Division of Metabolism, Endocrinology and Nutrition, University of Washington, Seattle, WA, USA.
Division of Metabolism, Endocrinology and Nutrition, University of Washington, Seattle, WA, USA.
Pharmacol Ther. 2016 Jul;163:109-17. doi: 10.1016/j.pharmthera.2016.03.012. Epub 2016 Mar 22.
World population continues to grow at an unprecedented rate, doubling in a mere 50years to surpass the 7-billion milestone in 2011. This steep population growth exerts enormous pressure on the global environment. Despite the availability of numerous contraceptive choices for women, approximately half of all pregnancies are unintended and at least half of those are unwanted. Such statistics suggest that there is still a gap in contraceptive options for couples, particularly effective reversible contraceptives for men, who have few contraceptive choices. Male hormonal contraception has been an active area of research for almost 50years. The fundamental concept involves the use of exogenous hormones to suppress endogenous production of gonadotropins, testosterone, and downstream spermatogenesis. Testosterone-alone regimens are effective in many men but high dosing requirements and sub-optimal gonadotropin suppression in 10-30% of men limit their use. A number of novel combinations of testosterone and progestins have been shown to be more efficacious but still require further refinement in delivery systems and a clearer understanding of the potential short- and long-term side effects. Recently, synthetic androgens with both androgenic and progestogenic activity have been developed. These agents have the potential to be single-agent male hormonal contraceptives. Early studies of these compounds are encouraging and there is reason for optimism that these may provide safe, reversible, and reliable contraception for men in the near future.
世界人口继续以空前的速度增长，仅在 50 年内就翻了一番，于 2011 年超过了 70 亿的里程碑。这种急剧的人口增长给全球环境带来了巨大的压力。尽管女性有许多避孕选择，但大约一半的怀孕是意外的，至少有一半是不想要的。这些统计数据表明，夫妻之间的避孕选择仍然存在差距，特别是对于男性来说，他们的避孕选择很少，而有效的可逆避孕方法则更少。男性荷尔蒙避孕已经是近 50 年来研究的一个活跃领域。其基本概念涉及使用外源性激素来抑制内源性促性腺激素、睾丸激素和下游精子发生的产生。单独使用睾丸激素在许多男性中是有效的，但 10-30%的男性需要高剂量的用药，并且促性腺激素抑制效果不佳，限制了其使用。已经证明一些新型的睾丸激素和孕激素组合更有效，但仍需要在给药系统方面进一步改进，并更清楚地了解潜在的短期和长期副作用。最近，具有雄激素和孕激素活性的合成雄激素已经被开发出来。这些药物有可能成为单一药物男性荷尔蒙避孕药。这些化合物的早期研究令人鼓舞，有理由乐观地认为，这些药物可能在不久的将来为男性提供安全、可逆和可靠的避孕方法。
