Male hormonal contraceptives: a potentially patentable and profitable product

Abstract

Although women have traditionally shouldered the responsibility of contraception, up to one-third of couples worldwide employ a male form of contraception (e.g., vasectomy or condoms). Vasectomy should be considered irreversible and long-term use of condoms is associated with a relatively high failure rate (pregnancy). Because many women are unable to use hormonal contraception and men want more contraceptive options, there is a need for a safe, effective, reversible and well-tolerated male hormonal contraceptive agent. Two large multicentre, multinational trials sponsored by the World Health Organization in the 1990s showed that high-dosage exogenous testosterone provided contraceptive efficacy similar to currently available female oral contraceptives. However, the supraphysiological dosages of testosterone used resulted in androgen-related adverse effects such as weight gain and suppression of high-density lipoprotein cholesterol levels. Subsequent efforts have been directed at combining testosterone with other agents, such as progestogens or gonadotropin-releasing hormone analogues, to decrease the dosage of testosterone (and thus androgen-related side effects) whilst achieving uniform azoospermia. In this article, the latest developments in male hormonal contraception supporting the feasibility of such an agent will be reviewed and suggestions for future directions of research and development will be offered.

Keywords::

• androgen
• gonadotropin-releasing hormone analogue
• gonadotropins
• male contraception
• progestogen
• spermatogenesis
• testosterone