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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone Basics & Questions
TRT used as birth control?
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<blockquote data-quote="madman" data-source="post: 274308" data-attributes="member: 13851"><p>Take home-point!</p><p></p><p><em><strong>*Testosterone is useful as a contraceptive in human males; however, a regimen with 100% effectiveness has remained elusive</strong></em><strong><em>.</em></strong></p><p><strong><em></em></strong></p><p><strong><em></em></strong></p><p><strong><em></em></strong></p><p><strong><em></em></strong></p><p><strong><em></em></strong></p><p><strong><em>*The second WHO study examined the fertility of both the men who became azoospermic and the men who achieved severe oligospermia on the TE regimen (World Health Organization, 1996).</em></strong><em> A total of 399 men were enrolled in this study. <strong>Of these, all but eight (2%) became severely oligospermic or azoospermic.</strong> <strong>In terms of fertility, there were no pregnancies fathered by the men who became azoospermic; in men whose sperm counts were suppressed to below 3 million per ml, fertility was reduced to 8.1 pregnancies per 100-person years. <u>The combined fertility rate for oligospermic and azoospermic men was 1.4 per 100-person years</u>. <u>Therefore, the overall failure rate (including the men who failed to suppress to oligospermia) was 3.4%, for an overall contraceptive efficacy of 96.6%</u>.</strong></em></p><p><strong></strong></p><p><strong><em>*</em><u><em>This research demonstrated that testosterone is safe, fully reversible, and effective as a contraceptive in the majority of men.</em></u><em> <u>Drawbacks to testosterone-alone methods are, however, apparent</u>. <u>While effective in those who achieve azoospermia, some men fail to suppress below 3 million sperm per ml and therefore presumably remain fertile</u>.</em></strong></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p>[URL unfurl="true"]https://www.excelmale.com/threads/women%E2%80%99s-birth-control-vs-trt-as-contraceptives-and-potential-infertility.25593/#post-227742[/URL]</p><p></p><p></p><p></p><p><strong>CONTRACEPTIVE TRIALS</strong></p><p><strong></strong></p><p><strong></strong></p><p><strong>Testosterone alone</strong></p><p></p><p><em>Testosterone given at slightly supraphysiological levels can suppress both FSH and LH production and simultaneously replace the androgen deficit caused by decreased LH levels. <strong>Low levels of LH also lead to decreases in intratesticular testosterone as the Leydig cell production of testosterone falls. This decrease in intratesticular testosterone is of crucial importance as normal local concentrations of testosterone and DHT are necessary for spermatogenesis (Morse et al, 1973).</strong></em></p><p><em></em></p><p><em>As early as the 1930s, the administration of testosterone was shown to suppress sperm counts (Heckel, 1939); however, <strong>the first systematic studies of testosterone as a contraceptive date from the 1970s. Several small studies were reported in 1977 (Steinberger and Smith, 1977a,b; Swerdloff et al, 1979) using TE alone given by intramuscular injection. In these trials of Caucasian men, more than half of the subjects were rendered azoospermic, and most of the others became severely oligospermic. As expected, the onset of azoospermia was at around 72 days, and the recovery of normal sperm counts occurred 3-4 months after testosterone was discontinued.</strong></em></p><p><em><strong></strong></em></p><p><em><strong>Based on these initial encouraging results, two large, multicentre trials of TE were conducted by the World Health Organization (WHO) (1990, 1996).</strong> The first study enrolled 271 subjects who were given weekly doses of 200 mg TE intramuscularly for a 6-month induction phase.<strong> Sixty-five percent of these men achieved azoospermia, and an additional 30% were rendered severely oligospermic.</strong> The fertility of the azoospermic men was then tested in a 12-month efficacy phase. <strong>Of the 119 couples who became azoospermic, continued the injections, and used no other form of birth control, only one pregnancy occurred. This pregnancy rate of 0.8 pregnancies per 100 person-years demonstrates that, in men rendered azoospermic, TE is an effective contraceptive.</strong> Patients discontinued involvement with the study mainly because of regimen failure and dislike of the injection schedule.</em></p><p><em></em></p><p><em><strong>The second WHO study examined the fertility of both the men who became azoospermic and the men who achieved severe oligospermia on the TE regimen (World Health Organization, 1996).</strong> A total of 399 men were enrolled in this study. <strong>Of these, all but eight (2%) became severely oligospermic or azoospermic.</strong> <strong>In terms of fertility, there were no pregnancies fathered by the men who became azoospermic; in men whose sperm counts were suppressed to below 3 million per ml, fertility was reduced to 8.1 pregnancies per 100-person years. <u>The combined fertility rate for oligospermic and azoospermic men was 1.4 per 100-person years</u>. <u>Therefore, the overall failure rate (including the men who failed to suppress to oligospermia) was 3.4%, for an overall contraceptive efficacy of 96.6%</u>.</strong></em></p><p><em><strong></strong></em></p><p><em><strong><u>This research demonstrated that testosterone is safe, fully reversible, and effective as a contraceptive in the majority of men.</u> <u>Drawbacks to testosterone-alone methods are, however, apparent</u>. <u>While effective in those who achieve azoospermia, some men fall to suppress below 3 million sperm per ml and therefore presumably remain fertile</u>. </strong>In addition, the necessity of weekly intramuscular injections is a deterrent. Twenty-five percent of patients in the second WHO study discontinued involvement for personal or medical reasons, or because of a dislike of the injection schedule. Last, high-dose testosterone has been shown to decrease serum high-density lipoprotein (HDL) cholesterol, which could contribute to accelerating atherosclerosis (Bagatell et al, 1994; Meriggiola et al, 1995). <strong>These failings have led to two additional avenues of research: (a) the addition of a second agent, either a GnRH analog or a progestin; </strong>and (b) attempts to improve the characteristics of testosterone administration.</em></p><p></p><p></p><p></p><p></p><p><strong>CONCLUSION</strong></p><p></p><p><em><strong><u>Testosterone is useful as a contraceptive in human males; however, a regimen with 100% effectiveness has remained elusive</u>. Combinations with GnRH antagonists improve the efficacy of testosterone but are presently impractical for widespread use. Testosterone combinations with progestins appear promising. Ongoing trials with testosterone plus LNG and CPA may offer a usable option for men, but difficulties in testosterone delivery may hinder their use. Recent insights into the molecular regulation of transcription by estrogen receptors may point to the existence of similar complexity in the androgen receptor and may provide new avenues for the generation of a male hormonally derived contraceptive. A better understanding of the molecular regulation of spermatogenesis will clearly increase the chances of successfully manipulating these systems to create an easily usable, long-term contraceptive for men, and something, finally, to complement the success of the estrogen-progestin pill for women.</strong></em></p></blockquote><p></p>
[QUOTE="madman, post: 274308, member: 13851"] Take home-point! [I][B]*Testosterone is useful as a contraceptive in human males; however, a regimen with 100% effectiveness has remained elusive[/B][/I][B][I]. *The second WHO study examined the fertility of both the men who became azoospermic and the men who achieved severe oligospermia on the TE regimen (World Health Organization, 1996).[/I][/B][I] A total of 399 men were enrolled in this study. [B]Of these, all but eight (2%) became severely oligospermic or azoospermic.[/B] [B]In terms of fertility, there were no pregnancies fathered by the men who became azoospermic; in men whose sperm counts were suppressed to below 3 million per ml, fertility was reduced to 8.1 pregnancies per 100-person years. [U]The combined fertility rate for oligospermic and azoospermic men was 1.4 per 100-person years[/U]. [U]Therefore, the overall failure rate (including the men who failed to suppress to oligospermia) was 3.4%, for an overall contraceptive efficacy of 96.6%[/U].[/B][/I] [B] [I]*[/I][U][I]This research demonstrated that testosterone is safe, fully reversible, and effective as a contraceptive in the majority of men.[/I][/U][I] [U]Drawbacks to testosterone-alone methods are, however, apparent[/U]. [U]While effective in those who achieve azoospermia, some men fail to suppress below 3 million sperm per ml and therefore presumably remain fertile[/U].[/I][/B] [URL unfurl="true"]https://www.excelmale.com/threads/women%E2%80%99s-birth-control-vs-trt-as-contraceptives-and-potential-infertility.25593/#post-227742[/URL] [B]CONTRACEPTIVE TRIALS Testosterone alone[/B] [I]Testosterone given at slightly supraphysiological levels can suppress both FSH and LH production and simultaneously replace the androgen deficit caused by decreased LH levels. [B]Low levels of LH also lead to decreases in intratesticular testosterone as the Leydig cell production of testosterone falls. This decrease in intratesticular testosterone is of crucial importance as normal local concentrations of testosterone and DHT are necessary for spermatogenesis (Morse et al, 1973).[/B] As early as the 1930s, the administration of testosterone was shown to suppress sperm counts (Heckel, 1939); however, [B]the first systematic studies of testosterone as a contraceptive date from the 1970s. Several small studies were reported in 1977 (Steinberger and Smith, 1977a,b; Swerdloff et al, 1979) using TE alone given by intramuscular injection. In these trials of Caucasian men, more than half of the subjects were rendered azoospermic, and most of the others became severely oligospermic. As expected, the onset of azoospermia was at around 72 days, and the recovery of normal sperm counts occurred 3-4 months after testosterone was discontinued. Based on these initial encouraging results, two large, multicentre trials of TE were conducted by the World Health Organization (WHO) (1990, 1996).[/B] The first study enrolled 271 subjects who were given weekly doses of 200 mg TE intramuscularly for a 6-month induction phase.[B] Sixty-five percent of these men achieved azoospermia, and an additional 30% were rendered severely oligospermic.[/B] The fertility of the azoospermic men was then tested in a 12-month efficacy phase. [B]Of the 119 couples who became azoospermic, continued the injections, and used no other form of birth control, only one pregnancy occurred. This pregnancy rate of 0.8 pregnancies per 100 person-years demonstrates that, in men rendered azoospermic, TE is an effective contraceptive.[/B] Patients discontinued involvement with the study mainly because of regimen failure and dislike of the injection schedule. [B]The second WHO study examined the fertility of both the men who became azoospermic and the men who achieved severe oligospermia on the TE regimen (World Health Organization, 1996).[/B] A total of 399 men were enrolled in this study. [B]Of these, all but eight (2%) became severely oligospermic or azoospermic.[/B] [B]In terms of fertility, there were no pregnancies fathered by the men who became azoospermic; in men whose sperm counts were suppressed to below 3 million per ml, fertility was reduced to 8.1 pregnancies per 100-person years. [U]The combined fertility rate for oligospermic and azoospermic men was 1.4 per 100-person years[/U]. [U]Therefore, the overall failure rate (including the men who failed to suppress to oligospermia) was 3.4%, for an overall contraceptive efficacy of 96.6%[/U]. [U]This research demonstrated that testosterone is safe, fully reversible, and effective as a contraceptive in the majority of men.[/U] [U]Drawbacks to testosterone-alone methods are, however, apparent[/U]. [U]While effective in those who achieve azoospermia, some men fall to suppress below 3 million sperm per ml and therefore presumably remain fertile[/U]. [/B]In addition, the necessity of weekly intramuscular injections is a deterrent. Twenty-five percent of patients in the second WHO study discontinued involvement for personal or medical reasons, or because of a dislike of the injection schedule. Last, high-dose testosterone has been shown to decrease serum high-density lipoprotein (HDL) cholesterol, which could contribute to accelerating atherosclerosis (Bagatell et al, 1994; Meriggiola et al, 1995). [B]These failings have led to two additional avenues of research: (a) the addition of a second agent, either a GnRH analog or a progestin; [/B]and (b) attempts to improve the characteristics of testosterone administration.[/I] [B]CONCLUSION[/B] [I][B][U]Testosterone is useful as a contraceptive in human males; however, a regimen with 100% effectiveness has remained elusive[/U]. Combinations with GnRH antagonists improve the efficacy of testosterone but are presently impractical for widespread use. Testosterone combinations with progestins appear promising. Ongoing trials with testosterone plus LNG and CPA may offer a usable option for men, but difficulties in testosterone delivery may hinder their use. Recent insights into the molecular regulation of transcription by estrogen receptors may point to the existence of similar complexity in the androgen receptor and may provide new avenues for the generation of a male hormonally derived contraceptive. A better understanding of the molecular regulation of spermatogenesis will clearly increase the chances of successfully manipulating these systems to create an easily usable, long-term contraceptive for men, and something, finally, to complement the success of the estrogen-progestin pill for women.[/B][/I] [/QUOTE]
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Testosterone Replacement, Low T, HCG, & Beyond
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TRT used as birth control?
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