Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2020 Jul:66:83-94.
doi: 10.1016/j.bpobgyn.2020.02.003. Epub 2020 Feb 19.

Continuing the search for a hormonal male contraceptive

Fiona Yuen  1 , Brian T Nguyen  2 , Ronald S Swerdloff  3 , Christina Wang  4
Affiliations
Review

Continuing the search for a hormonal male contraceptive

Fiona Yuen et al. Best Pract Res Clin Obstet Gynaecol. 2020 Jul.

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.

Keywords: Acceptability; Androgens; Male contraception emerging market; Progestins; Spermatogenesis suppression.

PubMed Disclaimer

Conflict of interest statement

Declaration of Competing Interest The authors received support for clinical trials under the Contraceptive Clinical Trials Network, Eunice Shriver National Institute of Child Health and Human Development (HHSN275201300024I), National Institutes of Health, Bethesda, USA. Dr. Yuen is a recipient of a F32HD097932 fellowship award from Eunice Shriver National Institute of Child Health and Human Development.

Figures

Fig. 1.
Fig. 1.
This figure shows the hypothalamic-pituitary-testis axis. Spermatogenesis is dependent on the high testosterone concentration within the testis and FSH acting on the Sertoli cells to allow the completion of qualitatively and quantitatively normal spermatogenesis. Exogenous androgens and/or progestins or Gonadotropin-Releasing Hormone (GnRH) antagonists suppress the production of LH and FSH leading to low intratesticular testosterone and low Sertoli function resulting in the suppression of spermatogenesis. Androgen action in the men is sustained by the exogenously administered testosterone or another androgen. This is the basis of hormonal male contraception.
See this image and copyright information in PMC

References

    1. De Leo V, Musacchio MC, Cappelli V, Piomboni P, Morgante G. Hormonal contraceptives: pharmacology tailored to women’s health. Hum Reprod Update 2016;22(5):634–46. - PubMed
    1. Trussell J Contraceptive failure in the United States. Contraception 2011;83(5):397–404. - PMC - PubMed
    1. Ross J, Hardee K. Use of male methods of contraception worldwide. J Biosoc Sci 2017;49(5):648–63. - PubMed
    1. Ostrowski KA, Holt SK, Haynes B, Davies BJ, Fuchs EF, Walsh TJ. Evaluation of vasectomy trends in the United States. Urology 2018;118:76–9. - PubMed
    1. Herrel LA, Goodman M, Goldstein M, Hsiao W. Outcomes of microsurgical vasovasostomy for vasectomy reversal: a meta-analysis and systematic review. Urology 2015;85(4):819–25. - PubMed