Male contraception: mechanical, hormonal and non-hormonal methods.

There is a definite need for an effective and reversible form of male contraception, both for maintaining a stable population in industrial countries and for diminishing population growth in developing countries. It has been agreed upon that contraception is an essential component of reproductive health for men and women (the Weimar Manifesto on Male Contraception). The development of new, effective methods of male contraception has been identified as a high priority by the WHO Task Force on methods of regulation of male fertility. Hormonal male contraception is based on suppression of gondotrophins and substitution of testosterone in order to maintain male sexual function and bone mineralisation and to prevent muscle waist. For complete interruption of spermatogenesis, an adequate suppression of intratesticular testosterone production is needed. Various contraceptive regimens have been developed and tested, including testosterone monotherapy, androgen/progestin combinations, testosterone with GnRH analogs, and selective androgen and progestin receptor modulators. The combination of testosterone with progestogen is currently the most promising approach to hormonal male contraception. Also, several non-hormonal approaches to male contraception are promising and may offer the foundation for developing new male contraceptives.