(293) Observed Relationship Between Testosterone Levels and Perceived Body Image
Authors: Kassab J , Garcia Keeme-sayre A , Lipshultz L 
Published: February 2024

Abstract

Introduction
A positively perceived body image is an important part of one’s conception of oneself and one’s own identity, abilities, and worth. Past research has shown an inverse relationship between testosterone concentration and one’s sense of self, as manifested by increased depression. We hypothesized, therefore, that a subjectively negative self-image would be associated with the objective findings of hypogonadism (low testosterone).

Objective
To investigate the relationship between one’s own serum testosterone and a personal assessment of one’s body image and satisfaction.

Methods
An electronic survey was delivered through REDCap to patients at our urology clinic with a recent testosterone value documented in the observation interval 1/1/2020-12/31/2022. The survey included components of the following validated surveys: the Self-Rated Bodily Attractiveness Survey, the Male Body Image Self-Conscious Scale, and the Body Esteem Scale. Specifically, we asked each patient about their perceived bodily attractiveness as it pertains to sexual intercourse as well as specific inquiries about feelings towards specific body parts. Each answer choice corresponded to a five-point Likert-Scale, enabling respondents to indicate their level of agreement or disagreement. We then retrospectively recorded the most recent testosterone value recorded in each respondent’s electronic medical record. T-tests were utilized to compare testosterone values for men with high versus low survey scores using SPSS.

Results
The men who reported a positive cumulative body image score from the survey had an average testosterone of 749.15 ng/dL, whereas men who had a negative body image score from our survey had an average testosterone of 340.67 ng/dL. Importantly, these testosterone values were statistically significant from each other, as indicated by a t-value of 2.58 and a p-value of .0095. To establish clear distinctions between the positive and negative body image cohorts, we set threshold scores for each group: the positive body image cohort was defined as individuals scoring at least 34 out of 45 (≥ 75%), while the negative body image cohort comprised those with scores no higher than 30 out of 45. Interestingly, there were no respondents whose cumulative scores fell within the range of 30 to 34. The positive body image cohort had an average score of 39.92 out of 45, while the negative body image cohort had an average score of 23.00 out of 45.

Conclusions
Based on our findings, it appears that men with hypogonadism, as characterized by low testosterone, may be more likely to experience a negative body image. This relationship is supported by this cohort’s response to several questionnaires addressing one’s own assessment of self-worth. Men with low testosterone versus eugonadal controls scored significantly lower in surveys addressing bodily attractiveness, male body image self-consciousness, and body esteem. These results highlight the relationship between low testosterone and body image, contributing to our understanding of the psychological factors that can influence well-being in men. Healthcare professionals should be aware of the potential implications and challenges faced by individuals with hypogonadism, addressing concurrently both their hormonal deficiencies and their negative sense of self.

Disclosure
Any of the authors act as a consultant, employee or shareholder of an industry for: Larry Lipshultz: AbbVie (Consultant) American Medical Systems/Boston Scientific (Speaker) Aytu BioScience (Consultant) Contraline, Inc. (Consultant) Endo Pharmaceuticals (Consultant/Speaker) Inherent Biosciences (Advisor) Lipocine (Consultant).