Male hormonal contraception

Czech version

Authors: I. Poršová-Dutoit
Authors‘ workplace: Šilinkův nadační fond, Praha, ředitel prof. MUDr. RNDr. Luboslav Stárka, DrSc.
Published in: Vnitř Lék 2006; 52(11): 1077-1084
Category: Review

Overview

Human reproduction is a complex phenomenon remaining at the center of interest of many medical and extra-medical disciplines and the search for new contraceptive methods is an important part of its research effort. The developement of effective forms of male hormonal contraception (MHC) is one of the priorities of World Health Organisation (WHO Task Force on Methods of Regulation of Male Fertility). The principle of MHC consists in the supression of spermatogenesis, conserving, at the same time, all others aspects of male glands function (especially preservation of sexual functions, bone metabolism and lean muscle mass). To stop spermatogenesis is possible by blocking gonadotrophines, FSH a LH, secretion, by testosterone administration (isolated or in combination with other hormones). The variants of MHC, existing in the present time, are based on testosterone application (which has in the same time the role of substitutive treatment - the so-called androgen „add-back“) either in monotherapy (oral, intramuscular, transdermal and subcutaneous form) or in combination with various progestins (levonorgestrel, norethisterone, desogestrel, etonogestrel, medroxyprogesterone), antiandrogens or GnRH analogues. The most promising, at the present, seems to be the methods using combination of depot testosterone preparations with long-acting progestins. To what extent will be the role of MHC important in the future, it will be only possible to judge after establishing their sufficiently efficace, fully reversible, safe, acceptably applying and financially accessible forms in clinical practice.

Key words:
male hormonal contraception - testosterone - spermatogenesis - progestins

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