Is there already a safe, effective, reversible male hormonal contraceptive available?


Context: Hormonal male contraceptive regimens effectively andreversibly suppress sperm production, but there are few large-scaleefficacy studies.

Objective: The safety, contraceptive efficacy, reversibility,and feasibility of injectable testosterone undecanoate (TU)in tea seed oil as a hormonal male contraceptive was assessed.

Design: This was a multicenter, phase III, contraceptive efficacyclinical trial.

Participants: A total of 1045 healthy fertile Chinese men wererecruited throughout China into the study.

Intervention(s): Injections of 500 mg TU were administered monthly for 30 months. A definition of severe oligozoospermia (1 x 106/ml)was used as a criterion of spermatogenic suppression and asthe threshold for entering the contraceptive efficacy phase.

Main Outcome Measure(s): The primary outcome was pregnancy ratein the partner. Other outcomes include: semen parameters, testisvolumes, reproductive hormone levels, and safety laboratorytests.

Results: Forty-three participants (4.8%) did not achieve azoospermiaor severe oligozoospermia within the 6-month suppression phase.A total of 855 participants entered into the efficacy phase,and 733 participants completed monthly TU treatment and follow-up.There were nine pregnancies in 1554.1 person-years of exposurein the 24-month efficacy phase for a cumulative contraceptivefailure rate of 1.1 per 100 men. The combined method failurerate was 6.1%, comprising 4.8% with inadequate suppression and1.3% with postsuppression sperm rebound. No serious adverseevents were reported. Spermatogenesis returned to the normalfertile reference range in all but two participants.

Conclusions: Monthly injection of 500 mg TU provides safe, effective, reversible, and reliable contraception in a high proportion of healthy fertile Chinese men.

Source: “Multicenter Contraceptive Efficacy Trial of Injectable Testosterone Undecanoate in Chinese Men” from The Journal of Clinical Endocrinology & Metabolism Vol. 94, No. 6 1910-1915

So why isn’t it available? Three reasons:

1) It’s by injection, not a pill, so that makes it a lot less palatable to the average consumer.

2) It’s not patentable, so drug companies have zero incentive to promote it.

3) It’s testosterone. Yeah, “steroids.” So it’s a marketing nightmare if not a downright legal problem because you’ve just gone from prescription drug to a scheduled drug (steroids are controlled more tightly than “Roofies” – the “date rape” drug and are only one step down from cocaine, opium and methamphetamine.)

As seen in the study, it’s totally safe and 500mg a month isn’t going to make anyone buff and turn them into this guy. However, asking your doctor for it might get you the same reaction as asking him to prescribe you heroin.

There’s one solid takeaway from this study: Ladies, if you want to have sex with guys who are in great shape and you don’t want to get pregnant, date guys who cheat at sports.

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