Recently, an editorial in the Journal of the American Geriatrics Society cited “disease-mongering” of testosterone to men for conditions for which it is not approved. Increasingly low libido, obesity and other age-related changes are attributed to “Low T” or low testosterone.
This spring, I interviewed a coauthor of the editorial, Thomas Perls, a professor of medicine and director of the New England Centenarian Study at Boston Medical Center and Boston University School of Medicine. He defined disease-mongering as “inventing new broader definitions of a disease or even the invention of a disease in conjunction with widespread marketing to increase sales of specific drugs and therapies.”
True instances of testosterone deficiency such as hypogonadism are rare, he said, but “massive marketing campaigns” now claim that common middle-age symptoms like lack of energy, poor sleep and poor libido will respond to testosterone and the number of men labeled with Low T has skyrocketed. Hypogonadism, a condition that is legitimately treated with testosterone, was redefined and some of the consensus panels were sponsored by pharmaceutical companies making and marketing testosterone, he told me.
Both the FDA and Health Canada warn of an increased risk of blood clots in the legs and lungs from testosterone therapy. Cardiac rhythm disturbances like atrial fibrillation and symptoms of coronary artery disease are see in the patients on the hormone therapy and even violent behavior (“roid rage”) impulsiveness and suicide, Dr. Perls told me. Studies suggest dormant cancers can be accelerated or activated by testosterone stimulation.
Sales of testosterone products in the US were $2 billion in 2012.
Of course, everyone (except hormone hawkers) realizes that people lose hormones as they age, they do not age because they lose hormones. But there should be another level of outrage to this marketing: this whole sad scenario has unfolded before—twice, when addressed to women.
A bestselling book in 1966 called Feminine Forever by Robert A. Wilson, a Wyeth-funded gynecologist, told women they would be “flabby,” “shrunken,” “dull-minded,” and “desexed” unless they took hormone replacement therapy. “No woman can be sure of escaping the horror of this living decay,” he warned. A 1946 Smith, Kline and French ad in Psychosomatic Medicine actually calls electric shock and estrogenic therapy “fundamental measures” for menopause. Yes, you read that correctly.