaging, like an MRI of the prostate or refer to a urologist for biopsy.

And then, with cardiovascular health, exact same as kind of knowing when your risk factors start to change. Is that an increase in blood pressure? Is it an increase in cholesterol or blood sugar? Other things that we know that contribute to development of coronary artery disease over time.

So, that's the importance of regular routine screening testing, is to make sure that we're aware of the risk factors and trending those over time and intervening before the problem really occurs.

Host: Better safe than sorry for sure.

Van Williamson, MD: Absolutely.

Host: Well, we trust you're now more familiar with man colds and other perhaps more realistic men's health issues. Doctor, valuable information. Thanks so much again.

Van Williamson, MD: My pleasure. Thank you for having me.

Host: Absolutely. And to find a physician, please visit novanthealth.org. For more health and wellness information from Novant Health experts, please visit healthyheadlines.org. Thanks so much again for being part of Meaningful Medicine, a Novant Health podcast.