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Novel male hormonal contraceptive combinations: the hormonal and spermatogenic effects of testosterone and levonorgestrel combined with a 5alpha-reductase inhibitor or gonadotropin-releasing hormone antagonist

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dc.contributor.author McLachlan, Robert I. en_US
dc.contributor.author Bremner, William J. en_US
dc.contributor.author Amory, John K. en_US
dc.contributor.author Matthiesson, Kati L. en_US
dc.contributor.author Ugoni, Antony en_US
dc.contributor.author Berger, Richard E. en_US
dc.date.accessioned 2008-10-17T20:44:05Z
dc.date.available 2008-10-17T20:44:05Z
dc.date.issued 2005-01 en_US
dc.identifier.citation J Clin Endocrinol Metab. 2005 Jan;90(1):91-7. Epub 2004 Oct 27 en_US
dc.identifier.uri http://hdl.handle.net/1773/4501
dc.description.abstract We postulated that the addition of a combined types I and II, 5alpha-reductase inhibitor (dutasteride) or long-acting GnRH antagonist (acyline) to combination testosterone plus levonorgestrel treatment may be advantageous in the suppression of spermatogenesis for male contraception. This study aimed to examine effects of novel combination contraceptive regimens on serum gonadotropins and androgens and sperm concentration.This study was divided into three phases: screening (2 wk), treatment (8 wk), and recovery (4 wk). Twenty-two men (n = 5-6/group) received 8 wk of treatment with testosterone enanthate (TE, 100 mg im weekly) combined with one of the following: 1) levonorgestrel (LNG) 125 mug orally daily; 2) LNG 125 microg plus dutasteride 0.5 mg orally daily; 3) acyline 300 microg/kg sc every 2 wk (as a comparator for any additional progestin effects); or 4) LNG 125 microg orally daily plus acyline 300 microg/kg sc every 2 wk.Serum gonadotropin levels were similarly suppressed by all treatments, falling to a nadir between 1.2 and 3.4% and 0.5 and 0.8% baseline for FSH and LH, respectively (P < 0.05). Serum dihydrotestosterone levels were significantly (P < 0.05) decreased in the dutasteride group throughout the treatment period to a nadir of 31% baseline (wk 7). No significant differences in sperm concentrations among treatment groups were seen. Severe oligospermia (0.1-3 million/ml) or azoospermia was seen in none of five and four of five in TE + LNG; two of six and four of six in TE + LNG + dutasteride; two of six and four of six in TE + acyline; and one of five and three of five in TE + LNG + acyline groups, respectively. There was one nonresponder in each of the TE + LNG and TE + LNG + acyline groups.We conclude that the addition of a combined types I and II, 5alpha-reductase inhibitor or long-acting GnRH antagonist to a testosterone plus LNG regimen provides no additional suppression of gonadotropins or sperm concentration over an 8-wk treatment period. However, further evaluation of the effects of these regimens on the testis (including testicular steroid levels and germ cell maturation) and the treatment of larger numbers of men (and for longer periods) may provide data to support their place in contraceptive development. en_US
dc.language.iso en_US en_US
dc.publisher Endocrine Society en_US
dc.subject male contraception en_US
dc.subject andrology en_US
dc.subject 5-alpha reductase inhibitors en_US
dc.subject gonadotropins en_US
dc.subject testosterone en_US
dc.subject.mesh Spermatogenesis, drug effects en_US
dc.subject.mesh Cholestenone 5 alpha-Reductase, antagonists & inhibitors en_US
dc.subject.mesh Sex Hormone-Binding Globulin, analysis en_US
dc.subject.mesh Gonadorelin, antagonists & inhibitors en_US
dc.subject.mesh Research Support, U.S. Gov't, P.H.S. en_US
dc.subject.mesh Levonorgestrel, administration & dosage en_US
dc.subject.mesh adult en_US
dc.subject.mesh Humans en_US
dc.subject.mesh Contraceptive Agents, Male, pharmacology en_US
dc.subject.mesh Prospective Studies en_US
dc.subject.mesh Research Support, Non-U.S. Gov't en_US
dc.subject.mesh Male en_US
dc.subject.mesh Middle Aged en_US
dc.subject.mesh Sperm Count en_US
dc.subject.mesh Luteinizing Hormone, blood en_US
dc.subject.mesh Testosterone, administration & dosage, blood en_US
dc.title Novel male hormonal contraceptive combinations: the hormonal and spermatogenic effects of testosterone and levonorgestrel combined with a 5alpha-reductase inhibitor or gonadotropin-releasing hormone antagonist en_US
dc.type Article en_US


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