Androgens and male contraception

Purpose of reviewAt present, family planning still caters for a predominantly female clientele. The major reason for that is the shortcoming of currently available male contraceptives. Most recent clinical trials demonstrate that hormonal contraception may be feasible for men too. This chapter will discuss the efforts performed over the past decades to develop a male hormonal contraceptive analogous to the hormonal methods so successful in women, focusing in particular on the developments carried out in the last few years. Recent findingsLong-acting androgen–progestin regimens seem to be the best available choice to induce profound and reversible suppression of spermatogenesis in Caucasian men. Although more sensitive to the steroid suppressive effects on spermatogenesis, Chinese men may also benefit by the addition of a progestin to testosterone to obtain a regimen that provides optimal contraceptive protection. Larger efficacy studies are warranted to prove the efficacy and safety of these regimens. Recent surveys suggest that potential acceptability of new male hormonal contraceptives is high among both men and women. SummaryRecent studies have demonstrated that androgen–progestin regimens may represent optimal regimens for contraception in men. Effectiveness and safety of these regimens will have to be proved in large-scale, long-term trials that are currently being planned.