Hormonal Male Contraception: Getting to Market

Abstract

Rates of unplanned pregnancies are high and stagnant globally, burdening women, families and the environment. Local limitations placed upon contraceptive access and abortion services exacerbate global disparities for women. Despite survey data suggesting men and their partners are eager for expanded male contraceptive options, efforts to develop such agents have been stymied by a paucity of monetary investment. Modern male hormonal contraception, like female hormonal methods, relies upon exogenous progestins to suppress the hypothalamic-pituitary-gonadal axis, in turn suppressing testicular testosterone production and sperm maturation. Addition of an androgen augments gonadotropin suppression, more effectively suppressing spermatogenesis in men, and provides androgenic support for male physiology. Previous contraceptive efficacy studies in couples have shown that hormonal male methods are effective and reversible. Recent efforts have been directed at addressing potential user and regulatory concerns by utilizing novel steroids and varied routes of hormone delivery. Provision of effective contraceptive options for men and women is an urgent public health need. Recognizing and addressing the gaps in our contraceptive options and engaging men in family planning will help reduce rates of unplanned pregnancies in the coming decades.

On-demand male contraception via acute inhibition of soluble adenylyl cyclase

“…Similarly, hormonal strategies for men currently in clinical trials work by blocking testicular sperm production. These methods 49 , as well as other experimentally validated hormonal and non-hormonal strategies which affect spermatogenesis 10 , 12 , 50 , 51 , require months of continuous usage before sperm numbers fall to subfertile levels. These methods also need months after cessation of therapy to recover normal sperm counts.…”

Willingness to Use Male Contraceptive Pill: Spain-Mozambique Comparison

“…In addition to this reason, further research would be needed to know if there is other reasons likely to drive Mozambican men into using MCP, given that the willingness to use the pill seems to have a high social component [ 17 ]. It is possible that with comprehensive sex education and a social activism [ 31 , 32 ], they would be more willing to use this kind of contraceptive. Likewise, the difference in willingness to take a MCP between the two countries could be related to the greater acceptance of the use of the method by men’s referents and their social environment, as is the case with the condom [ 13 ].…”

“…The findings from previous and the current study suggest that provisions of a male contraceptive pill in low middle income countries such as Mozambique will need to be subsidized by the government, since the cost would likely be a matter of concern [ 14 ]. In addition, the use of male contraceptive pill promotion must be accompanied by counselling programs stressing the efficacy of the contraceptive pill and how to mitigate possible negative side effects [ 32 , 36 ]. Finally, the development of educational programs to promote more equitable roles in regard to sex and gender (e.g., responsibility of both partners for contraception) will provide populations, especially in Mozambique, with the social and educational support to improve sexual health decision making, and potentially increase men’s willingness to use MCP [ 31 , 32 , 34 , 37 ].…”

Biomaterial platforms offer capability of efficacious male contraceptives

“…2 , 5 This outlook has limited funding and therefore research into male-directed methodologies, despite surveys suggesting a significant willingness (44-83%) on the part of men from around the world to take more responsibility for using contraception, 4 , 6 particularly if contemporary methods are reversible, long-lasting, and lack side effects. 5 Accordingly, recent analysis suggests that such novel reversible methods could signifi cantly decrease unintended pregnancies by as much as 30-40%, even under the assumption…”