Although much criticized, the early experiences with testes preparations also suggested another application of male sex hormones: the treatment of sexual disorders, like impotence and loss of libido, in particular in elderly men (Organon Archive 13 February 1931). This indication is also described as the climacterium virile, the male menopause.25 Organon did not, however, put much effort into promoting hormonal treatment of these menopausal symptoms in men. They did not initiate clinical trials in order to test the therapeutic effect of male sex hormone therapy for the treatment of impotence and libido problems. This can partly be understood from the lack of an institutional context in which clinical trials could be organized. In the 1920s, the taboo on sexuality still constrained men with sexual problems from seeking medical care. Men with prostate hypertrophy would eventually ask for medical care; but older men with impotence seldom visited the general practitioner or the clinician. Moreover, sexological clinics did not yet exist in the 1930s. Organon’s advertising policy reflects this apprehensive approach. Although by 1937, hormonal treatment of men with impotence and libido problems had developed into one of the major medical indications in Germany, Laqueur persuaded Organon to emphasize instead the treatment of prostate hypertrophy (Organon Archive 8 May 1937). Laqueur argued that emphasis on sexual impotence in advertising male sex hormones was far too risky because of the negative connotations with the claims of Brown-Sequard (Organon Archive 19 October 1938). The ghost of Brown-Sequard was apparantly still very much alive in the late 1930s, and so were gland transplant surgeries. This restriction by Organon in advertising its male sex hormones seems to have been confined specifically to The Netherlands. In Britain, Organon advertised sexual impotence to the same extent as prostate hypertrophy (Figure 5.3).
Although heavily criticized by Laqueur, Organon decided that this type of advertising was quite appropriate for Britain, because of the different mentality of British general practitioners, who were not likely to object to such advertisements (Organon Archive 21 November 1939). In addition to these cultural constraints on the hormonal treatment of impotence, the therapeutic relevance of this treatment was also criticized (Organon Archive 13 May 1937). Many scientists as well as clinicians emphasized the psychological character of impotence and libido problems.
A third indication suggested for male sex hormone therapy were psychological disorders, such as depression, melancholy and schizophrenia (Organon Archive 17 November 1932; 11 October 1933). In 1931 Laqueur advised Organon to place Hombreol at the disposal of psychiatrists in order to implement clinical trials (Organon Archive 10 March 1931). These clinical trials seem to have taken place only on a small scale.26 This indication, in particular schizophrenia, was also handled with the utmost care. In discussing this hormone therapy for schizophrenia with Organon’s pharmaceutical industrial partner in Britain, Laqueur was advised that pharmaceutical companies should not arrange clinical trials because psychiatrists were skeptical and could be won over to hormone therapy only if the pharmaceutical industries did not push too hard:
There must be, of course, a number of psychiatrists intent on finding an organic basis for schizophrenic disorders, and it would be nice to have them buy their therapeutic material from us; but perhaps this is more likely to happen if we do not arrange a clear-cut experiment.
(Organon Archive 30 November 1935)
In contrast to the female menopause, the medical attention given to the male menopause, which was characteristic of the last decade of the nineteenth century, gradually diminished during the early decades of the twentieth century. Here we see how the pre-idea that virility is controlled by the male gonads gradually disappears from the forefront in sex endocrinology. The scientific community distanced itself quite clearly from the earlier claims on male hormones, promoted by scientists like Brown-Sequard and Steinach. This does not mean that the idea that virility can be affected by male hormones totally disappeared. The idea is kept alive in more popular writings on sex hormones, exemplified in The Male Hormone, that strongly advocates the use of testosterone for evoking “eternal manhood” (Kruif undated). This shift in focus from male menopause to female menopause can be understood in the context of professionalization that took place in the medical sciences at the turn of the century. To demarcate the boundaries between the medical profession and the flourishing paramedical practice, clinicians increasingly opposed clinical quackery. The pharmaceutical company anticipated the reservations of the scientific community toward this use of male sex
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