Latest Advances in Oral Hormonal Male Contraception: Efficacy, Mechanisms of Action, and Future Perspectives

Recent advances in oral hormonal male contraception focus on two agents, dimethandrolone undecanoate (DMAU) and 11β-methylnortestosterone dodecylcarbonate (11β-MNTDC), which suppress gonadotropin secretion and spermatogenesis by targeting the hypothalamic–pituitary–gonadal axis. Phase I and IIa trials indicate these agents effectively reduce hormone levels to contraceptive levels with favorable safety profiles and mild adverse effects, such as slight weight gain and minor libido changes. 11β-MNTDC is associated with milder adverse effects compared to DMAU. Further phase IIb and III trials are needed to confirm their long-term efficacy, reversibility, and safety, with the potential for these agents to become the first reversible oral hormonal male contraceptives.