Friday, May 31, 2013

Pushing Testosterone

After blanketing cable TV and the internet with ads for erectile dysfunction drugs over the past few years (see The E.D. Epidemic), the pharmaceutical industry is now pushing testosterone supplementation.  Like the E.D. campaign, the ads feature attractive, middle aged couples and offer a simple fix for relationship problems.  In reality, these drugs are likely targeted at aging baby boomers, especially those with young mistresses or young, second wives; of course, the testosterone supplements may also appeal to younger men intent on improving their athletic or sexual performance.

While the ads provide a litany of potential side effects from the use of testosterone, the visual effect of young, happy couples outweighs the more sober warnings of the narrator.  Physicians are well aware of the risks associated with hormone supplementation, including estrogen, testosterone and cortisone; yet, some will comply with their patient's request and the ads are designed to trigger that demand.  The ads also suggest that there is a clear-cut association between one's serum testosterone level and a variety of emotional or sexual problems; this message greatly oversimplifies the approach to such disorders and exaggerates the true incidence of clinically significant testosterone deficiency.

Most disconcerting is the fact that these pharmaceutical companies devote so many dollars to the production, promotion and distribution of these agents when far more common and serious medical conditions are not adequately addressed, when health care costs are out of control and when many Americans have inadequate access to quality health care.  Erectile dysfunction and testosterone deficiency, well down the list of pressing health care issues, are getting a large proportion of the exposure.