The most common male contraception is the condom but due to misuse or to the minimizing effect of pleasure many couples use non-reliable methods, which can lead to unplanned pregnancies. A male hormonal contraception can reduce the rate of unplanned pregnancies if it is effective, safe and reversible. The aim of this study is to spread knowledge about the male hormonal contraception and to reduce fear for the men of this new agent. Many men are skeptical to put hormones into their bodies, and that is why this study is necessary. Which agent is the most effective, safe and reversible? Four agents were evaluated and compared. Testosterone enanthate, testosterone undecanoate, testosterone + nestorone, and dimethandrolone undecanoate were evaluated based on available data from the literature. To estimate the effectiveness of male contraceptives the proportion of the subjects in the studies that reached no sperm in the semen (azoospermia) was measured. To consider safety issues, multiple side effects were taken into account including acne, weight gain, total cholesterol, hematocrit and sexual impact. Of the subjects that were assigned to receive testosterone enanthate 61% reached azoospermia. Two studies were performed with testosterone undecanoate, therein 98% and 89% reached azoospermia, respectively. Similar efficacy was shown for testosterone + nestorone. The first study 89% reached azoospermia and the second one it was not determined. No individual reached azoospermia with dimethandrolone undecanoate. None of the agents gave serious adverse events and overall, the side effects were similar in type and proportion between the agents. The study populations and method of delivery differed in the various studies considered here. Testosterone enanthate was given intramuscular as well as testosterone undecanoate. The combination of testosterone + nestorone was given transdermally and dimethandrolone undecanoate orally. Oral administration is preferred due to easy delivery, but it did not show effectiveness on suppressing the spermatogenesis. The studies on testosterone undecanoate had the biggest populations with 294 and 329 subjects respectively. This makes these studies more reliable. Too few became azoospermic with testosterone enanthate and the study only contained 40 subjects. This together with the delivery way does not support the use of this formulation as a male contraceptive. Testosterone undecanoate and testosterone + nestorone have the most potential of a male hormonal contraception due to their high percentage of azoospermic subjects and reasonable doses. However, the testosterone + nestorone have a better accepted delivery way that makes it more useful than with testosterone undecanoate even though fewer participants became azoospermic when using this combination.
| Identifer | oai:union.ndltd.org:UPSALLA1/oai:DiVA.org:lnu-112783 |
| Date | January 2022 |
| Creators | Viktorsson, Hannah |
| Publisher | Linnéuniversitetet, Institutionen för kemi och biomedicin (KOB) |
| Source Sets | DiVA Archive at Upsalla University |
| Language | English |
| Detected Language | English |
| Type | Student thesis, info:eu-repo/semantics/bachelorThesis, text |
| Format | application/pdf |
| Rights | info:eu-repo/semantics/openAccess |
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