Approaches to Hormonal Male Contraception
Of all the different experimental approaches and pharmacological methods tested so far for male contraception, hormonal methods come closest to fulfilling the criteria set out above (see Chap. 27). The endocrine feedback mechanism operating between hypoth
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29
Eberhard Nieschlag and Hermann M. Behre
Contents 29.1
Principle of Hormonal Male Contraception....... 577
29.2
Androgens Alone ................................................... 578 29.2.1 29.2.2 29.2.3 29.2.4 29.2.5 29.2.6
29.3
581
GnRH Agonists ....................................... 581 GnRH Antagonists .................................. 581
Androgens Plus Gestagens ................................... 582 29.4.1 29.4.2 29.4.3 29.4.4 29.4.5
29.5
578 579 579 581 581
Androgens Combined with GnRH Analogues ... 581 29.3.1 29.3.2
29.4
Testosterone Enanthate ........................... Testosterone Buciclate ............................ Testosterone Undecanoate ...................... Testosterone Pellets................................. 19-Nortestosterone .................................. 7α-Methyl-19-Nortestosterone (MENT) ..................................................
Depot Medoxyprogesterone Acetate (DMPA)................................................... Levonorgestrel ........................................ Norethisterone......................................... Cyproterone Acetate ............................... Desogestrel and Etonogestrel .................
583 583 583 583 584
Résumé and Outlook ............................................ 584
References ........................................................................... 585
E. Nieschlag () Centre of Reproductive Medicine and Andrology of the University of Münster, D-48149 Münster, Germany, e-mail: [email protected]
29.1 Principle of Hormonal Male Contraception Of all the different experimental approaches and pharmacological methods tested so far for male contraception, hormonal methods come closest to fulfilling the criteria set out above (see Chap. 27). The endocrine feedback mechanism operating between hypothalamus, pituitary and testes is the basis on which hormonal approaches to male contraception rest. Its goal is to suppress spermatogenesis and to reduce sperm concentration, if possible to azoospermia or at least to a sperm concentration low enough to provide contraceptive protection (
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