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  • Title: Use of low-dosage oral cyproterone acetate as a male contraceptive.
    Author: Wang C, Yeung KK.
    Journal: Contraception; 1980 Mar; 21(3):245-72. PubMed ID: 6771091.
    Abstract:
    To ascertain the effects of low-dosage cyproterone acetate (CPA) on the reproductive and endocrine functions of normal men, 25 volunteers were given CPA 0, 5 or 10 mg daily over 16 weeks, preceded by 12 weeks pretreatment observation and followed by 24 weeks posttreatment follow-up. CPA caused a decrease in sperm concentration, percentage motility, proportion of normal sperm and ability of the sperm to penetrate a column of cervical mucus in most patients. In addition, circulating testosterone, estradiol, LH and FSH levels were significantly reduced during treatment. All these changes reverted to the pretreatment level upon drug withdrawal. These findings suggest that firstly, although low dosage CPA was able to induce changes in seminal analyses, azoospermia was present in only one out of 15 subjects exposed to the drug. Secondly, the marked decrease in androgen levels associated with CPA treatment renders CPA unsuitable as a single entity agent for long-term male contraception. The effects of 5 and 10 mg cyproterone acetate (CPA) dose, vs. the effects of placebo, on the normal endocrine and reproductive functions of men were studied. 25 normal, healthy males, aged 20-51 years, were recruited from the Family Planning clinic of Hong Kong. 8 received 10 mg of CPA/day; 7 received 5 mg of CPA/day; and the 3rd group (n=10) received placebo. After exposure to 5 mg of CPA/day, 5 of 7 men showed lowered sperm counts, falling from pretreatment values of 98.1 +/- 74.6 million-29.6 +/- 19.8 million. In the 10- mg group, again mean sperm count was significantly lowered (P .01 vs. pretreatment). This effect was first observed at about 8 weeks of drug exposure and was maximal at 16 weeks. Sperm motility also decreased dramatically at both dosage levels (to below 40% motility). A decrease in oval sperm forms and increases in head and tail irregularities marked the CPA effect on sperm morphology. Sperm became unable to penetrate a column of cervical mucus. Circulating levels of follicle stimulating hormone, luteinizing hormone, estradiol, and testosterone were significantly reduced (p .05) throughtout treatment. It is concluded that the marked decrease in androgen levels renders this unsuitable therapy for long-term male contraception.
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