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    Only 'Wonder Man' Can Resist Male Contraceptive Shots


    "Adverse effects are inherent to these compounds, but they were not really serious," Nieschlag asserts. "There was some increase in body weight, and some complained of nightly sweating, but this was a dose question. We think in later studies we can adjust the dose on an individual basis to minimize these effects."

    Ronald S. Swerdloff, MD, is the chief of the division of endocrinology at Harbor-UCLA Medical Center, director of a World Health Organization collaborative center in reproduction, and director of a Mellon Foundation center for contraceptive development. He agrees with Nieschlag's assessment of the "wonder man."

    "In all forms of medication there are people that don't respond -- that usually is of concern, but none of the available contraceptives for men or women are universally effective," Swerdloff tells WebMD. "There will be a failure rate with any form of contraception. In developed countries, the ability to check sperm counts is desired until we get a better understanding about the percentage of men that might be failures. Most studies suggest that the [effectiveness] of this type of approach may be better than any currently available male contraceptive methods."

    The $64,000 question, of course, is whether men will use such a product.

    "We think it will be acceptable," Swerdloff says. He breaks the question of acceptability into three parts.

    Will men be willing to participate in the family-planning process? "All surveys done to date have suggested yes, but most of the approaches to hormonal male contraception are designed for men in stable relationships rather than multipartner males," Swerdloff notes.

    Will women trust men to use contraception when they say they do? "The focus on male-directed contraception without a clear-cut indicator of effective compliance means that the groups that will be using this will probably be stable couples where men and women trust each other for every aspect of their relationship," Swerdloff says.

    What delivery system will be most appealing? Different formulations of male contraceptives are being studied. These include so-called depot injections that slowly seep into the bloodstream, patches, and implants. "These things are not so clear," Swerdloff notes. "Long-acting depot injections have great appeal where compliance is a concern. It is not selected in general as the most favored way of taking medications. But in a situation where this is chronic use without a disease state, the depot preparations in many people's minds are highly desirable. Ultimately there will be several types of formulations that will come to market: some depot or implantable, some more traditional oral or [patch] types of approaches."

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