Hormones of Life: Endocrinology, the Pharmaceutical Industry, and the Dream of a Remedy for Sterility 1930–1970 (review)

Although its title may suggest a more expansive topic, Hormones of Life is actually the biography of a single, rather unsuccessful drug called Gonadex (chorionic gonadotropin) that was produced and marketed by the Swedish company Aktiebolaget Leo from 1948 to 1986 as a remedy for female sterility, as well as for menstrual problems and menopausal discomforts. The author, Christer Nordlund, locates the trajectory of this drug’s birth, life, and death in a rich context of scientific knowledge about hormones and reproduction, medical treatment of infertility, the culture of academic–medical–industrial collaborations, international competition in the pharmaceutical industry, the global politics of World War II and its aftermath, and the history of eugenics and population policies from the 1930s to the 1970s. Hormones of Life takes its place on the bookshelf alongside other drug biographies, such as Nelly Oudshoorn’s Beyond the Natural Body, Toine Pieters’s Interferon, and Jordan Goodman and Vivien Walsh’s The Story of Taxol, that use the lifecycle of a particular pharmaceutical product as a lens to investigate the relationships among industry, medicine, academia, the state, and the media in modern health care.¹

The book begins with an introduction that lays out the author’s theoretical and methodological orientations and then proceeds in three sections of three chapters each. The first section, “Tradition,” provides narrative background for the science, the industry, and one key individual involved in shaping the genesis of Gonadex. The first chapter gives the history of endocrinology and endocrine therapy from the late 1800s to the 1930s; the second introduces the clinician and researcher Axel Westman and his interest in infertility; and the third presents Aktiebolaget Leo and its foray into hormone production. The next section, “Innovation,” takes a close look at Gonadex in the late 1940s. Chapter 4 traces the development and testing of the preparation that would become Gonadex; chapter 5 details the company’s release of the product in 1948, its coordinated public relations campaign, and subsequent sensational reporting by the media; chapter 6 explores the reception of Gonadex by the medical profession and prospective users. The final section, “Development,” presents the decades-long denouement of the Gonadex story. Chapter 7 explains how Leo refashioned Gonadex in the early 1950s, after the drug was denied full licensing because of problems with its standardization. Chapters 8 discusses developments in research on the pituitary gland and the impact of this research on Gonadex, and chapter 9 describes Leo’s development of a new gonadotropin product to complement Gonadex in the treatment of infertility. The conclusion explains how the technology of in vitro fertilization displaced hormones from the center of the therapeutic conversation about assisted reproduction.

Nordlund’s consideration of the fate of Gonadex as an infertility treatment in light of changing values of population size is especially interesting. Gonadex was developed in the immediate postwar years, when Sweden was concerned about falling birth rates and the quality of its population, and Nordlund sees the positive efforts to promote fertility with pharmaceutical assistance as the counterpart to Sweden’s negative efforts to control reproduction with its infamous sterilization policy. By the 1960s, however, concerns about overpopulation meant that the Swedish welfare state demonstrated less interest in helping involuntarily childless couples to conceive; rather, its attention was focused on techniques for preventing pregnancy. Nordlund demonstrates how this shift in policy influenced industrial strategies for hormone production and forced Leo to seek markets for its gonadotropin products outside Sweden’s borders.

Hormones of Life was originally published in Swedish in 2008. The book is meticulously researched; Nordlund succeeded in gaining access to Leo’s corporate archives, and he mines these records along with other archival collections to paint a detailed portrait of pharmaceutical production, regulation, marketing, and use in the mid-twentieth century. The book suffers in places...