Male hormonal contraception: hope and promise

• Published in: The lancet. Diabetes & endocrinology Vol. 5; no. 3; pp. 214 - 223
• Main Authors: Piotrowska, Katarzyna, MD, Wang, Christina, MD, Swerdloff, Ronald S, MD, Liu, Peter Y, Dr
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.03.2017
• Subjects: Androgens - therapeutic use; Contraception - methods; Contraceptive Agents, Male - therapeutic use; Endocrinology & Metabolism; Female; Humans; Male; Other; Pregnancy; Pregnancy Outcome; Progestins - therapeutic use; Risk Factors
• ISSN: 2213-8587; 2213-8595
• DOI: 10.1016/S2213-8587(16)00034-6

Summary Family planning is a shared responsibility, but available male-directed contraceptive methods are either not easily reversible (vasectomy) or not sufficiently effective (condom). However, roughly 20% of couples using a contraceptive method worldwide, and up to 80% in some countries, still choose a male-directed method. Male hormonal contraception is highly effective, with perfect use failure rates of 0·6% (95% CI 0·3–1·1) if sperm concentrations of less than 1 million per mL are maintained. After cessation of male hormonal contraception, sperm output fully recovers in a predictable manner, resulting in pregnancies and livebirths. Spontaneous miscarriage and fetal malformation rates after recovery of sperm output overlap those in the general population. Short-term adverse events—acne, night sweats, increased weight, and altered mood and libido—are recognised, but are generally mild. Further optimisation of specific androgen-progestin regimens and phase 3 studies of lead combinations are still needed to successfully develop an approved male hormonal contraceptive and to identify long-term side-effects.