Progress towards a male pill.

In order to determine the demand for hormonal male contraceptive agents a survey was undertaken of the attitudes of 450 men in four centers of a Contraceptive Development Network: Edinburgh Scotland; Cape Town South Africa; Hong Kong; and Shanghai China. In Edinburgh and Cape Town 66-68% of the men indicated that they would definitely or probably use a male daily pill but this percentage dropped to 48-50% in Hong Kong and Shanghai. Except in Cape Town there was little support for a monthly injection and the idea of implants was universally unpopular. To determine the attitudes of women about a male contraceptive pill a survey was made of over 400 women attending family planning clinics in Edinburgh and Shanghai. In each case most of the women were positive about the possibility and indicated that they would adopt such a method. There was also almost universal agreement that women bear too much of the responsibility for contraception. Currently one of the greatest challenges facing development of an acceptable male hormonal contraceptive is discovering a satisfactory formulation to replace testosterone at physiological doses while inhibiting sperm production. Two World Health Organization trials have revealed that incomplete suppression of spermatogenesis remains a problem and research is focusing on development of a long-lasting testosterone injection with administration of an oral gestagen. Development of a safe and reliable male oral contraceptive may require another 5-10 years.