Summary of the available and theoretical methods of male contraception
DOI: 10.22591/magyurol.2020.4.balloa.141
Author:
Balló András dr.
Pécsi Tudományegyetem KK, Urológiai Klinika,Pécs (igazgató: Szántó Árpád dr.)
Summary
Despite of available female contraceptive methods, unwanted pregnancy rate is still high, nearly 50%. The half of the men want to participate equally with their partner in family planning, but male contraceptive methods are used only 14% of those worldwide. There are not available pharmaceutical preparations. Currently two methods are available one of this is condom, which despite of the protection against sexually transmitted diseases has high failure rate, while the other option is vasectomy which is very effective but its reversibility is poor. Among the pharmaceutical preparations of contraception, men’s hormonal contraceptives are the closest to commercialization. Their effect based on the disruption of spermatogenesis, as exogenous androgen administration causes the hypothalamic-pituitary gonadal axis to be suppressed. The androgens such as monotherapy or in combination with progestin have been tested in clinical trials – achieving the efficacy of the female oral contraceptive pills – but due to their different individual efficacy and side effects, their usage has not spread. Non-hormonal contraceptive methods may be more specific, and their mechanism of action is based on selective inhibition of spermatogenesis, sperm transport, or fertilizing ability. Only a few of them have been tested in clinical trials most are still in preclinical development or have been abandoned due to its toxicity. Consequently, in the absence of reliable, safe and practical male contraception, women will continue to bear the most of the contraception burden.