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An Inhumane Consequence of Medical Blinders - My Opinion
I came across this mind-boggling article during a search for testosterone studies.
It appeared in the October 2006 issue of The Journal of Clinical Endocrinology and Metabolism. My opinion
follows below.
J Clin Endocrinol Metab. 2006 Oct;91(10):3697-710. Epub 2006 Oct 3.
Androgen therapy in women: an Endocrine Society Clinical Practice guideline.
Wierman ME, Basson R, Davis SR, Khosla S, Miller KK, Rosner W, Santoro N.
University of Colorado at Denver and Health Sciences Center, Aurora, CO 80010, USA.
OBJECTIVE: The objective was to provide guidelines for the therapeutic use of androgens in women.
PARTICIPANTS: The Task Force was composed of a chair, selected by the Clinical Guidelines Subcommittee (CGS)
of The Endocrine Society, six additional experts, a methodologist, and a medical writer. The Task Force
received no corporate funding or remuneration.
EVIDENCE: The Task Force used systematic reviews of available evidence to inform its key recommendations.
The Task Force used consistent language and graphical descriptions of both the strength of recommendation and
the quality of evidence, using the recommendations of the Grading of Recommendations, Assessment, Development,
and Evaluation (GRADE) group. The strength of a recommendation is indicated by the number 1 (strong recommendation,
associated with the phrase "we recommend") or 2 (weak recommendation, associated with the phrase "we suggest").
The quality of the evidence is indicated by cross-filled circles, such that [1 cross-filled circle, 3 empty circles]
denotes very-low-quality evidence, [2 cross-filled circles, 2 empty circles] low quality, [3 cross-filled circles,
1 empty circle] moderate quality, and [4 cross-filled circles] high quality. Each recommendation is followed by a
description of the evidence.
CONSENSUS PROCESS: Consensus was guided by systematic reviews of evidence and discussions during one group
meeting, several conference calls, and e-mail communications. The drafts prepared by the task force with the
help of a medical writer were reviewed successively by The Endocrine Society's CGS, Clinical Affairs Committee
(CAC), and Executive Committee. The version approved by the CGS and CAC was placed on The Endocrine Society's
web site for comments by members. At each stage of review, the Task Force received written comments and
incorporated needed changes.
CONCLUSIONS: We recommend against making a diagnosis of androgen deficiency in women at present because of
the lack of a well-defined clinical syndrome and normative data on total or free testosterone levels across
the lifespan that can be used to define the disorder. Although there is evidence for short-term efficacy of
testosterone in selected populations, such as surgically menopausal women, we recommend against the generalized
use of testosterone by women because the indications are inadequate and evidence of safety in long-term studies
is lacking. A review of the data currently available is presented, and areas of future research are outlined.
To formulate clinical guidelines for use of testosterone in women, additional information will be necessary.
This includes defining conditions that, when not treated with androgens, have adverse health consequences to
women; defining clinical and laboratory parameters that distinguish those with these conditions; and assessing
the efficacy and long-term safety of androgen administration on outcomes that are important to women diagnosed
with these conditions. This necessary clinical research cannot occur until the biological, physiological, and
psychological underpinnings of the role of androgens in women and candidate disorders are further elucidated.
PMID: 16749913 [PubMed - as supplied by publisher]
Unbelievably, this "task force" is recommending that physicians pretend that
a severe medical condition, a devastating disease, simply doesn't exist. It would be ludicrous if it wasn't so tragic.
> For some unfortunate reason a twenty-two year old woman has to have both
of her testosterone secreting ovaries removed. At the very least, ahead of her are a withering clitoris and
a drying vagina. Her
libido and ability to have an orgasm will soon be non-existent. Many types of her social and personal
relationships are going to forever become things of the past. She is certainly going to become weak and fatigued,
depressed or anxious (or both) and is going to suffer the decades too early onset of osteoporosis.
Is it the opinion
of this task force that her doctors should ignore this general deterioration as it ensues and progresses, or
blame it all on something else? What would be their recommendation if a young man had to have both his testes removed?
Let's be very clear about the nature of this recommendation. The members of this task force did not
convene to advise on the
existence of testosterone deficiency in the female of our species. They stated: "The objective was to provide
guidelines for the therapeutic use of androgens in women." Clearly, there first had to be an accepted
consensus of the parent organization, The Endocrine Society, that such a condition existed.
It would be irresponsible enough if they chose as individuals to be so callous
and sexually biased, but because they couldn't decide on guidelines they're suggesting that the entire medical
community pretend the condition doesn't exist. I don't know which is the greater, their egocentrism or childish
mentation, but certainly, their scientism has displaced their humanity and common sense.
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