In 1948, amidst great hype, the drug Gonadex was launched in Sweden promising a major cure for sterility. Portrayed as a victory for science and modern-based medicine, Gonadex was also heralded as a key product for promoting the Swedish company Aktiebolager Leo (Helsingborg) on to the international stage. What happened to Gonadex and how it was developed, received and then taken off the market in 1986 is the subject of Norlund’s insightful book Hormones of Life. Based on archival papers from Aktiebolager Leo, Norlund’s study provides a rich illustration of the complex relationships that underlie the discovery and development of a drug, and how its success or otherwise is bound up with complex relationships between society and medicine as well as the intricate networks between the pharmaceutical industry and academic medical research. Given the withdrawal of Gonadex, this history is particularly illuminating of what happens to drugs launched with great hope and which then fade from view. Thus, it provides a counterbalance to histories which focus on success stories.

Initially the book offers an overview of the history of endocrinology and the ways in which medical experts handled sterility. This is done by examining how the field of sterility was shaped by wider government concerns about a declining population. At the forefront of this work was Axel Westman, the professor of gynaecology and obstetrics at Uppsala University. From the 1930s Westman had become a champion of endocrinology for solving infertility, supported by Leo, which sponsored the first laboratory of hormones in the academic community. Critically Westman became a focal point for helping the company to standardise its sex hormones and clinically test new drugs.

Westman’s clinic and his partnership with Leo provided the base for the development of Gonadex, which emerged from the new hormone preparations Leo was developing in consultation with Westman in the 1940s. By 1948 the company had succeeded in developing a crystalline chorionic gonadotropin which was seen as suitable for marketing. The raw starting material for the drug hinged on the collection of large quantities of urine taken from pregnant women. This system was heavily dependent on the co-operation of pregnant women as well as nurses and midwives who had to supervise collection in addition to their routine work.

Gonadex marked a major milestone for Leo. Crucially it gave Leo the tools to move on from the position of being a distributor of drugs to a company able to create and market its own innovations on the world stage. With so much of its future hanging in the balance, Leo pushed forward in marketing with only a few trials completed. Hailed as a Swedish scientific triumph and on the back of the scientific credibility of Westman, the drug was promoted for a number of indications, with its ability to treat infertility centre stage.

Greeted with widespread enthusiasm by the medical profession and potential users, the hype surrounding Gonadex, however, soon deflated. The bubble burst when the National Pharmaceutical Laboratory raised questions about standardisation of the drug. In 1949 Leo withdrew its application for the drug’s registration. The story of Gonadex, however, did not end here. As Norlund points out, instead the drug changed identities and was relaunched by the company for the specific treatment of amenorrhoea. Its release on to the market would pave the way for Leo’s successful marketing of Homogonal, a drug to treat infertility in 1968.

Interestingly, while Homogonal would be withdrawn from the market in 1979, due to its small uptake, Gonadex, despite being an older drug, would continue until 1986. Norlund argues this could be because, while the quality of Gonadex remained unchanged, techniques for determining its purity had improved and refined, making it seem a more attractive drug than when it first appeared in 1948.

This study of Gonadex is a powerful reminder that history is not just about the celebration of winners. Tracing the ups and downs of Gonadex, Norlund provides a telling tale of how the history of drugs is influenced by the complex medical-academic framework in which they are developed and a powerful reminder that the boundaries between science, technology and society are not fixed.