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  • Hormones for Life: Endocrinology, the Pharmaceutical Industry, and the Dream of a Remedy for Sterility, 1930-1970 by Christer Nordlund
  • Dominique A. Tobbell (bio)
Hormones for Life: Endocrinology, the Pharmaceutical Industry, and the Dream of a Remedy for Sterility, 1930-1970. By Christer Nordlund. Sagamore Beach, MA: Science History Publications, 2011. Pp. ix+297. $34.95.

In Hormones for Life, Christer Nordlund provides a compelling biography of Gonadex, an all-but-unknown hormone drug that on its public launch in Sweden in 1948 was hailed as a cure for sterility. A veritable "loser" among the "wonder drugs" of the post-World War II era, Nordlund rightly sees value in tracing the life cycle of Gonadex from its conception in the 1940s, through its transformation in the 1950s, and ultimately its market death in 1986. Based on extensive research in corporate archives, government documents, clinic records, press coverage, and the published scientific literature, Nordlund follows Gonadex out of the laboratory and into the clinic and the public sphere, capturing the complexity of pharmaceutical innovation.

Gonadex was developed and marketed by the Swedish pharmaceutical firm Aktiebolaget Leo (Leo). As Nordlund shows, however, the development of Gonadex depended on extensive production and distribution networks established by Leo with academic researchers, physicians, hospitals, and women's clinics throughout Sweden. Of particular importance was the firm's close and long-standing collaboration with Professor Axel Westman, a leading hormone researcher and gynecologist based for most of his career at the Royal Caroline Hospital in Stockholm. The research and testing that led Leo to develop Gonadex depended on the company's collaborative relationship with Westman's laboratory. It also depended on the firm's ability to mobilize its network of consultants and forge productive relationships with abattoirs, women's clinics, and old-age homes to procure sufficient amounts of raw material (initially urine from pregnant mares; later versions of the drug derived from the urine of pregnant and post-menopausal [End Page 428] women). Following Gonadex's launch, Leo mobilized a distribution network of its physician-consultants who used the drug in their clinics, promoted the drug to their colleagues, and served as mediators (interlocuters) between Leo, the press, and patients.

The history of Gonadex underscores the influence of therapeutic culture on corporate strategy. Nordlund shows that Leo's decision to invest in endocrinological research and treatment in the 1930s was as much motivated by sociopolitical considerations as it was by scientific and clinical imperatives. He argues that Leo's investment in and Westman's commitment to the sterility field were shaped by the population debates of the 1930s, particularly Sweden's pronatalist and eugenic preoccupation with "improving" Swedish stock. As Gonadex faltered clinically and financially, Leo remained committed to the project, ultimately transforming the drug into a "'base product,' which helped kick off research and development" in the new field of endocrinology, and generating "spin-off" products. One such spin-off product was Homogonal, which Leo introduced to the Swedish market in 1967.

Nordlund's analysis shows clearly the importance of path dependency for understanding the company's decision to continually reinvest in a project that consistently fell short of the mark, even as the "therapeutic culture" changed significantly. Indeed, the sociopolitical context in which Homogonal was developed was markedly different from the context of Gonadex's origins. Instead of the pronatalism of the 1930s, the 1960s were defined by growing national and global fears of overpopulation. In this context, there was little political support (or much of a potential market) for sterility drugs as national governments, the World Health Organization, population-control advocates, and pharmaceutical companies focused on the development and distribution of contraceptives to stem the tide of population growth. In this milieu, Leo did not expect Homogonal to generate large sales volume but instead hoped its high price would ensure a sufficient financial return from the narrow sterility market.

Although Hormones for Life does not break new historiographical ground, it is a valuable contribution to the fields of pharmaceutical history, science and technology studies, and innovation theory. Challenging the linear model of science-based innovation, Nordlund's close study of the history of Gonadex reveals the ways in which endocrinological...

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