Male hormonal contraception.
Although women have traditionally shouldered the responsibility of contraception, up to a third of couples worldwide employ a male form of contraception (e.g., condoms or vasectomy). Some women are unable to use hormonal contraception; vasectomy is best considered irreversible; and long-term use of condoms is associated with a relatively high failure rate (pregnancy). Thus, a need exists for a safe, effective, reversible, well-tolerated male hormonal contraceptive agent. Two large multi-centre, multi-national trials sponsored by the World Health Organization in the 1990s showed that high-dosage exogenous testosterone provided contraceptive efficacy similar to existing female oral contraceptives. However, the supraphysiological dosages of testosterone used resulted in androgen-related adverse effects such as weight gain and suppression of high-density lipoprotein cholesterol levels. Subsequent efforts have been directed at combining testosterone with other agents, such as progestogens or gonadotropin-releasing hormone analogues, to decrease the dosage of testosterone (and thus androgen-related side effects) while achieving uniform azoospermia. This review discusses the latest developments in male hormonal contraception.
Cornia
Paul B
PB
VA Puget Sound Healthcare System, 1660 South Columbian Way (S-111-GIMC), Seattle, WA 98108-1597, USA. paul.cornia@med.va.gov
Anawalt
Bradley D
BD
D000728:Androgens / Q000009:adverse effects / Q000494:pharmacology*; D003267:Contraception; D003272:Contraceptive Agents, Male / Q000009:adverse effects / Q000494:pharmacology*; D004338:Drug Combinations; D007987:Gonadotropin-Releasing Hormone / Q000031:analogs & derivatives / Q000494:pharmacology; D006801:Humans; D008297:Male; D011372:Progestins / Q000494:pharmacology; D013091:Spermatogenesis / Q000187:drug effects* / Q000502:physiology; D013739:Testosterone / Q000494:pharmacology
D000728:Androgens; D003272:Contraceptive Agents, Male; D004338:Drug Combinations; D011372:Progestins; D007987:Gonadotropin-Releasing Hormone; D013739:Testosterone