Division of Endocrinology, Department of Medicine, Harbor-UCLA Medical Center and Los Angeles Biomedical Research Institute (LA BioMed) Torrance, CA, USA.
Division of Endocrinology, Department of Medicine, Harbor-UCLA Medical Center and Los Angeles Biomedical Research Institute (LA BioMed) Torrance, CA, USA.
Lancet Diabetes Endocrinol. 2017 Mar;5(3):214-223. doi: 10.1016/S2213-8587(16)00034-6. Epub 2016 Feb 23.
Family planning is a shared responsibility, but available male-directed contraceptive methods are either not easily reversible (vasectomy) or not sufficiently effective (condom). However, roughly 20% of couples using a contraceptive method worldwide, and up to 80% in some countries, still choose a male-directed method. Male hormonal contraception is highly effective, with perfect use failure rates of 0·6% (95% CI 0·3-1·1) if sperm concentrations of less than 1 million per mL are maintained. After cessation of male hormonal contraception, sperm output fully recovers in a predictable manner, resulting in pregnancies and livebirths. Spontaneous miscarriage and fetal malformation rates after recovery of sperm output overlap those in the general population. Short-term adverse events-acne, night sweats, increased weight, and altered mood and libido-are recognised, but are generally mild. Further optimisation of specific androgen-progestin regimens and phase 3 studies of lead combinations are still needed to successfully develop an approved male hormonal contraceptive and to identify long-term side-effects.
计划生育是共同的责任，但现有的男性节育方法要么不易逆转（输精管切除术），要么效果不够理想（避孕套）。然而，全球大约 20%的夫妇在使用避孕方法，在某些国家甚至高达 80%，仍然选择男性主导的方法。男性荷尔蒙避孕法非常有效，如果精子浓度保持在每毫升少于 100 万，其完美使用失败率为 0.6%（95%CI 0.3-1.1）。停止男性荷尔蒙避孕后，精子的产量会以可预测的方式完全恢复，从而导致怀孕和活产。精子产量恢复后的自然流产和胎儿畸形率与一般人群重叠。人们认识到短期不良反应（痤疮、夜间出汗、体重增加以及情绪和性欲改变），但通常是轻微的。进一步优化特定的雄激素-孕激素方案和主要组合的 3 期研究仍然需要成功开发出一种经过批准的男性荷尔蒙避孕药，并确定长期副作用。
