The combined use of oral medroxyprogesterone acetate and methyltestosterone in a male contraceptive trial programme

Abstract

A male contraceptive trial was undertaken in 23 men using a combination of oral medroxyprogesterone acetate (MPA) and oral methyl-testosterone (MeT). The men were divided into four groups according to varying drug dosages and were followed for 15 months (control — 3 months, treatment — 6 months, follow-up — 6 months). The parameters assessed included sperm count and motility, serum gonadotropins and sex steroids, and several biochemical and hematological tests. A questionnaire dealing with side-effects and changes in sexual function was administered intermittently.Although sperm count was suppressed (most dramatically at the highest drug doses, MPA 20mg, MeT 20mg), it was not suppressed to infertile levels. Sperm motility was unaltered; LH was modestly suppressed, FSH was not suppressed; testosterone was suppressed even at low doses; dihydrotestosterone responses were inconsistent. No significant biochemical abnormalities or side-effects occurred although some men experienced mild transient acne, gynecomastia and decreased testicular size.We conclude that in the doses used in this trial, the combination of MPA and MeT is not effective for male contraceptive purposes and that higher doses may induce severe and undesirable side-effects.