Division of Endocrinology, Department of Medicine, The Lundquist Institute at Harbor-UCLA Medical Center, Torrance, CA, 90509, USA.
Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90007, USA.
Best Pract Res Clin Obstet Gynaecol. 2020 Jul;66:83-94. doi: 10.1016/j.bpobgyn.2020.02.003. Epub 2020 Feb 19.
This chapter discusses the mechanisms of action of hormonal male contraception, which suppresses the hypothalamic-pituitary-testis axis. When the intratesticular concentration of testosterone is subsequently suppressed to adequately low concentrations, spermatogenesis is arrested. Androgens are a necessary hormonal male contraceptive component because they not only suppress the hypothalamic-pituitary-testis axis, but also provide the male hormone necessary to maintain peripheral androgen functions. Past studies using testosterone alone and testosterone combined with progestins demonstrated contraceptive efficacy in the female partner at rates similar to combined hormonal female methods. Newer hormonal male contraceptive formulations and the alternative routes of administration are discussed, along with potential barriers, challenges, and opportunities for hormonal male contraceptive development. Novel methods that are safe, effective, reversible, user-friendly, and coitus-independent are intrinsic to equitably meet the various needs and limitations of an increasingly diverse population.
本章讨论了激素男性避孕的作用机制，即抑制下丘脑-垂体-睾丸轴。当睾丸内的睾酮浓度随后被抑制到足够低的浓度时，精子发生就会停止。雄激素是一种必要的激素男性避孕药成分，因为它们不仅抑制下丘脑-垂体-睾丸轴，还提供维持外周雄激素功能所需的男性激素。过去使用单独的睾酮和睾酮与孕激素联合的研究表明，在女性伴侣中的避孕效果与联合激素女性方法相似。本文还讨论了新的激素男性避孕药配方和替代给药途径，以及激素男性避孕药开发的潜在障碍、挑战和机遇。安全、有效、可逆、易于使用且不依赖性交的新型方法对于公平满足日益多样化人群的各种需求和限制至关重要。
