Nonhormonal drugs for contraception in men: a systematic review.
Nonhormonal drugs for contraception in men may have advantages over hormonal methods. The nonhormonal methods can have more rapid onset and less interference with androgen-dependent functions. This systematic review summarizes the clinical studies evaluating nonhormonal drugs administered to men for contraception. Relevant clinical results were found for gossypol, which is derived from the cotton plant, and for extracts of Tripterygium, a plant used in Chinese traditional medicine. Randomized, controlled trials were available on the efficacy of gossypol and on the effect of gossypol on potassium levels. Gossypol had problems with low efficacy and toxicity. For Tripterygium, 2 observational studies described men who were treated for rheumatoid arthritis. Although sperm density was lower among those taking Tripterygium, later reports indicated some toxicity. Nonclinical research continues on isolates of Tripterygium. No clinical studies for contraception in men were found for nonhormonal vaccines or neem, which is also a plant used for medicinal purposes. Clinical trials studied injecting styrene maleic anhydride into the vas deferens, but no comparative data were provided. At this time, no safe and effective nonhormonal drug is available for contraception in men.


BACKGROUND
Obstetricians & Gynecologists, Family Physicians.


OBJECTIVE
After completion of this article, the reader should be able to state that the number of studies concerning the use of nonhormonal drugs for male contraception are very limited, point out that the two nonhormonal drugs used to a small degree have varying results and serious side effects, and recall that there are limited clinical studies on use of vas deferens injections and vaccines in humans.
Lopez
Laureen M
LM
Family Health International, Research Triangle Park, North Carolina 27709, USA. llopez@fhi.org
Grimes
David A
DA
Schulz
Kenneth F
KF
D003272:Contraceptive Agents, Male / Q000009:adverse effects / Q000627:therapeutic use*; D006072:Gossypol / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008516:Medicine, Chinese Traditional; D028321:Plant Preparations / Q000009:adverse effects / Q000627:therapeutic use*; D011188:Potassium / Q000097:blood; D016032:Randomized Controlled Trials as Topic; D029757:Tripterygium / Q000737:chemistry*
D003272:Contraceptive Agents, Male; D028321:Plant Preparations; D006072:Gossypol; D011188:Potassium