Steroid hormones for contraception in men.

[crowman]

Abstract
BACKGROUND:

Male hormonal contraception has been an elusive goal. Administration of sex steroids to men can shut off sperm production through effects on the pituitary and hypothalamus. However, this approach also decreases production of testosterone, so 'add-back' therapy is needed.
OBJECTIVES:

To summarize all randomized controlled trials (RCTs) of male hormonal contraception.
SEARCH METHODS:

In January and February 2012, we searched the computerized databases CENTRAL, MEDLINE, POPLINE, and LILACS. We also searched for recent trials in ClinicalTrials.gov and ICTRP. Previous searches included EMBASE. We wrote to authors of identified trials to seek additional unpublished or published trials.
SELECTION CRITERIA:

We included all RCTs that compared a steroid hormone with another contraceptive. We excluded non-steroidal male contraceptives, such as gossypol. We included both placebo and active-regimen control groups.
DATA COLLECTION AND ANALYSIS:

The primary outcome measure was the absence of spermatozoa on semen examination, often called azoospermia. Data were insufficient to examine pregnancy rates and side effects.
MAIN RESULTS:

We found 33 trials that met our inclusion criteria. The proportion of men who reportedly achieved azoospermia or had no detectable sperm varied widely. A few important differences emerged. 1) Levonorgestrel implants (160 μg daily) combined with injectable testosterone enanthate (TE) were more effective than levonorgestrel 125 µg daily combined with testosterone patches. 2) Levonorgestrel 500 μg daily improved the effectiveness of TE 100 mg injected weekly. 3) Levonorgestrel 250 μg daily improved the effectiveness of testosterone undecanoate (TU) 1000 mg injection plus TU 500 mg injected at 6 and 12 weeks. 4) Desogestrel 150 μg was less effective than desogestrel 300 μg (with testosterone pellets). 5) TU 500 mg was less likely to produce azoospermia than TU 1000 mg (with levonorgestrel implants). 6) Norethisterone enanthate 200 mg with TU 1000 mg led to more azoospermia when given every 8 weeks versus 12 weeks. 7) Four implants of 7-alpha-methyl-19-nortestosterone (MENT) were more effective than two MENT implants. We did not conduct any meta-analysis due to intervention differences.Several trials showed promising efficacy in percentages with azoospermia. Three examined desogestrel and testosterone preparations or etonogestrel and testosterone, and two examined levonorgestrel and testosterone.
AUTHORS' CONCLUSIONS:

No male hormonal contraceptive is ready for clinical use. Most trials were small exploratory studies. Their power to detect important differences was limited and their results imprecise. In addition, assessment of azoospermia can vary by sensitivity of the method used. Future trials need more attention to the methodological requirements for RCTs. More trials with adequate power would also be helpful.

 

[whowhatwhenwhere]

Why do you think it is that we have not pursued this further? Seems like there would be more guys out there who want to have the option.

 

[crowman]

Why do you think it is that we have not pursued this further? Seems like there would be more guys out there who want to have the option.

Honestly, im not sure. I do know a long time ago in Australia they were giving men Low dose Deca as a form of male birth control or to at least cut back on the sperm count and likely hood of pregnancy. I would say one part is none of the hormones im aware of completely kill sperm count. I have had plenty of friends on HRT impregnate the wifey whether they were trying to or not. Another reason is if both you and i took the same med we would still have different sprerm count totals due to a different genetic background so saying "Test ENT" is going to cut the chance of pregnancy by x % is very hard. Now, I can say not near enough time and money has been dumped into the study of this like you originally questioned. I really dont have an answer for you. Im going to ask one of my Physicians and see if he knows.

 

[BLTC]

In situ this type of BC doesn't work. I know a bunch of guys that fathered children jacked to the gills on test and other compounds.

 

[whowhatwhenwhere]

Both of my daughters were conceived on a TRT dose.....although it was 100's of fires before they landed so I def get that point. But I would think they would be able to create the right dose to kill your sperm or something to that effect. BUT then I would think you would need to kickstart it back somehow

 

[crowman]

I just text one Dr. his response was male BC is only about 70% effective where as female is about 99.5% effective. Hmm if we figure out how to crush production we could become rich. No one wants a vasectomy, it just sounds scary lol.

 

[graniteman]

I leave it to the woman! lol

 

[Lizard King]

I leave it to the woman! lol

Aim for the face. Crow hit on it, so many different variables.

 

[JackD]

LOL...Nice LK

Seriously, when it comes to male Birth control, the only option is not an option any of the DR's want to dose out. But they include Testosterone replacement, and then a low dosage progesterone pill on top of that which should kill the little sperms.

Now the reason why woman can still get pregnant is because even though a guy is shooting testosterone, that level does nothing to shut down sperms, and don't quote me, but I believe testosterone is also needed in a way to help produce sperm. And since the body hormone system acts like your household thermostat, that even when it reads a healthy level of testosterone, ans shuts down testosterone production, it might not read a healthy level for sperm production, and need to send out some FSH which produces the little swimmers.

So the idea was by adding in pure progesterone would be enough to turn off the feedback loop. Example would be turning your furnace on in the summer, since the temperature is above where it would kick on, there is no need for they system to run, hence is the same idea for the body and sperm production.