Male hormonal contraception: a safe option?

Hormonal male contraception is based on the administration of testosterone alone or more likely with a progestogen. Testosterone has been used for several decades for the treatment of male hypogonadism, with an excellent safety record. Use as part of a contraceptive regimen by healthy people for prolonged periods will necessitate careful re-examination of safety issues. Although potential male contraceptive regimens have been investigated for many years, there have been mostly small-scale studies unable to assess safety. This is now changing, with larger studies of regimens underway. This, and the increasing involvement of the pharmaceutical industry, means that much more data will shortly be forthcoming and it is hoped that this will also provide valuable information relevant to normal male health. The main areas of interest are the cardiovascular system and the prostate, but bone health and body composition are also important, as are behavioral and psychologic aspects. The development of this field also allows the investigation of potential health benefits, which may be related to the use of synthetic androgens with tissue-selective metabolism or action.