[Male contraception]. / Contraception masculine.

CONTEXT: Contraception is a major global health issue, which is still dominated by female contraception. Developments in male contraception could help redistribute the contraceptive burden. METHODS: A literature search was carried out to review the existing options and the criteria for optimal contraception, to establish the principles of a male pre-contraception consultation, and to review the various research avenues with their advantages and disadvantages. RESULTS: The new male contraception options are detailed, whether hormonal (androgen therapy, combination of progestins and testosterone) or non-hormonal, particularly thermal, with current results and avenues for improvement. Condom use and vasectomy remain the only 2 validated options. The recent development of minimally invasive vasectomy without the need for a scalpel and of occlusion techniques has simplified the procedure, minimised the risk of complications (pain, haematomas, post-vasectomy pain syndrome) and improved efficacy. The issues of regret and the possibility of repermeabilisation are also raised. CONCLUSION: The question of male contraception will become increasingly important in consultations with urologists. The urologist will have to inform the patient, as required by law, before the vasectomy is performed, and provide the best possible advice on the technique, which will often be minimally invasive without the need for a scalpel. New reversible options should also broaden the range of options available on a routine basis, with a view to gradually moving towards contraceptive equity.

Men's willingness to use novel male contraception is linked to gender-equitable attitudes: Results from an exploratory online survey.

OBJECTIVES: To explore the association of men's willingness to use a novel male contraceptive with their attitudes toward gender equity. STUDY DESIGN: We conducted an anonymous online survey examining willingness to use male contraception among reproductive-age (18-50 years) cisgender men from the United States and Canada, recruited via online forums, social media ads, and male contraceptive mailing lists from April through July of 2022. We collected sociodemographics and reproductive histories and used a 20-item Gender-Equitable Men Scale to examine men's gender role attitudes. We conducted bivariate analyses to inform a multivariable logistic regression isolating the independent influence of increasingly gender-equitable attitudes on cis-men's willingness to use novel male contraceptives. RESULTS: We received 2066 surveys from primarily white (n = 1192; 58%), heterosexual (n = 1816; 88%), married cis-men (n = 1008; 49%), below age 30 (n = 1010; 49%), and who had not completed a bachelor's degree (n = 1173; 57%). The majority reported sex multiple times per week (n = 946; 46%), but had never gotten someone pregnant (n = 907; 44%); nearly half (n = 994; 48%) identified as parents. Three-quarters of respondents reported being willing to use novel male contraceptives (n = 1545; 75%); willingness was independently linked to having had an abortion (adjOR: 2.04; 95% CI: 1.37-3.02) and increasing total Gender-Equitable Men Scale scores (adjOR: 1.05; 95% CI: 1.02-1.08), even after controlling for age, race/ethnicity, and education. CONCLUSIONS: Three-quarters of cis-men surveyed reported willingness to use new male contraceptives, which was correlated with increasingly gender-equitable attitudes. IMPLICATIONS: As gender-equitable attitudes are linked to men's willingness to use novel male contraceptives, older population surveys may underestimate male contraceptive demand. Further, given the association of abortion experience with willingness to use novel male contraceptives, abortion-providing clinics may be considered for future dissemination of male contraceptives.

Catalyzing momentum in male contraceptive development†.

Globally, nearly half of all pregnancies are unplanned. Male contraceptives offer the potential to decrease unintended pregnancy and introduce contraceptive equity, but decades of research have yet to bring a novel product to market. New funding avenues from the philanthropic sector seek to stimulate research in male contraceptives through investments, grants, and support for trainees alongside other programs that encourage product development and ultimately commercialization. This Forum outlines the purpose of and funding opportunities provided by Male Contraceptive Initiative, a funding agency and non-profit focused on the advancement of non-hormonal, reversible contraceptive technologies for those who produce sperm.

Male Participation in Reproductive Health Interventions in Sub-Saharan Africa: A Scoping Review.

CONTEXT: Despite improvements in reproductive health indicators among women living in Sub-Saharan Africa, the persistence of poor outcomes underscores the need to examine recent interventions to inform future research, programming and policy. Because men in this context have an outsize role in reproductive decision making, assessing their involvement in reproductive health programs is an important step in meeting men's needs, supporting women's health and improving family health. METHODS: A scoping review was conducted to identify relevant literature and assess evidence of the impact of male involvement in reproductive health interventions. Seven databases were searched using terms related to male involvement and reproductive health; searches were limited to research conducted in Sub-Saharan Africa and published in English between 2007 and 2018. Remaining studies were assessed by participant characteristics, settings, research design, theoretical frameworks, outcome measures and findings. RESULTS: Searches identified 18 studies conducted in eight countries. Interventions engaged participants by using such strategies as community health workers, written invitation, peers, community or religious leaders and media campaigns. Results show that men are willing to participate in reproductive health programs and that their involvement is associated with increased uptake of family planning services, and HIV counseling and testing; reduction in risk behaviors; and improved maternal health and spousal communication. CONCLUSIONS: Given the findings that male involvement is positively associated with improved reproductive health outcomes in Sub-Saharan Africa, health providers and program planners should consider including men in reproductive health interventions, when feasible.

RESUMEN Contexto: A pesar de las mejoras observadas en los indicadores de salud reproductiva en las mujeres que viven en África subsahariana, la persistencia de malos resultados subraya la necesidad de examinar intervenciones recientes para sustentar futuras investigaciones, programas y políticas. Debido a que los hombres en este contexto tienen un papel enorme en la toma de decisiones reproductivas, evaluar su participación en los programas de salud reproductiva es un paso importante para responder a las necesidades de los hombres, apoyar la salud de las mujeres y mejorar la salud familiar. Métodos: Se realizó una revisión de alcance para identificar bibliografía relevante y evaluar la evidencia del impacto de la participación masculina en las intervenciones de salud reproductiva. Se realizaron búsquedas en siete bases de datos utilizando términos relacionados con la participación masculina y la salud reproductiva; las búsquedas se limitaron a investigaciones realizadas en África subsahariana y que fueron publicadas en inglés entre 2007 y 2018. Los estudios restantes se evaluaron según las características de los participantes, los entornos, el diseño de la investigación, los marcos teóricos, las medidas de resultado y los hallazgos. Resultados: Las búsquedas identificaron 18 estudios conducidos en ocho países. Las intervenciones involucraron a los participantes mediante estrategias tales como la labor de trabajadores de salud comunitarios, invitaciones por escrito, interacción con pares, líderes comunitarios o religiosos y campañas en los medios. Los resultados muestran que los hombres están dispuestos a participar en programas de salud reproductiva y que su participación está asociada con una mayor aceptación de los servicios de planificación familiar, así como de consejería y pruebas de VIH, reducción de comportamientos de riesgo, y mejor salud materna y comunicación conyugal. Conclusiones: Con base en los hallazgos que indican que la participación masculina se asocia positivamente con mejores resultados de salud reproductiva en el África subsahariana, los proveedores de servicios de salud y los planificadores de programas deberían considerar incluir a los hombres en las intervenciones de salud reproductiva cuando sea posible.

RÉSUMÉ Contexte: Malgré l'amélioration des indicateurs de santé reproductive chez les femmes d'Afrique subsaharienne, la persistance de résultats défavorables souligne la nécessité d'examiner les interventions récentes en vue d'éclairer la recherche, la programmation et les politiques futures. Étant donné, dans ce contexte, l'immense rôle des hommes dans les décisions ayant trait à la reproduction, l'évaluation de leur participation aux programmes de santé reproductive représente une étape importante en termes de réponse aux besoins des hommes, de soutien de la santé des femmes et d'amélioration de la santé des familles. Méthodes: Un examen de portée a été effectué pour identifier la littérature pertinente et évaluer les signes de l'impact de la participation masculine aux interventions de santé reproductive. La recherche a été menée dans sept bases de données au moyen de termes associés à la participation masculine et à la santé reproductive; elle s'est limitée aux études effectuées en Afrique subsaharienne et publiées en anglais entre 2007 et 2018. Les études restantes ont été évaluées d'après les caractéristiques des participants, les contextes, le plan de recherche, les cadres théoriques, les mesures de résultat et les observations. Résultats: La recherche a identifé 18 études menées dans huit pays. Les interventions engageaient les participants au moyen de stratégies recourant, notamment, aux agents de santé communautaire, aux invitations écrites, aux pairs, aux dirigeants communautaires ou religieux et aux campagnes médiatiques. Les résultats montrent que les hommes sont disposés à participer aux programmes de santé reproductive et que leur participation est associée à une adoption accrue des services de planification familiale et du conseil et dépistage du VIH, à la réduction des comportements à risques et à l'amélioration de la santé maternelle et de la communication au sein du couple. Conclusions: Face au constat de l'association positive entre la participation masculine et l'amélioration des résultats de santé reproductive en Afrique subsaharienne, il convient que les prestataires de santé et les planificateurs de programmes incluent si possible les hommes dans les interventions de santé reproductive.

Gender Differences in Sexual Behaviors in Korean Adolescents.

PURPOSE: The purposes of this study were to identify whether there are gender differences in sexual behaviors among Korean adolescents and to explore the factors that influence safe sex practices across both sexes. METHODS: A secondary analysis was conducted using nationally representative data obtained from the 2014 Youth Risk Behavior Web-based Survey. Sample consisted of 3,210 adolescents who had experience of sexual intercourse. The dependent variable in this study was practicing safe sex. The independent variables included a range of individual, family, and school factors. RESULTS: Female adolescents were less likely to practice safe sex (i.e., always using a condom). Individual (smoking, no drinking before sexual intercourse), family (living with parents, higher allowance per week) and school factors (non-coeducational school students, had received school-based sex education) were significant predictors of practicing safe sex in males. In contrast, family (lower economic status) and school factors (middle school students) predicted practicing safe sex among female adolescents. CONCLUSION: We demonstrated that gender plays an important role in the sexual behavior of adolescents. The findings of this study indicate a need to design and implement gender-specific interventions.

Assessment of spermicidal activity of the antimicrobial peptide sarcotoxin Pd: A potent contraceptive agent.

OBJECTIVES: In searching for new spermicidal microbicides for use in the prevention of unplanned pregnancy and sexually transmitted infections (STIs) we investigated the spermicidal and cytotoxicity activities of the antimicrobial peptide sarcotoxin Pd. METHODS: Washed sperm from 10 healthy, normal volunteers was treated with different concentrations of sarcotoxin Pd. Sperm motility and morphology were assessed at 0, 0.3, 5, 10 and 15 min. The cytotoxicity of sarcotoxin Pd in normal human cervical HeLa cells was measured. Percentage cell survival was expressed as the number of live cells in the test group. RESULTS: The cytotoxic effect of sarcotoxin Pd was concentration-dependent. Significant cytotoxicity was observed at concentrations above 24 µg/ml. Sarcotoxin Pd immobilised 100% of spermatozoa at a dose of 90 and 80 µg/ml after 0.3 and 5 min, respectively, and immobilised 50% of spermatozoa after 15 min at lower doses. Sarcotoxin Pd inhibited sperm motility in a dose-dependent manner. The peptide immobilised sperm within 20 s at its maximal effective concentration of 90 µg/ml. CONCLUSIONS: Sarcotoxin Pd appears to be a good candidate for a contraceptive agent in the prevention of unplanned pregnancy and STIs.

RISUG: an intravasal injectable male contraceptive.

Over the last two decades RISUG has been drawing attention in the field of male contraception. It promises to sterile men for a period of up to 10-15 years. According to recent studies in animal models, it proves to be completely reversible. Practically, there are no better options available that can assure complete sterility and precise reversibility. Regardless of so much of information available, RISUG is still holding up for many reasons, firstly, the available information engender bewilderment such as what is this copolymer, how does it work and is reversal really possible? Secondly, advancement of this outstanding invention is drastically slow and thirdly, effects of long-term contraception with RISUG and reports on evaluation of anomalies (if any) in F 1 , F 2 progenies, are lacking. In this review the lacunae as well as advances in the development of RISUG in the light of published work and available resources are pointed out. Formulation of the RISUG, its mode of action and clinical trials have been addressed with particular emphasis.

Demand for male contraception.

The biological basis for male contraception was established decades ago, but despite promising breakthroughs and the financial burden men increasingly bear due to better enforcement of child support policies, no viable alternative to the condom has been brought to market. Men who wish to control their fertility must rely on female compliance with contraceptives, barrier methods, vasectomy or abstinence. Over the last 10 years, the pharmaceutical industry has abandoned most of its investment in the field, leaving only nonprofit organisations and public entities pursuing male contraception. Leading explanations are uncertain forecasts of market demand pitted against the need for critical investments to demonstrate the safety of existing candidate products. This paper explores the developments and challenges in male contraception research. We produce preliminary estimates of potential market size for a safe and effective male contraceptive based on available data to estimate the potential market for a novel male method.

Assessment of tamsulosin as a potential male contraceptive in healthy volunteers.

OBJECTIVE: To investigate the efficacy and safety of tamsulosin, an α(1A)-adrenoceptor antagonist, as a potential male contraceptive. METHODS: Forty healthy male volunteers were equally divided into 2 groups, each of which received placebo and tamsulosin sequentially in a crossover manner. Ejaculatory profile was examined 4 to 6 hours after administration and adverse effects were noted. RESULTS: Anejaculation occurred in all subjects after taking 0.8-mg of tamsulosin. Total functional sperm count was significantly reduced in subjects after taking 0.4-mg of tamsulosin. Six subjects receiving 0.8-mg of tamsulosin complained of tolerated discomfort, which disappeared 10 hours after administration. CONCLUSION: When administered at 0.8 mg, tamsulosin can cause anejaculation with some transient side effects. Our results imply that tamsulosin and related drugs might potentially be used as male contraceptive agents in the future, which needs more studies to verify.

Determinants of the rate and extent of spermatogenic suppression during hormonal male contraception: an integrated analysis.

CONTEXT: Male hormonal contraceptive methods require effective suppression of sperm output. OBJECTIVE: The objective of the study was to define the covariables that influence the rate and extent of suppression of spermatogenesis to a level shown in previous World Health Organization-sponsored studies to be sufficient for contraceptive purposes (< or =1 million/ml). DESIGN: This was an integrated analysis of all published male hormonal contraceptive studies of at least 3 months' treatment duration. SETTING: Deidentified individual subject data were provided by investigators of 30 studies published between 1990 and 2006. PARTICIPANTS: A total of 1756 healthy men (by physical, blood, and semen exam) aged 18-51 yr of predominantly Caucasian (two thirds) or Asian (one third) descent were studied. This represents about 85% of all the published data. INTERVENTION(S): Men were treated with different preparations of testosterone, with or without various progestins. MAIN OUTCOME MEASURE: Semen analysis was the main measure. RESULTS: Progestin coadministration increased both the rate and extent of suppression. Caucasian men suppressed sperm output faster initially but ultimately to a less complete extent than did non-Caucasians. Younger age and lower initial blood testosterone or sperm concentration were also associated with faster suppression, but the independent effect sizes for age and baseline testicular function were relatively small. CONCLUSION: Male hormonal contraceptives can be practically applied to a wide range of men but require coadministration of an androgen with a second agent (i.e. progestin) for earlier and more complete suppression of sperm output. Whereas considerable progress has been made toward defining clinically effective combinations, further optimization of androgen-progestin treatment regimens is still required.

Synthesis and assessment of fertility-regulating potential of 2-(2''-chloroacetamidobenzyl)-3-(3'-indolyl) quinoline in adult rats as a male contraceptive agent.

BACKGROUND: The purpose of this study was to investigate the fertility-regulating potential of the compound 2-(2''-chloroacetamidobenzyl)-3-(3'-indolyl) quinoline in male rats. STUDY DESIGN: Rats of proven fertility were treated with the compound by oral gavage for 1 to 8 consecutive weeks. Functional fertility, testicular, epididymal and seminal vesicular weight, epididymal sperm count and spermatogenesis were quantitated. Reproductive hormones and some biochemical parameters were measured. RESULTS: Functional fertility was reduced significantly as revealed by a fall in fertility and pregnancy rate. The weight of the reproductive organs was reduced significantly. A reduction of sperm count and number of different types of testicular cells was observed. The treatment with the compound resulted in decline of testosterone and an increase of FSH hormone levels. The compound effectively reduced testicular protein, glycogen and epididymal glyceryl phosphorylcholine. Increase in testicular alkaline phosphatase and cholesterol was also observed. Fertility and other effects were regained gradually after cessation of treatment. CONCLUSION: The results revealed from the study indicate that the compound has reversible antifertility activity and can be explored as male contraceptive agent.