Endocrine Disease, Hypertension, Hypogonadism, Male
Conditions
Keywords
Hypogonadism, Anticipated Stigma, Illness Identity, Quality of Life, Chronic Endocrine Diseases, Psychosocial Factors
Brief summary
This study aims to systematically compare the levels of anticipated illness stigma and illness identity among men diagnosed with hypogonadism to those of men with other chronic endocrine conditions (e.g., diabetes mellitus, hypothyroidism, and hypertension). Furthermore, it examines whether these psychosocial variables predict quality-of-life deterioration specifically within the hypogonadism cohort.
Detailed description
Hypogonadism is a chronic endocrine condition characterized by subnormal serum testosterone levels. Unlike other chronic metabolic conditions, hypogonadism directly threatens core attributes of male gender identity, including sexual function, physical capacity, and reproductive potential. While biological manifestations and medical management are well documented, the psychosocial dimensions of hypogonadism, specifically anticipated stigma and illness identity, remain insufficiently explored in clinical research. Anticipated stigma involves cognitive expectations of negative reactions, judgment, or discrimination from interpersonal, occupational, and healthcare environments. In conditions where illness poses a direct threat to gender role identity, anticipated stigma may be heightened compared to non-identity-threatening chronic conditions such as diabetes or hypertension. Furthermore, the degree to which an individual integrates the diagnosis into their self-concept (illness identity) may interact with anticipated stigma to exacerbate health-related quality-of-life impairments. This study systematically evaluates anticipated stigma and illness identity in men with hypogonadism in comparison to age-matched controls with other chronic endocrine conditions treated in the same clinical setting. The primary objective is to determine whether anticipated stigma levels differ significantly between these groups and to examine the predictive capacity of anticipated stigma and illness identity on disease-specific symptom burden and quality-of-life outcomes within the hypogonadism cohort.
Interventions
None listed
Sponsors
Hacettepe University
Study design
Observational model
CASE_CONTROL
Time perspective
CROSS_SECTIONAL
Eligibility
Sex/Gender
MALE
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Cases: * Male, aged 18 years or older. * Biochemically confirmed hypogonadism (total testosterone \< 300 ng/dL with at least one clinical symptom). * Regular follow-up at the endocrinology outpatient clinic. * Fluent in reading and understanding Turkish. * Signed informed consent. Controls: * Male, aged 18 years or older. * Diagnosed with diabetes, hypertension, or hypothyroidism under regular endocrinology follow-up. * Total testosterone ≥ 300 ng/dL. * Age-matched to a participant in the case group (±5 years). * Fluent in reading and understanding Turkish. * Signed informed consent.
Exclusion criteria
* Active psychiatric diagnosis (e.g., active psychosis, bipolar disorder). * Chronic inflammatory or rheumatological diseases affecting body composition (e.g., chronic kidney disease, IBD, rheumatoid arthritis, SLE, ankylosing spondylitis). * Uncontrolled co-existing endocrine conditions or severe complications (e.g., HbA1c \> 8.0%, diabetic neuropathy/nephropathy/retinopathy, non-euthyroid state). * Cognitive impairment or dementia precluding questionnaire completion. * Klinefelter syndrome. * Literacy limitations preventing completion of self-report measures. * Additional control exclusion: Diagnosis or clinical suspicion of hypogonadism.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Chronic Illness Anticipated Stigma Scale (CIASS) Score | Baseline (Single session, day 1) | Measures anticipated stigma across three subscales (friends/family, work, healthcare workers) on a 5-point Likert scale. |
| Brief Illness Perception Questionnaire (Brief IPQ) Score | Baseline (Single session, day 1) | Assesses cognitive and emotional representations of illness. Higher total scores indicate a more threatening illness perception. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Aging Males' Symptoms (AMS) Scale Score | Baseline (Single session, day 1) | Evaluates the severity of symptoms related to aging/hypogonadism across somatic, psychological, and sexual domains. |
| Hospital Anxiety and Depression Scale (HADS) Score | Baseline (Single session, day 1) | Measures anxiety and depression symptom severity via 14 items (7 anxiety, 7 depression). |
Countries
Turkey (Türkiye)
Outcome results
None listed