Testosterone & Hypogonadism vs Disease Mongering

About 4 months ago, I wrote about disease mongering & the medicalization of the human condition.  But to some degree, that's medical progress.  After all, we didn't talk about depression, at least not among family physicians, until we developed selective serotonin reuptake inhibitors.  Nor did we talk about erectile dysfunction until we had phosphodiesterase-5 inhibitors.  Of course we had other drugs before the SSRIs & PDE-5 inhibitors, but they were difficult to prescribe and rife w/side effects.  Given pharmacologic advances, does that make depression & ED an example of disease mongering?

What about cholesterol & heart disease?  Yes we had plenty of difficult therapeutic options prior to the development of statins.  But does that make treatment of hyperlipidemia w/statins disease mongering?  I would vote no.  Granted, we didn't know about all the attendant side effects associated w/statins when we first started prescribing them.  

Think back to the advent of estrogen and menopause.  Prior to estrogen, women just had to tough it out.  But discovering prompt relief in a pill, patch or cream doesn't make treatment of menopause disease mongering, does it?  Yes, we downplayed the risks early on, but we also almost threw the baby out with the bath water over a decade ago.  And let's not forget the overactive bladder and urge incontinence along with my favorite from years back, onychomycosis.  Again, we never asked about these conditions until we had a semi-effective solution.

So what about hypogonadism and andropause?  Is it real?  How do we define it?  What are the risks of Testosterone (T)?  I'll be the first to admit that I don't remember learning much about this back in the late 80s when I went to school (gee, where'd the time go?).  In fact, it really wasn't brought to my attention by a patient until early 2000 or so.  And now we have practices that focus on this niche!  Can benefit be had from supplementation?  I believe so, yes, in some patients.  But does every guy need it?  Absolutely not!  What about the risks?  Time to pull out Donald Rumsfeld's quote about known knowns, known unknowns, and unknown unknowns.  But that's why we continue to study this condition & therapy.  In the meantime, check out the New York Times perspective on the medicalization of hypogonadism.  And plan to keep T out of the water for now!

Follow @alvinblin
Tweet
This site complies with the HONcode standard for trustworthy health information:
verify here.

Search only trustworthy HONcode health websites: