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Hormonal male contraception: progress and prospects for the 21st century
Author(s) -
Handelsman DAVID J.
Publication year - 1995
Publication title -
australian and new zealand journal of medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.596
H-Index - 70
eISSN - 1445-5994
pISSN - 0004-8291
DOI - 10.1111/j.1445-5994.1995.tb02885.x
Subject(s) - medicine , family planning , male contraceptive , azoospermia , hormonal contraception , developed country , testosterone (patch) , fertility , population , gynecology , infertility , pregnancy , environmental health , endocrinology , research methodology , biology , genetics
Abstract: During the second half of the 20 th century, progress in developing novel, practical contraceptive methods for men has lagged significantly behind developments for women. Despite the lack of reliable, reversible methods, men throughout the world continue to be strongly involved in family planning but a greater involvement will require more attractive and reliable contraceptive options for men. The closest to fruition are hormonal methods the features of which are reviewed. Landmark WHO contraceptive efficacy studies have established that hormonally‐induced azoospermia provides highly effective and reversible contraception for at least 12 months with minimal short‐term side effects. Even among the small subgroup of men who remain oligozoospermic during hormonal suppression, good contraceptive efficacy is achieved. The present goals are to develop improved second generation hormonal regimens which provide more uniform azoospermia to obviate the need for monitoring of sperm output and to develop long‐acting depot testosterone formulations used alone or with additional gonadotrophin suppressive agents such as progestins or GnRH antagonists. Significant obstacles to progress are the flight of industry from contraceptive R&D due to the financial deterrent posed by the product liability crisis as well as the low priority accorded male reproductive health. Together these will determine whether the range of contraceptive options available to our children in the 21st century will improve, or whether the historically recent unbalanced increase in reliance on women for family planning will continue.