Background: In 1889, Brown-Séquard, aged 72, reported dramatic rejuvenating effects after self-administering testicular extracts of dogs and guinea-pigs. His report resulted in widespread use of testicular extracts throughout Europe and North America for several decades. More recently, the male ageing process has been attributed to partial androgen deficiency, or "andropause", and testosterone treatment is claimed to improve well-being in middle-aged and elderly men.
Design: We prepared extracts from five dog testes using Brown-Séquard's methods and assayed testosterone concentrations.
Results: Testosterone concentrations were four orders of magnitude less than that required for a biological effect.
Conclusions: Our study illustrates the marked placebo response that can be evoked by androgen treatment. It cautions against the empirical use of testosterone treatment for older men, unless a diagnosis of hypogonadism has been substantiated.
- 1. Brown-Séquard CE. Note on the effects produced on man by subcutaneous injections of a liquid obtained from the testicles of animals. Lancet 1889; 2: 105-107.
- 2. Medvei VC. The history of clinical endocrinology. Carnforth: Parthenon Publishing Group, 1993: 159-166.
- 3. Borell M. Organotherapy, British physiology, and discovery of the internal secretions. J Hist Biol 1976; 9: 235-268.
- 4. Schwartz TB. Henry Harrower and the turbulent beginnings of endocrinology. Ann Intern Med 1999; 131: 702-706.
- 5. Lamberts S, van den Beld AW, van der Lely AJ. The endocrinology of aging. Science 1997; 278: 419-424.
- 6. Snyder PJ, Peachey H, Hannoush P, et al. Effect of testosterone treatment on body composition and muscle strength in men over 65 years of age. J Clin Endocrinol Metab 1999; 84: 2647-2653.
- 7. Conway AJ, Handelsman DJ, Lording DW, et al. Use, misuse and abuse of androgens. The Endocrine Society of Australia consensus guidelines for androgen prescribing. Med J Aust 2000; 172: 220-224. <eMJA full text>
- 8. Seidman SN, Spatz E, Rizzo C, Roose SP. Testosterone replacement therapy for hypogonadal men with major depressive disorder: a randomized, placebo-controlled clinical trial. J Clin Psychiatry 2001; 62: 406-412.
- 9. Griffin JE, Wilson JD. Disorders of the testes and the male reproductive tract. In: Wilson JD, Foster DW, Kronenberg HM, Larsen PR, editors. Williams textbook of endocrinology. Philadelphia: WB Saunders Company, 1998: 819-875.
Publication of your online response is subject to the Medical Journal of Australia's editorial discretion. You will be notified by email within five working days should your response be accepted.