John K Amory1. 1. Center for Research in Reproduction and Contraception, Department of Medicine, University of Washington, Seattle, Washington 98195, USA. jamory@u.washington.edu
Abstract
PURPOSE OF REVIEW: Testosterone functions as a contraceptive by suppressing the secretion of luteinizing hormone and follicle-stimulating hormone from the pituitary. Low concentrations of these hormones deprive the testes of the signals required for spermatogenesis and results in markedly decreased sperm concentrations and effective contraception in a majority of men. Male hormonal contraception is well tolerated and acceptable to most men. Unfortunately, testosterone-alone regimens fail to completely suppress spermatogenesis in all men, meaning that in some the potential for fertility remains. RECENT FINDINGS: Because of this, novel combinations of testosterone and progestins, which synergistically suppress gonadotropins, have been studied. Two recently published testosterone/progestin trials are particularly noteworthy. In the first, a long-acting injectable testosterone ester, testosterone decanoate, was combined with etonogestrel implants and resulted in 80-90% of subjects achieving a fewer than 1 million sperm per milliliter. In the second, a daily testosterone gel was combined with 3-monthly injections of depot medroxyprogesterone acetate producing similar results. SUMMARY: Testosterone-based hormone combinations are able to reversibly suppress human spermatogenesis; however, a uniformly effective regimen has remained elusive. Nevertheless, improvements, such as the use of injectable testosterone undecanoate, may lead to a safe, reversible and effective male contraceptive.
PURPOSE OF REVIEW: Testosterone functions as a contraceptive by suppressing the secretion of luteinizing hormone and follicle-stimulating hormone from the pituitary. Low concentrations of these hormones deprive the testes of the signals required for spermatogenesis and results in markedly decreased sperm concentrations and effective contraception in a majority of men. Male hormonal contraception is well tolerated and acceptable to most men. Unfortunately, testosterone-alone regimens fail to completely suppress spermatogenesis in all men, meaning that in some the potential for fertility remains. RECENT FINDINGS: Because of this, novel combinations of testosterone and progestins, which synergistically suppress gonadotropins, have been studied. Two recently published testosterone/progestin trials are particularly noteworthy. In the first, a long-acting injectable testosterone ester, testosterone decanoate, was combined with etonogestrel implants and resulted in 80-90% of subjects achieving a fewer than 1 million sperm per milliliter. In the second, a daily testosterone gel was combined with 3-monthly injections of depot medroxyprogesterone acetate producing similar results. SUMMARY:Testosterone-based hormone combinations are able to reversibly suppress human spermatogenesis; however, a uniformly effective regimen has remained elusive. Nevertheless, improvements, such as the use of injectable testosterone undecanoate, may lead to a safe, reversible and effective male contraceptive.
Authors: R A Anderson; Z M Van Der Spuy; O A Dada; S K Tregoning; P M Zinn; O A Adeniji; T A Fakoya; K B Smith; D T Baird Journal: Hum Reprod Date: 2002-11 Impact factor: 6.918
Authors: Leo Turner; Ann J Conway; Mark Jimenez; Peter Y Liu; Elise Forbes; Robert I McLachlan; David J Handelsman Journal: J Clin Endocrinol Metab Date: 2003-10 Impact factor: 5.958
Authors: Monique M Cherrier; B D Anawalt; K L Herbst; J K Amory; S Craft; A M Matsumoto; W J Bremner Journal: J Clin Endocrinol Metab Date: 2002-07 Impact factor: 5.958