Abstract | BACKGROUND:
Male hormonal contraception has been an elusive goal. Administration of sex steroids to men can shut off sperm production through effects on the pituitary and hypothalamus. However, this approach also decreases production of testosterone, so "add-back" therapy is needed. OBJECTIVES: SEARCH STRATEGY: We searched the computerized databases Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, Popline, and LILACS (each from inception to February, 2003) for randomized controlled trials of hormonal contraception in men. We wrote to authors of identified trials to seek unpublished or published trials that we might have missed. SELECTION CRITERIA: We included all randomized controlled trials in any language that compared a steroid hormone with another contraceptive. We excluded non-steroidal male contraceptives, such as gossypol. We included both placebo and active-regimen control groups. All trials identified included only healthy men with normal semen analyses. DATA COLLECTION AND ANALYSIS:
Azoospermia (absence of spermatozoa on semen examination) was the primary outcome measure. Data were insufficient to examine pregnancy rates and side effects. MAIN RESULTS: REVIEWERS' CONCLUSIONS: No male hormonal contraceptive is ready for clinical use. All trials published to date have been small exploratory studies. As a result, their power to detect important differences has been limited and their results imprecise. In addition, the definition of oligospermia has been imprecise or inconsistent in many reports. To avoid bias, future trials need more attention to the methodological requirements for randomized controlled trials. Trials with adequate power would also be helpful.
|
Authors | D Grimes, M Gallo, V Grigorieva, K Nanda, K Schulz |
Journal | The Cochrane database of systematic reviews
(Cochrane Database Syst Rev)
Issue 3
Pg. CD004316
( 2004)
ISSN: 1469-493X [Electronic] England |
PMID | 15266528
(Publication Type: Journal Article, Review, Systematic Review)
|
Chemical References |
- Contraceptive Agents, Male
- Contraceptives, Oral, Hormonal
- Contraceptives, Oral, Synthetic
- Drug Implants
- Testosterone
- Levonorgestrel
- testosterone enanthate
|
Topics |
- Contraception
(methods)
- Contraceptive Agents, Male
(therapeutic use)
- Contraceptives, Oral, Hormonal
(therapeutic use)
- Contraceptives, Oral, Synthetic
(therapeutic use)
- Drug Implants
- Humans
- Levonorgestrel
(therapeutic use)
- Male
- Oligospermia
(chemically induced)
- Randomized Controlled Trials as Topic
- Testosterone
(analogs & derivatives, therapeutic use)
|