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Progress and prospects in male hormonal contraception
1Center for Research in Reproduction and Contraception, Department of Medicine, University of Washington, Seattle, Washington 98195, USA. jamory@u.washington.edu
Current Opinion in Endocrinology, Diabetes, and Obesity
|April 29, 2008
Summary
Testosterone combined with progestins shows promise for male contraception by suppressing sperm production. While not universally effective, these hormonal combinations offer a reversible and potentially safe option for men.
Area of Science:
- Endocrinology
- Reproductive Medicine
- Pharmacology
Background:
- Testosterone suppresses pituitary hormones (luteinizing hormone and follicle-stimulating hormone), reducing sperm production.
- Male hormonal contraception is generally well-tolerated but testosterone-alone regimens are not fully effective for all men.
Purpose of the Study:
- To review the efficacy of testosterone-based hormonal combinations for male contraception.
- To assess novel combinations of testosterone with progestins for improved suppression of spermatogenesis.
Main Methods:
- Review of recent clinical trials investigating testosterone/progestin combinations.
- Analysis of studies using injectable testosterone decanoate with etonogestrel implants.
- Evaluation of trials combining daily testosterone gel with depot medroxyprogesterone acetate injections.
Main Results:
- Testosterone/progestin combinations synergistically suppress gonadotropins, leading to decreased sperm counts.
- Injectable testosterone decanoate with etonogestrel achieved sperm concentrations below 1 million/mL in 80-90% of subjects.
- Daily testosterone gel with depot medroxyprogesterone acetate yielded similar results in suppressing spermatogenesis.
Conclusions:
- Testosterone-based hormonal combinations effectively suppress spermatogenesis reversibly in men.
- A uniformly effective male contraceptive regimen remains elusive, but improvements are ongoing.
- Injectable testosterone undecanoate shows potential for a safe, reversible, and effective male contraceptive.
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