Journal of Andrology
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Published-Ahead-of-Print April 25, 2007, DOI:10.2164/jandrol.107.002683

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7{alpha}-methyl-19-nortestosterone (MENT) vs. testosterone in combination with etonogestrel implants for spermatogenic suppression in normal men

Melanie J Walton , Narender Kumar , David T Baird , Helen Ludow , and Richard A Anderson *

* To whom correspondence should be addressed. E-mail: r.a.anderson{at}hrsu.mrc.ac.uk.

Testosterone with a progestogen can suppress spermatogenesis for contraception. The synthetic androgen 7{alpha}-methyl-19-nortestosterone (MENT) may offer advantages as it is resistant to 5{alpha}-reduction and is therefore less active at the prostate. This study aimed to investigate MENT implants in combination with etonogestrel on spermatogenesis, gonadotropins, and androgen-dependent tissues in comparison with a testosterone/etonogestrel regimen. Normal men (n=29) were recruited and randomized to receive 2 etonogestrel implants with either 600mg testosterone pellets repeated every 12 wk or 2 MENT implants, for up to 48 wk. Testosterone concentrations in the testosterone group remained in the normal range. Subjects with 2 MENT implants showed peak MENT levels at 4 wk with testosterone concentrations 2nmol/L. Sperm concentrations fell rapidly to <1x106/ml at 12 wk in 8/10 subjects in the MENT group and 13/16 subjects in the testosterone group with equally suppressed gonadotropins. Thereafter suppression was not maintained in the MENT group and 6 men noted loss of libido. 14 men completed 48 wk of testosterone treatment and all became azoospermic. Hemoglobin concentrations rose and HDL-C fell in both groups. The MENT group showed a fall in PSA with no change in bone mass. MENT with a progestogen can achieve rapid suppression of spermatogenesis similar to testosterone but this promising result was not sustained due to a decline in MENT release from the implants. This dose of testosterone, compared to previous studies using a lower dose with a higher dose of etonogestrel, had non-reproductive side effects without any increase in spermatogenic suppression. These data indicate the importance of the doses of progestogen and testosterone for optimum spermatogenic suppression while minimising side effects.


Key words: Androgen • Contraception • Hormone • Prostate • Spermatogenesis






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