3. From Estrogen to Testosterone


Steve Talbott



You have probably heard, over the past year or so, about the progressive collapse of the Medical establishment's long-standing and confident case for hormone replacement therapy the use of estrogen and other hormones in older women to ease the symptoms of menopause and postpone the signs of aging. Not only are there previously unforeseen risks associated with this widely employed therapy, but the "obvious" benefits have been evaporating upon closer inspection.


Since neither this nor any other misjudgment ever leads the mainstream media to question scientific authority, I would like to mention in passing two closely related lessons of the hormone replacement debacle.


In the first place, the episode underscores how far we still are from anything like the holism to which so many pay lip service. You cannot help being amazed when you consider the ready willingness of almost the entire medical community to fiddle so casually with the fundamental developmental processes of the human being. If it were really understood -- and how could this be missed? -- that these processes are organically related to just about everything that goes on in the human being, then neither researchers nor physicians could have been satisfied with the inherently limited studies focused on the presence or absence of this or that particular side-effect. There would have been an extremely powerful presumption -- scarcely altered by mountains of the usual sorts of "evidence" -- that such therapy must bend the organism out of shape in one way or another. I am certain that, with the recent studies, we have scarcely begun to understand the full and subtle implications of hormone replacement.


The reasons for this may become clearer when you consider how the body tries to adapt to a stimulus -- even to an extreme stimulus -- in an organic and harmonious way. Anyone who has studied human physiology knows that any significant event -- say, an injury to one part of the body -- leads to a cascade of adjustments in blood functioning, respiration, muscle tension, psychological state, and so on without limit. The organism re-shapes itself around the disruptive occurrence. And this global, organic re-shaping means that you have no set of well-defined and restricted places to look for unwelcome changes. They can show up as a contributing factor to almost anything else that happens. The same holds true for arbitrary chemical stimuli. The statement, "We tested drug X for this and that, and we found no ill side-effects" is always inadequate.


This, then, is the second lesson: conventional research methods the methods that for so long confirmed to physicians the advisability of hormone replacement -- are by themselves unequal to the task we have assigned them. It may not be immediately obvious what is missing, but I will in the future be suggesting that our scientific investigations require a greatly strengthened qualitative element if they are to reveal very much about the altered shape of an organism as a whole. This is because the only language and the only truth that can speak through any whole, characterizing it as a whole, are a qualitative language and a qualitative truth.


Not that we should expect such lessons to penetrate science or society very quickly. There is now a rapidly growing employment of testosterone therapy among men, with doctors prescribing it for uses far beyond the federally approved ones involving severe testosterone deficiency. Last year more than 800,000 men were given this therapy. What we're looking at is the early stage of yet another "fountain of youth" syndrome, and the medical establishment seems no less driven to craziness by the strange hallucinations of this syndrome than is the general public.