Brown-Séquard revisited: A lesson from history on the placebo effect of androgen treatment

Background: In 1889, Brown-Séquard, aged 72, reported dramatic rejuvenating effects after self-administering testicular extracts of dogs and guinea-pigs. His report resulted in widespread use of testicular extracts throughout Europe and North America for several decades. More recently, the male ageing process has been attributed to partial androgen deficiency, or "andropause", and testosterone treatment is claimed to improve well-being in middle-aged and elderly men. Design: We prepared extracts from five dog testes using Brown-Séquard's methods and assayed testosterone concentrations. Results: Testosterone concentrations were four orders of magnitude less than that required for a biological effect. Conclusions: Our study illustrates the marked placebo response that can be evoked by androgen treatment. It cautions against the empirical use of testosterone treatment for older men, unless a diagnosis of hypogonadism has been substantiated.