INTRODUCTION
Male hormone levels play a crucial role in men's physical and mental health with variations influenced by factors such as illness, stress, and lifestyle changes. In particular, studies have shown that a decrease in male hormone levels can lead to a diagnosis of testosterone deficiency syndrome, characterized by symptoms including reduced a decrease in sexual desire, depression, erectile dysfunction, and fatigue [1]. In addition, fluctuations in male hormone levels are also closely associated with benign prostatic hyperplasia (BPH), a prevalent condition among middle-aged and older men with symptom of difficulties in urination [2].
While medical research has established the connection between male hormone levels and BPH, little studies has been conducted to explore how this information is communicated to the public and perceived through media and community channels. Understanding how social perceptions of male hormone levels and BPH are shaped and conveyed in these contexts is crucial for assessing public comprehension and its impact on healthcare-related behavior.
Urology is a critical field impacting human health and wellbeing [2] with ongoing advancements in technology and surgical methods [3]. Despite this, in South Korea, about half of adults over 20 are hesitant to visit urologists [4]. It poses a barrier to early detection and management of conditions like testosterone deficiency and prostate enlargement. The coronavirus disease 2019 pandemic has exacerbated this issue leading to more than 50% decline in in-person consultations and a threefold increase in non–face-to-face consultations, such as phone appointments [5]. The rise of virtual health systems and digital health technologies has further accelerated this shift [6], with the public increasingly using mobile health apps to monitor their well-being [7]. As contactless interactions become more common, individuals may also be more inclined to discuss urology-related topics, including male hormone levels and prostate enlargement, within community forums.
On the other hand, news reports provide official information about male hormone levels. Therefore, by analyzing news reports and community discussions together, we can better understand social perceptions and public reactions to male hormone levels and BPH.
This study aims to identify key issues and public concerns related to male hormone levels and prostate enlargement through a comparative analysis of Korean community and news data over the past three years, from July 2021 to June 2024. To do so, we collected data from the news and community platforms of Naver, Daum, and Google, which have the most active users in Korea, using the keyword ‘male hormone levels,’ and analyzed the data using text mining techniques.
In this regard, this study aimed to analyze how the issues related to male hormone levels and prostate enlargement are perceived by the public and portrayed in the media. This study will contribute to a deeper understanding of social perceptions and public concerns so that it can offer insights into how these issues are discussed and understood.
Theoretical Background
Social perception of male hormone levels
In South Korea, testosterone is predominantly viewed as a symbol of masculinity and a marker of health [8]. It is directly associated with attributes such as strength, stamina, and sexual function [9]. Elevated testosterone levels are often seen as a positive reinforcement of masculinity and as a factor that strengthens a man’s self-esteem and social status. This perception drives men to seek ways to maintain or boost their testosterone levels through various methods including exercise, dietary supplements, and other health practices. Consequently, testosterone has become a significant indicator of men’s health in Korean society.
Social perceptions of BPH
BPH is a prevalent condition among middle-aged and older men, characterized by symptoms such as difficulty urinating [10]. Traditionally, BPH has been viewed as a natural consequence of aging, and many societies have accepted it as a common aspect of later life. However, recent years have seen a shift in this perception, with BPH increasingly recognized as a critical component of men’s health care. Public awareness of BPH is growing, in particular, regarding the importance of early diagnosis and treatment [11]. It is now understood that an enlarged prostate can pose significant health challenges beyond mere inconvenience. This heightened awareness has also spurred interest in available treatment options for BPH. Medications such as 5α-reductase inhibitors have demonstrated effectiveness in slowing the progression of the disease and alleviating symptoms [12]. As a result, there is a growing recognition among middle-aged men of the importance of both preventive measures and effective management of BPH. This shift is reflected in increased social discourse surrounding regular health checkups and lifestyle modifications aimed at mitigating the impact of BPH.
Relationship between male hormone levels and BPH
Male hormones, especially testosterone and its metabolite dihydrotestosterone (DHT), are intricately linked to BPH. Testoster one is the main hormone that stimulates prostate cell growth, and it is converted to DHT by the enzyme called 5α-reductase. DHT is a much more potent androgen than testosterone and can promote the proliferation and growth of prostate cells, which can lead to an enlarged prostate [13].
Studies have shown that DHT is found in high concentrations within the prostate and plays a significant role in the development of BPH [14]. Although testosterone levels naturally decline with age, DHT concentrations may either remain stable or increase, which increases the risk of BPH [14].
Some studies suggest that high testosterone levels might reduce the risk of BPH, while low testosterone levels could increase the risk [13]. However, the relationship between high testosterone levels and BPH remains inconclusive. These studies imply that BPH is influenced by a combination of factors, including age, DHT levels, and other hormonal and physiological variables [14].
MATERIALS AND METHODS
Research Design
In this study, text mining techniques were applied to transform unstructured textual data into structured information that could be effectively analyzed [15]. For this purpose, news and community data were collected using Textom (www.textom. com), a platform specifically designed for data collection and analysis. The collected data were then subjected to time series analysis and N-gram analysis to identify the main keywords and topics related to male hormone levels in both community and news data. The data analysis process was conducted in three steps as shown in (Fig. 1) data collection, preprocessing, and data analysis [16].
Data Collection and Refinement
News data was collected from Naver News, Daum News, and Google News, the three major portal sites most visited by Koreans using the keyword ‘male hormone levels.’ The data collection period spanned from 1 July 2021 to 30 June 2024. Time series data was collected on a monthly basis, and the scope of the collection includes the title, body, and URL of each news item. The total volume of news data collected was 3.63 MB.
Community data was sourced from Naver Cafe, Naver Knowledge, Daum Cafe, and Google Facebook, which have the most active users in Korea. The data collection period and methodology were consistent with those used for the news data. The scope included the title, body, and URL of each post with a total of 11.08 MB of community data collected.
For morphological analysis, MeCab was employed to process both the news and community data. Deduplication was performed to eliminate any duplicate entries with completely matching values across the selected columns. Data preprocessing involved refining the text by removing unnecessary characters and symbols, as well as eliminating duplicate data. The parts of speech analyzed included nouns, verbs, adjectives, foreign words, and numbers.
Analysis Methods
Time series analysis
Time series analysis is a technique used to analyze patterns and changes in data points collected over time to predict future values or identify trends. This method considers the temporal continuity of the data and is used to assess correlations and periodicity, and long-term fluctuations [17]. In this study, time series analysis was performed on monthly news and community data collected from July 2021 to June 2024. This approach enabled to track changes in the data over time and examine how major events correlate with increases in activity. The analysis also helps to visually observe the upward and downward trends in social attention related to specific events. It also provides a comprehensive view of how the data evolved over time.
N-gram analysis
N-gram is a probabilistic technique used in natural language processing to analyze the patterns and structure of language based on ‘N’ consecutive words. It predicts subsequent words by determining the frequency and association of world combinations [18].
In this study, we chose 2-gram to analyze the frequency and association between word pairs to effectively extract key patterns and meaningful relationships within the text data. Through this analysis, the top 20-word pairs were visualized to clearly draw out the key patterns and themes in the data, and based on this, the thematic flow and meaningful associations within the text were comprehensively analyzed.
RESULTS
Time Series Analysis of News Coverage
As shown in (Fig. 2), the most notable peaks in news coverage occurred in November 2021 (A), January 2023 (B), August 2023 (C), and January 2024 (D) across Naver and Google.
In November 2021 (A), coverage surged with 283 articles from Daum News, 111 from Naver News, and 42 from Google News, a significant increase compared to other times points (B), (C), and (D).
In November 2021 (A) and August 2023 (C), significant social attention was garnered by issues related to the male hormone levels of prominent Korean male. In November 2021 (A), singer Kim Jong-Kook faced accusations from a foreign health YouTuber regarding the use of performance-enhancing drugs to maintain his physique [19]. This led to a high-profile defense including a doping test, which drew widespread media attention [20]. Similarly, in August 2023 (C), actor Julien Kang attracted headlines when he disclosed his exceptionally high male hormone levels on his YouTube channel, placing him in the top 1% of men in their 40s [21].
In January 2024 (D), the participation of transgender athlete Leah Thomas in women’s competitions sparked a major controversy surrounding gender-specific hormone regulation and fairness in sports. This debate led the International Swimming Federation to revise its regulations, contributing to a broader global discussion on the subject [22].
On the other hand, news coverage of BPH has centered on providing medical information and treatment updates. According to statistics from the Korea Food and Drug Administration, November and December are peak months for prostate cancer visits, attributed to winter-induced prostate muscle contraction [23]. In January 2023 (B), the approval of the Rezum procedure for BPH by the Ministry of Food and Drug Safety became a major news topic, reflecting an increased focus on new treatment options [24].
Overall, news coverage of male hormone levels tends to spotlight celebrity-related events and socially controversial issues, whereas coverage of prostate enlargement primarily provides medical information and treatment options. This difference in focus influences how each topic shapes public perception.
Time Series Analysis of Online Community Discussions
Time series analysis of community data, as illustrated in (Fig. 3), highlights notable periods in November 2021 (A), January 2024 (B), and May 2024 (C), marked by increased discussions about male hormone levels.
In November 2021 (A) and January 2024 (B), community discussions reflected the same events covered in the news. In November 2021 (A), the issue of male hormone levels concerning a South Korean celebrity led to in-depth community discussions about the incident, including topics such as hormone levels in teenagers and Kim Jong-Kook’s hormone levels. In January 2024 (B), the debate over Leah Thomas’s participation in women’s sports sparked extensive discussions about the fairness of gender-specific hormone levels and transgender women in sports.
Although the Rezum procedure for BPH was reported in January 2023, initial community discussions were minimal. Interest increased slightly in November and December 2023, with discussions focusing on symptoms, management, and the cost of the procedure, alongside personal experiences. By May 2024 (C), a study linking low male hormone levels to an increased risk of cardiovascular disease [25] stimulated discussions about testosterone levels and overall health.
These findings indicate that news coverage often triggers and shapes community discussions. Major news events in November 2021 and January 2024 led to substantial community engagement, where users shared information about their health conditions and hormone management. This interplay highlights how news and community discussions complement each other in shaping public awareness and interest.
N-gram Analysis Results
The 2-gram analysis yielded a total of 79,148-word combinations for the news data and 265,415-word combinations for the community data. The top 20-word pairs of each data were visualized as shown in (Fig. 4).
In news data, frequent word combinations related to ‘male hormone levels’ and variations of high and low levels. Notably, terms such as ‘Greg Doucette’ and ‘Single Again Four Men,’ a popular Korean entertainment show featuring divorced four celebrities discussing various issues, were prominent. This confirms that ‘high’ male hormone levels are often associated with masculinity and it reflects cultural values such as ‘confidence,’ ‘attractiveness,’ and ‘sexual desire’ among middle-aged Korean men.
On the other hand, the keyword ‘male hormone levels’ also frequently appeared alongside ‘prostate enlargement.’ It suggests that changes in male hormone levels are perceived not only as markers of masculinity, but also as linked to medical issues.
In online community discussions, there was a notable emphasis on ‘low’ or ‘increased’ hormone levels rather than high levels. This trend suggests a greater concern among community users about low hormone levels and their management. For instance, the co-occurrence of terms such as ‘heavy metals,’ ‘harmful’, ‘rancidity,’ and ‘omega 3’ implies a belief that environmental factors contribute to low testosterone levels and a growing interest in nutritional supplements like omega 3 to address these concerns. In addition, the frequent appearance of words such as ‘testicles,’ ‘function,’ and ‘decline’ underscores a focus on sexual function related to hormone levels.
The analysis reveals a discrepancy between news and community discussions. While the news often highlights high hormone levels and associated cultural connotations, community conversations are more concerned with the effects of low hormone levels and their impact on sexual function. This suggests that community discussions prioritize practical concerns about hormone level changes, contrasting with the news media’s focus on broader cultural and medical issues.
DISCUSSION
This study analyzed news and community data from July 2021 to June 2023 to identify key issues and public concerns regarding male hormone levels and BPH. The findings indicate that news coverage on male hormone levels is largely driven by celebrity and event-related stories, aimed at capturing public attention. In contrast, news reports on BPH predominantly focus on medical treatments and health information. Community discussions, spurred by news events, show a strong emphasis on sexual health issues related to low male hormone levels and sexual dysfunction, rather than on BPH. Despite ‘BPH’ being a high-frequency term in news reports, it ranked relatively low in community discussions. It suggests a divergence in how the media and public discourse address the relationship between male hormone levels and BPH.
The findings indicate that news platforms and online communities work complementarily to raise social awareness and interest in male hormone level and BPH. However, this socialization process can also lead to information bias and the spread of misconceptions. News platforms, in particular, may present biased overage due to editorial leanings, which can result in selective reporting on issues related to male hormone levels. This can misinform the public and negatively influence social perceptions. Online communities, on the other hand, are often dominated by specific demographics, such as younger men or individuals with specific health interests, which can further amplify biased viewpoints. Community discussions frequently rely on personal experience, and subjective opinions may overshadow objective information grounded in scientific evidence. To ensure that health information on male hormone levels and BPH is accurately and objectively communicated to the public, here are some suggestions.
First, strengthening expert review processes and certification of health information is crucial to minimize bias in news reporting and ensure that accurate information reaches the public. Second, to reduce demographic biases in online discussions, it is essential to create inclusive environments that encourage participation from diverse groups and ensure that information shared is verified and balanced. Third, long-term studies should be conducted to track changing societal perceptions of male hormones and BPH. This will help monitor shifts in public opinion and inform the development of effective communication strategies. Fourth, enhancing media literacy education is critical to equip the public with the skills to critically evaluate information and resist misinformation. This approach will empower individuals to make informed decisions based on reliable health information.
This study has utilized news and community data analyses to uncover key issues and public concerns regarding male hormone levels and BPH, offering insights into social perceptions. The findings contribute to a better understanding of these health topics and lay the groundwork for more effective communication strategies. This study has limitations that its focus on two sources analyzed over a short period. Further studies can be done to expand the scope beyond South Korea to include other East Asian cultures, specifically China and Japan. This broader approach will enable a comparative analysis of how the cultural and social contexts of each country influence perceptions of male hormones and BPH. Furthermore, it can extend the data collection period to over 10 years to conduct a long-term time series analysis to capture the evolution of public perceptions over time. This extended analysis will be critical in understanding the impact of changes in healthcare policy and media coverage on societal views.
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