These tools will no longer be maintained as of December 31, 2024. Archived website can be found here. PubMed4Hh GitHub repository can be found here. Contact NLM Customer Service if you have questions.


Pubmed for Handhelds

PUBMED FOR HANDHELDS

Search MEDLINE/PubMed

  • Title: Hormonal male contraception: progress and prospects for the 21st century.
    Author: Handelsman DJ.
    Journal: Aust N Z J Med; 1995 Dec; 25(6):808-16. PubMed ID: 8770357.
    Abstract:
    During the second half of the 20th 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 dur to the financial deterrent posed by the product liability crisis as well as the low priority accorded male reproductive health. Together those 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. In 1993, 12 international public sector agencies, including the International Women's Health Coalition, identified the development of reliable and reversible male contraceptive methods as a top priority at the Mexico City International Symposium "Contraceptive Research and Development for the Year 2000 and Beyond." Even though such methods do not yet exist, men worldwide are willing to share burdens as well as benefits of effective family planning and to increase their share of responsibility, but their greater participation depends on more reliable and attractive reversible male contraceptive alternatives. Two landmark World Health Organization male contraceptive efficacy studies found that a prototype androgen-alone regimen can induce azoospermia and oligospermia to levels that provide effective, reliable, and reversible contraception with acceptable levels of minor side effects. The focus must be on developing second-generation contraceptive methods that improve suppression of spermatogenesis and are convenient. Androgens alone as well as combination regimens with progestins or gonadotropin-releasing hormone antagonists appear to form the basis of reliable and reversible male contraceptives. In China and Indonesia, existing, affordable, non-optimized contraceptive prototypes have already achieved acceptable levels of contraceptive efficacy and safety. They are not entirely convenient, however. The answer to the question on whether or not improved male contraceptives will reach the wider market depends largely on political factors, specifically funding of research and development in male contraception and taking actions to stop exploitation of product liability laws. Developing countries may need to lead the way, since there is an urgency to provide a wider range of attractive family planning options. They can introduce the first practical hormonal male contraceptive regimens.
    [Abstract] [Full Text] [Related] [New Search]