Update on Male Hormonal Contraception: Is the Vasectomy in Jeopardy?

GJ Manetti and SC Honig

Disclosures

Int J Impot Res. 2010;22(3):159-170. 

In This Article

Testosterone and Progestins

Progestins have been used in multiple small studies of men for suppression of spermatogenesis and testosterone production. Progestins used alone result in significant side effects such as loss of libido and erectile dysfunction. The mechanism of action of progestins is thought to be either negative feedback on the pituitary–gonadal axis, inhibition of LH receptor expression or direct effects on sperm.[56,57] Progestins alone cannot suppress spermatogenesis in dosages tolerable for administration and without significant side effects. However, by combining lower doses of progestins with testosterone supplementation to restore exogenous testosterone, safety and efficacy may be improved and side effects lessened.

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