Muscle dysmorphia symptoms linked with sexual difficulties among boys and young men
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Boys and young men who report greater symptoms of muscle dysmorphia may also be more likely to experience a range of sexual difficulties, according to a new study examining the intersection of body image and sexual health.
Researchers analyzed data from 1,116 sexually active boys and men ages 15 to 35 in Canada and the United States. Greater muscle dysmorphia symptoms were associated with seven of the eight sexual difficulties examined, including anxiety during sex, lack of sexual interest or enjoyment, lack of arousal, difficulty reaching climax, physical pain during sex and difficulty getting or maintaining an erection.
The findings suggest that sexual health may be an important but often overlooked component of care for boys and men experiencing significant muscularity and body-image concerns. The paper is published in the journal Body Image.
"Muscle dysmorphia is often understood in terms of body dissatisfaction, compulsive exercise or the pursuit of muscularity, but our findings suggest that its impacts may extend into intimate and sexual experiences as well," said Kyle T. Ganson, Ph.D., MSW, lead author of the study and associate professor at the University of Toronto's Factor-Inwentash Faculty of Social Work. "Sexual health should be part of the conversation when clinicians are assessing boys and men with significant muscle dysmorphia symptoms."
Body dissatisfaction and sexual anxiety
Muscle dysmorphia is characterized by an intense preoccupation with muscularity, significant dissatisfaction with one's body or muscularity, and impairment in social, psychological or everyday functioning.
In this study, appearance-related distress stood out as particularly important. Greater dissatisfaction with appearance and greater discomfort with one's body were consistently linked with a broad range of sexual difficulties. The strongest association was with feeling anxious during sex.
"One possible explanation is that intense body dissatisfaction and self-consciousness make it more difficult to be present and comfortable during sexual experiences," Ganson said. "If someone is highly focused on how their body looks or worried about being seen by a partner, those thoughts may interfere with sexual interest, arousal, enjoyment and functioning."
The findings add to the growing evidence that body image is closely connected with sexual well-being. Persistent body dissatisfaction, shame, self-consciousness and preoccupation with appearance may make it more difficult to feel comfortable or engaged during sexual experiences.
Behaviors associated with the pursuit of muscularity may also play a role, including excessive exercise, restrictive eating and the use of anabolic-androgenic steroids or other muscle-enhancing substances.
Bringing sexual health into clinical care
"Body image and sexual health are often treated as separate areas of health, but they may be deeply interconnected," Ganson said. "For some boys and men, addressing distress about their bodies may also be important for understanding difficulties they are experiencing in their sexual lives."
The findings suggest clinicians treating boys and men with substantial muscle dysmorphia symptoms may benefit from asking about sexual health and functioning as part of a broader assessment.
Overall, the study highlights sexual functioning as a potentially important dimension of health for researchers and clinicians working with boys and young men experiencing muscle dysmorphia symptoms.
More information
Kyle T. Ganson et al, Associations between muscle dysmorphia symptoms and sexual functioning among sexually active boys and young men, Body Image (2026). DOI: 10.1016/j.bodyim.2026.102201
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