Male hormonal contraception: where do we stand?

The hormonal control of spermatogenesis was unravelled decennia before the recent advances in genetics and molecular biology. This explains why hormonally active agents, with the potential of suppressing pituitary gonadotropins, have been used in attempts to develop clinically applicable contraceptives for men.

Earlier studies indicated that high-normal or supraphysiological levels of androgens are needed to achieve an acceptable suppression of spermatogenesis, especially in some Caucasian men. Therefore, non-androgenic agents have been used instead to induce hypogonadism and suppression of spermatogenesis, the resultant hypoandrogenism being counteracted by exogenous testosterone supplementation. In spite of the considerable progress made in male hormonal contraception, further improvements, pertaining to different aspects, are still needed. The most promising regimen to date is a combination of testosterone and a progestin.

Now that male hormonal contraception is technically possible, its refinement and wide implementation depend solely on the willingness of the pharmaceutical industry to invest in the further development of this method. For the time being, condoms and vasectomy remain the only widely available methods for male contraception.