Zusammenfassung
Das Prinzip der hormonellen Kontrazeption beim Mann bedingt die möglichst komplette Suppression der Gonadotropine LH (luteinisierendes Hormon) und FSH (follikelstimulierendes Hormon), um ein Erliegen der Spermatogenese und damit eine Azoospermie zu erzielen. Simultan wird das zur Kontrazeption eingesetzte Testosteron exogen ersetzt. Jedoch nur in Kombination mit einem Gestagen (Injektion oder Implantat) ist die vollständige Gonadotropinsuppression erreichbar. Da die Hemmung der Gonadotropinsezernierung sehr gleichmäßige Serumspiegel der zugesetzten Sexualsteroide verlangt, waren bisherige Versuche mit oralen oder transdermalen Präparaten nicht so erfolgreich, als dass zur Zeit die Kontrazeption beim Mann in Form einer Pille bestehen könnte. Injektionskombinationen sind jedoch in weit fortgeschrittener klinischer Erprobung.
Abstract
The current status of hormonal contraception in men involves the principle of suppression of gonadotropins, LH, and FSH. This must be achieved as completely as possible to facilitate cessation of spermatogenesis and, thus, reach azoospermia. Simultaneously testosterone has to be replaced. Exogenous testosterone administration achieves the goal of gonadotropin suppression, but needs in addition the supplementation of a gestagen to fully suppress secretion of LH and FSH. Suppression of gonadotropins by steroids requires constant serum concentrations of sex steroids; hence, attempts using daily oral or transdermal preparations were, so far, unsuccessful. Thus, the immediate prospect for male contraception is not a“pill” itself but a regimen of combined injectable steroids, which are in advanced clinical testing.
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Zitzmann, M. Hormonelle Kontrazeption beim Mann: noch immer aktuell. Urologe 49, 16–19 (2010). https://doi.org/10.1007/s00120-009-2193-z
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DOI: https://doi.org/10.1007/s00120-009-2193-z