title: Male hormonal contraception: hope and promise.
abstract: Family planning is a shared responsibility, but available male-directed contraceptive methods are either not easily reversible (vasectomy) or not sufficiently effective (condom). However, roughly 20% of couples using a contraceptive method worldwide, and up to 80% in some countries, still choose a male-directed method. Male hormonal contraception is highly effective, with perfect use failure rates of 0·6% (95% CI 0·3-1·1) if sperm concentrations of less than 1 million per mL are maintained. After cessation of male hormonal contraception, sperm output fully recovers in a predictable manner, resulting in pregnancies and livebirths. Spontaneous miscarriage and fetal malformation rates after recovery of sperm output overlap those in the general population. Short-term adverse events-acne, night sweats, increased weight, and altered mood and libido-are recognised, but are generally mild. Further optimisation of specific androgen-progestin regimens and phase 3 studies of lead combinations are still needed to successfully develop an approved male hormonal contraceptive and to identify long-term side-effects.
authors.affiliation: Division of Endocrinology, Department of Medicine, Harbor-UCLA Medical Center and Los Angeles Biomedical Research Institute (LA BioMed) Torrance, CA, USA.
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Piotrowska
authors.affiliation: Division of Endocrinology, Department of Medicine, Harbor-UCLA Medical Center and Los Angeles Biomedical Research Institute (LA BioMed) Torrance, CA, USA.
authors.forename: Christina
authors.initials: C
authors.lastname: Wang
authors.affiliation: Division of Endocrinology, Department of Medicine, Harbor-UCLA Medical Center and Los Angeles Biomedical Research Institute (LA BioMed) Torrance, CA, USA.
authors.forename: Ronald S
authors.initials: RS
authors.lastname: Swerdloff
authors.affiliation: Division of Endocrinology, Department of Medicine, Harbor-UCLA Medical Center and Los Angeles Biomedical Research Institute (LA BioMed) Torrance, CA, USA. Electronic address: pliu@labiomed.org.
authors.forename: Peter Y
authors.initials: PY
authors.lastname: Liu
mesh_terms: D000728:Androgens / Q000627:therapeutic use; D003267:Contraception / Q000379:methods*; D003272:Contraceptive Agents, Male / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D011247:Pregnancy; D011256:Pregnancy Outcome; D011372:Progestins / Q000627:therapeutic use; D012307:Risk Factors
chemical_list: D000728:Androgens; D003272:Contraceptive Agents, Male; D011372:Progestins