As the latest news headlines discuss FDA concerns over the harmful effects of exogenous testosterone replacement, sociologists review the latest casualties from an advertising strategy called "medicalization." Medicalization is the intentional creation of disease terminology to describe normal bodily functions and processes. This is done to sell consumers products or services.
Advertisements and promotional materials may mimic scientific or medical reports but there is very little actual clinical research. In other cases, legitimate research may be intentionally misrepresented to support use of their products.
New face, same story
While much of the story has remained the same for decades now, there is a new face to the victims.
Testosterone is just the latest gimmick in a quasi-medical quest to find the fabled fountain of youth. For decades, the pharmaceutical companies have been marketing hormone replacement as the key to youth, vitality, glowing skin and sexual enjoyment. The only difference this time around in the ever revolving onslaught of ‘instant medical fixes” is the target audience: Men.
Related: See Abc's report on Testosterone & the Fountain of Youth.
Since the turn of the century, female health and sexuality were a source of avid interest and income for a myriad of quasi-medical practitioners and snake oil salesmen. Much of this interest was focused on retaining female desirability and sexual vitality, but masked as medical illness.
Menopause and the aging process itself were medicalized and re-catagorized as a disease state. Like any other medical disease, menopause and the female aging process were to be avoided at all costs. Generations of physicians were taught that not only was exogenous estrogen the cure for their female patients but that withholding prescriptions to this magical elixir was akin to a lifetime sentence of dull skin, deep wrinkles, a dowager’s hump and a sexless identity. Furthermore, as natural stores of estrogen ‘dried up’ within their withered patients, crippling depression and early dementia were likely to set in.
Estrogen as a “cure-all”
At the peak of this "medicalization" in the 1960’s; middle-aged and elderly women were subjected to enormous pressure and disinformation campaigns aimed at selling “youth in a bottle,” often with devastating effects. One of the guiding forces promoting estrogen replacement was famed gynecologist, Dr. Robert Wilson. In 1966, he published a landmark piece of propaganda, “Feminine Forever,” which advanced poorly supported theories that menopause and associated effects could be easily avoided with just a little pill. As explained by Robert Bazell at NBC news; whether Dr. Wilson's motives were financially or medically founded remains debatable, but the effects of his efforts are indisputable.
It’s no wonder then, as medical historians peruse vintage medical advertisements and journal articles, that record numbers of women were placed on hormone replacement therapies despite very limited knowledge of the long term effect of these treatments. It’s a decision that continues to haunt the medical community today; as the first generation of women to graduate from oral contraceptives in their 20’s to hormone replacement in their 50’s and are now entering their seventh and eighth decades, some still on hormone therapies.
In light of massive controversies of the 1990’s, estrogen is no longer seen as a panacea treatment for the normal aging process. As serious concerns regarding the link to female cancers (breast, uterine, ovarian/endometrial) emerged, as well as the cardiovascular effects and thrombogenic (clot-causing) potential regarding all types of female hormone replacement, including contraceptives, estrogen has lost its allure among executives. Companies no longer tout estrogen replacement as essential to the well-being of older womanhood, and it is no longer automatically prescribed by physicians unilaterally. But it has taken over forty years for chemists, medical specialists and the general public to understand that there is no “magic pill” for female youth and sexuality.
From avoiding aging to managing menopausal symptoms, to a cream for vaginal dryness
As concerns over the health effects of estrogen containing medications developed, estrogen doses were dramatically reduced. At the same time, the marketing strategies behind hormone replacement were downplayed. No longer an essential requirement to prevent America’s mothers and grandmothers from becoming withered, stooped and demented crones, hormone replacement was now marketed as a short-term bridge to alleviate the physical manifestations of menopause like hot flashes.
Most recently, it seems that estrogen has been downgraded to something along the lines of a prescriptive equivalent to K-Y jelly. For feminists and physicians alike, it’s been quiet victory for women’s health.
The Low T phenomenon
Just as estrogen was losing its marketability, along came a new segment of willing volunteers. Prompted by the success of erectile dysfunction and male pattern baldness prescriptions after widespread and pervasive ad campaigns in heavy television rotation, “male menopause” was born. As New Zealand researcher, Elizabeth Watkins explained in her 2007 article, “The medicalization of male menopause in America,” the concepts of “low T”, “testosterone replacement” and similar ideas didn’t come from scientific literature or medical research.
Instead “Low T” is the newest, less-than-subtle marketing foray into issues of male virility, ego and insecurities. Instead of selling penis pumps, hidden lift shoe inserts or woven toupees, older males are being sold a medical “condition” and a seemingly ‘easy’ cure: testosterone.
Serious medical side effects
Unfortunately, while the onslaught of ads manipulating men under the guise of medicine and health may represent advancements in gender equality, these very real medications also carry very real, serious and potentially fatal consequences. In fact, recent studies linked testosterone use to increased risk of heart attack, stroke and death. One study showed the risk of heart attack to be double in men taking testosterone.
Not for everyone, and never an easy decision
While there are legitimate medical uses of hormone therapies for both genders, these treatments are individualized for specific users and circumstances. Treatment options are made in conjunction with medical professionals who specialize in treating these conditions. Together patients and professionals carefully consider these issues while weighing the risks and consequences of use.
"If it sounds too good to be true"
There is no magic solution to restore youth, vitality or create a sexual satyr. But there is always someone out there ready to capitalize on our willingness to believe in fast, easy or miracle solutions.