Continuing the search for a hormonal male contraceptive

Abstract

This chapter discusses the mechanisms of action of hormonal male contraception, which suppresses the hypothalamic-pituitary-testis axis. When the intratesticular concentration of testosterone is subsequently suppressed to adequately low concentrations, spermatogenesis is arrested. Androgens are a necessary hormonal male contraceptive component because they not only suppress the hypothalamic-pituitary-testis axis, but also provide the male hormone necessary to maintain peripheral androgen functions. Past studies using testosterone alone and testosterone combined with progestins demonstrated contraceptive efficacy in the female partner at rates similar to combined hormonal female methods. Newer hormonal male contraceptive formulations and the alternative routes of administration are discussed, along with potential barriers, challenges, and opportunities for hormonal male contraceptive development. Novel methods that are safe, effective, reversible, user-friendly, and coitus-independent are intrinsic to equitably meet the various needs and limitations of an increasingly diverse population.

Knowledge and Perception Regarding the Development and Acceptability of Male Contraceptives Among Pharmacists: A Mixed Sequential Method

“…Clinically tested male OCPs included medroxyprogesterone acetate, norethisterone enanthate, testosterone enanthate, and testosterone undecanoate (Gava & Meriggiola, 2019). It was reported in clinical trials that androgens alone are less effective in suppressing spermatogenesis when compared with the combination of androgen and gonadotropin suppressive agents, for example, progestin (Yuen et al, 2020).…”

Blockade of GRTH/DDX25 Phosphorylation by Cyclic Peptides Provides an Avenue for Developing a Nonhormonal Male Contraceptive

“…Currently, available male contraceptive pills are hormone-based . However, a safe, reversible, effective nonhormonal contraceptive is needed.…”

“…Currently, available male contraceptive pills are hormonebased. 26 However, a safe, reversible, effective nonhormonal contraceptive is needed. Future refinements through experimental structure−activity studies combined with computational modeling may help overcome potential limitations in vivo, such as absorption and the ability to cross the blood− testis barrier, paving the way for novel fertility regulators in men.…”

Comparison of Testosterone Undecanoate (TU) and Testosterone Enanthate (TE) with Combination of Depot Medroxyprogesterone Acetate (DMPA) on Spermatogenic Cells in Men

“…Progestin have been used in clinical as female contraception also experimenting to man since early 1970s. 17 Its mechanism might interfere hypothalamicpituitary-gonadal axis by suppressing gonadotropin release and impairing spermatogenesis. 8 Study indicated that progestin could became a potent inhibitor of LH and FSH which leading to improved sperm supperession.…”

“…20 A trial conducted that progestin/progestogen could suppress sperm production but lowering intratesticular testosterone concentration leading to androgen deficiency. 17 Androgen peripheral activity to other functions such as libido, erection, ejaculation and maintaining muscle mass would have agitated. Adding testosterone regimen into combinations is a compulsion to maintain these functions.…”