Hormonal approaches to male contraception.
Hormonal approaches to male contraception.
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DOI：
10.1097/mou.0b013e32833f1b4a
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发表时间：
2010-11
影响因子：
2.5
通讯作者：
Swerdloff RS
中科院分区：
文献类型：
--
作者：
Wang C;Swerdloff RS
避孕和输精管结扎术是男性控制的计划生育方法，但在依从性（避孕套）和有限的可逆性（输精管结扎术）方面存在局限性;因此许多夫妇希望有其他选择。激素男性避孕方法已经在健康男性中进行了广泛的临床试验，并显示出有效，可逆和安全。单独使用注射睾酮的男性激素避孕的成功率很高，与女性避孕方法相当。在雄激素中加入孕激素可提高精子发生抑制率。在政府或非政府组织的支持下，目前的研究旨在找到睾酮和孕激素的最佳组合，以有效抑制精子发生，并探索这些激素的其他递送方法。要将这些进展转化为在发达国家的广泛使用，需要制药业的制造和营销技能。向发展中国家提供男性避孕药具可能需要政府和非政府机构作出承诺。在基本资源和人口需求明显不平衡的时候，这可能是一项非常明智的投资。男性激素避孕药对于处于稳定关系中的年轻男性目标人群是有效、可逆和安全的。精子发生的抑制是通过雄激素和睾丸激素的组合来实现的。与工业界的伙伴关系将加速男性荷尔蒙避孕药的销售。目前正在研究选择性雄激素和孕激素受体调节剂，以抑制精子发生，最大限度地减少潜在的不良事件，同时保留雄激素作用。
Condoms and vasectomy are male controlled family planning methods but suffer from limitations in compliance (condoms) and limited reversibility (vasectomy); thus many couples desire other options. Hormonal male contraceptive methods have undergone extensive clinical trials in healthy men and shown to be efficacious, reversible and appear to be safe. The success rate of male hormonal contraception using injectable testosterone alone is high and comparable to methods for women. Addition of progestins to androgens improved the rate of suppression of spermatogenesis. Supported by government or non-government organizations, current studies aim to find the best combination of testosterone and progestins for effective spermatogenesis suppression and to explore other delivery methods for these hormones. Translation of these advances to widespread use in the developed world will need the manufacturing and marketing skills of the pharmaceutical industry. Availability of male contraceptives to the developing world may require commitments of governmental and non-governmental agencies. In a time when imbalance of basic resources and population needs are obvious, this may prove to be a very wise investment. Male hormonal contraception is efficacious, reversible and safe for the target population of younger men in stable relationships. Suppression of spermatogenesis is achieved with a combination of an androgen and a progestin. Partnership with industry will accelerate the marketing of a male hormonal contraceptive. Research is ongoing on selective androgen and progesterone receptor modulators that suppress spermatogenesis, minimize potential adverse events while retaining the androgenic actions.