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Use of testosterone alone as hormonal male contraceptive

Utilisation de la testostérone seule comme contraception masculine hormonale

Abstract

The world population continues to grow rapidly while resources for sustainable living dwindle and manmade ecological problems increase proportionally to the overpopulation. Family planning is required to reduce population growth in developing countries and to stabilize populations in developed countries. Contraception makes abortion superfluous and provides the key to family planning. Women increasingly demand that men share the burden and risks of contraception and — as opinion polls show — men would be willing to use contraceptives if they were available. Research has established the principle of hormonal male contraception based on suppression of gonadotropins and spermatogenesis. All hormonal male contraceptives use testosterone, but in East Asian men, testosterone alone can suppress spermatogenesis to a level compatible with contraceptive protection. In Caucasians additional agents are required of which progestins are favoured.

Résumé

La croissance de la population mondiale se poursuit rapidement alors que les ressources pour un développement durable s’amenuisent et que les problèmes écologiques issus de l’activité humaine augmentent proportionnellement à la surpopulation. Une planification familiale est nécessaire pour réduire la croissance de la population dans les pays en développement et pour stabiliser celle des pays développés. La contraception rend l’avortement superflu et fournit les clés d’une planification familiale. Les femmes demandent de plus en plus que les hommes partagent le poids et les risques de la contraception, et — comme le montrent les enquêtes d’opinion — les hommes seraient prêts à utiliser des contraceptifs s’ils étaient disponibles. La recherche a établi le principe d’une contraception masculine hormonale basée sur la suppression des gonadotrophines et de la spermatogenèse. Toute contraception masculine hormonale utilise la testostérone, mais la testostérone seule ne peut réduire la spermatogenèse à un niveau compatible avec une protection contraceptive que chez les hommes d’Extrême-Orient (Asie de l’Est). Chez les Caucasiens, des substances additionnelles sont nécessaires pour atteindre ce niveau, parmi lesquelles les progestatifs sont privilégiés.

References

  1. 1.

    Nieschlag E, Behre HM (2010) Approaches to hormonal male contraception. In: E Nieschlag, HM Behre, S Nieschlag (eds) Andrology: Male reproductive health and dysfunction. 3rd ed. Springer, Heidelberg, pp 577–588

    Google Scholar 

  2. 2.

    Srinath BR, Wickings EJ, Witting C, Nieschlag E (1983) Active immunization with follicle-stimulating hormone for fertility control: a four 1/2 year study in male rhesus monkeys. Fertil Steril 40:110–117

    PubMed  CAS  Google Scholar 

  3. 3.

    Mauss J, Börsch G, Richter E, Bormacher K (1974) Investigations on the use of testosterone oenanthate as a male contraceptive agent. Contraception 19:281–289

    Article  Google Scholar 

  4. 4.

    World Health Organization Task Force on Methods for the Regulation of Male Fertility (1990) Contraceptive efficacy of testosterone-induced azoospermia in normal men. Lancet 336:955–959

    Article  Google Scholar 

  5. 5.

    World Health Organization Task Force on Methods for the Regulation of Male Fertility (1996) Contraceptive efficacy of testosterone-induced azoospermia and oligospermia in normal men. Fertil Steril 65:821–829

    Google Scholar 

  6. 6.

    Waites GM (2003) Development of methods of male contraception: impact of the World Health Organization Task Force. Fertil Steril 80:1–15

    PubMed  Article  Google Scholar 

  7. 7.

    Behre HM, Nieschlag E (2012) Testosterone preparations for clinical use in males. In: Testosterone: Action. Deficiency, substitution (ed. E Nieschlag, HM Behre). 4th ed. Cambridge University, Cambridge, pp 309–335

    Google Scholar 

  8. 8.

    Behre HM, Baus S, Kliesch S, et al (1995) Potential of testosterone buciclate for male contraception: endocrine differences between responders and nonresponders. J Clin Endocr Metab 80:2394–2403

    PubMed  CAS  Google Scholar 

  9. 9.

    McLachlan RI, McDonald J, Rushford D, et al (2000) Efficacy and acceptability of testosterone implants, alone or in combination with a 5alpha-reductase inhibitor, for male contraception. Contraception 62:73–78

    PubMed  CAS  Article  Google Scholar 

  10. 10.

    Nieschlag E, Hoogen H, Bölk M, et al (1978) Clinical trial with testosterone undecanoate for male fertility control. Contraception 18:607–614

    PubMed  CAS  Article  Google Scholar 

  11. 11.

    Nieschlag E (2006) Testosterone treatment comes of age: new options for hypogonadal men. Clin Endocrinol 65:275–281

    CAS  Article  Google Scholar 

  12. 12.

    Zhang GY, Gu YQ, Wang XH, et al (1999) A clinical trial of injectable testosterone undecanoate as a potential male contraceptive in normal Chinese men. J Clin Endocrinol Metab 84:3642–3647

    PubMed  CAS  Google Scholar 

  13. 13.

    Gu YQ, Wang XH, Xu D, et al (2003) A multicenter contraceptive efficacy study of injectable testosterone undecanoate in healthy Chinese men. J Clin Endocrinol Metab 88:562–568

    PubMed  CAS  Article  Google Scholar 

  14. 14.

    Gu Y, Liang X, Wu W, et al (2009) Multicenter contraceptive efficacy trial of injectable testosterone undecanoate in Chinese men. J Clin Endocrinol Metab 94:1910–1915

    PubMed  CAS  Article  Google Scholar 

  15. 15.

    Zhang L, Shal IH, Liu Y, et al (2006) The acceptability of an injectable, once-a-month male contraceptive in China. Contraception 73:548–553

    PubMed  Article  Google Scholar 

  16. 16.

    Kamischke A, Plöger D, Venherm S, et al (2000) Intramuscular testosterone undecanoate with or without oral levonorgestrel: a randomized placebo-controlled feasibility study for male contraception. Clin Endocrinol 53:43–52

    CAS  Article  Google Scholar 

  17. 17.

    Qoubaitary A, Meriggiola C, Ng CM, et al (2006) Pharmacokinetics of testosterone undecanoate injected alone or in combination with norethisterone enanthate in healthy men. J Androl 27:853–867

    PubMed  CAS  Article  Google Scholar 

  18. 18.

    Nieschlag E, Vorona E, Wenk M, et al (2011) Hormonal male contraception in men with normal and subnormal semen parameters. Int J Androl 34:556–567

    PubMed  CAS  Article  Google Scholar 

  19. 19.

    Knuth UA, Behre H, Belkien L, et al (1985) Clinical trial of 19-nortestosterone-hexoxyphenylpropionate (Anadur) for male fertility regulation. Fertil Steril 44:814–821

    PubMed  CAS  Google Scholar 

  20. 20.

    von Eckardstein S, Noe G, Brache V, et al (2003) International Committee for Contraception Research, The Population Council. A clinical trial of 7 alpha-methyl-19-nortestosterone implants for possible use as a long-acting contraceptive for men. J Clin Endocrinol Metab 88:5232–5239

    Article  Google Scholar 

  21. 21.

    Liu PY, Swerdloff RS, Anawalt BD, et al (2008) Determinants of the rate and extent of spermatogenic suppression during hormonal male contraception: an integrated analysis. J Clin Endocrinol Metab 93:1774–1783

    PubMed  CAS  Article  Google Scholar 

  22. 22.

    Büchter D, von Eckardstein S, von Eckardstein A, et al (1999) Clinical trials of transdermal testosterone and oral levonorgestrel for male contraception. J Clin Endocrinol Metab 84:1244–1249

    PubMed  Google Scholar 

  23. 23.

    Soufir JC, Meduri G, Ziyyat A (2011) Spermatogenetic inhibition in men taking a combination of oral medroxyprogesterone acetate and percutaneous testosterone as a male contraceptive method. Hum Reprod 26:1708–1714

    PubMed  CAS  Article  Google Scholar 

  24. 24.

    Nieschlag E (2011) The struggle for male hormonal contraception. Best Pract Res Clin Endocrinol Metab 25:369–375

    PubMed  CAS  Article  Google Scholar 

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Correspondence to E. Nieschlag.

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Nieschlag, E. Use of testosterone alone as hormonal male contraceptive. Basic Clin. Androl. 22, 136–140 (2012). https://doi.org/10.1007/s12610-012-0187-y

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Keywords

  • World population
  • Family planning
  • Male contraception
  • Spermatogenesis suppression
  • Testosterone preparations
  • Synthetic androgens

Mots clés

  • Population mondiale
  • Planification familiale
  • Contraception masculine
  • Suppression de la spermatogenèse
  • Formes de testostérone
  • Androgènes de synthèse