1. Combined transdermal testosterone gel and the progestin nestorone suppresses serum gonadotropins in men.
- Author
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Mahabadi V, Amory JK, Swerdloff RS, Bremner WJ, Page ST, Sitruk-Ware R, Christensen PD, Kumar N, Tsong YY, Blithe D, and Wang C
- Subjects
- Administration, Cutaneous, Adolescent, Adult, Contraception adverse effects, Contraceptive Agents, Male administration & dosage, Contraceptive Agents, Male adverse effects, Contraceptive Agents, Male pharmacology, Down-Regulation drug effects, Drug Combinations, Gels administration & dosage, Gels adverse effects, Gels pharmacology, Humans, Male, Middle Aged, Norprogesterones administration & dosage, Norprogesterones adverse effects, Progesterone Congeners administration & dosage, Progesterone Congeners adverse effects, Progesterone Congeners pharmacology, Sex Hormone-Binding Globulin analysis, Testosterone administration & dosage, Testosterone adverse effects, Young Adult, Contraception methods, Gonadotropins blood, Norprogesterones pharmacology, Testosterone pharmacology
- Abstract
Context: Testosterone (T) plus progestin combinations are the most promising hormonal male contraceptives. Nestorone (NES), a progestin without estrogenic or androgenic activity, when combined with T may be an excellent candidate for male contraception., Objective: Our objective was to determine the effect of transdermal NES gel alone or with T gel on gonadotropin suppression., Design and Setting: The randomized, unblinded clinical trial was conducted at two academic medical centers., Participants: A total of 140 healthy male volunteers participated., Interventions: One hundred subjects were randomized initially (20 per group) to apply NES gel 2 or 4 mg, T gel 10 g, or T gel 10 g plus NES gel 2 or 4 mg daily for 20 d. Because only about half of the subjects in T plus NES 4 mg group suppressed serum gonadotropins to 0.5 IU/liter or less (suboptimal suppression), two additional groups of 20 men were randomized to apply daily T gel 10 g plus NES gel 6 or 8 mg., Main Outcome Variable: Suppression of serum LH and FSH concentrations to 0.5 IU/liter or less after treatment was the main outcome variable., Results: A total of 119 subjects were compliant with gel applications with few study-related adverse events. NES alone reduced gonadotropins significantly but less than T gel alone. Combined T gel 10g plus NES gel 6 or 8 mg suppressed both serum gonadotropins to 0.5 IU/liter or less in significantly more men than either gel alone., Conclusion: Transdermal NES gel alone had gonadotropin suppression activity. Combined transdermal NES (6 or 8 mg) plus T gel demonstrated safe and effective suppression of gonadotropins, justifying a longer-term study of this combination for suppression of spermatogenesis.
- Published
- 2009
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