Development of new hormonal male contraception for the couple

Abstract

AbstractBackgroundCurrent options for male contraception are limited to condoms, the withdrawal method, or a vasectomy. Studies indicate that men have expressed growing interest in bearing responsibility for family planning.ObjectivesTo review prior studies investigating the role of an androgen‐only or androgen with progestin regimen for hormonal male contraception and to provide an update of a promising new hormonal agent, a transdermal gel.DiscussionThus far, there have been six studies conducted in couples evaluating the contraceptive efficacy of an androgen‐only or androgen co‐administered with a progestin regimen for hormonal male contraception. The only ongoing study is by the National Institute of Child Health and Human Development, in collaboration with the Population Council. They have developed a novel transdermal gel containing testosterone and segesterone acetate (Nestorone), a progestin. An ongoing phase II study enrolling more than 460 couples has shown great potential with respect to the product's efficacy, safety, reversibility, and acceptability. As this agent advances in development, a rapid at‐home test for sperm concentration will provide couples with immediate feedback regarding their potential for pregnancy.ConclusionThere is promise for the first‐of‐its‐kind hormonal male contraceptive, a transdermal gel, to achieve market approval for distribution in the United States and elsewhere. Its safety, efficacy, reversibility, and user‐control are all appealing qualities that make it readily adoptable for clinical practice.