Combined Nestorone–testosterone gel suppresses serum gonadotropins to concentrations associated with effective hormonal contraception in men

Document Type

Article (peer-reviewed)

Publication Date



Background: Novel male‐based contraceptives are needed to broaden family planning choices. A progestin, Nestorone® (Nes) gel, plus a testosterone (T) gel suppresses sperm concentrations to levels associated with effective contraception in normal men. However, administration of two gels on different parts of the body daily is impractical. Objective: Compare the effectiveness of daily application of a single, combined 8.3 mg Nes‐62.5 mg T gel (Nes‐T) vs. 62.7 mg T gel to suppress serum FSH and LH concentrations to ≤1.0 IU/L (a threshold associated with suppression of sperm concentrations to ≤1 million and effective contraception) and to compare the pharmacokinetics of serum Nes and T concentrations between the gel groups. Design: We conducted a 28‐day, double‐blind, controlled trial of 44 healthy men randomized to daily Nes‐T or T gel with measurement of hormones at baseline, treatment, and recovery and during 24‐h pharmacokinetic studies on days 1 and 28 of treatment. Results: Of the subjects who met pre‐defined inclusion criteria, 84% of the Nes‐T group suppressed serum gonadotropin concentrations to ≤ 1.0 IU/L at days 21–28 vs. 16.7% in the T group (p < 0.001). On day 1, Nes concentrations rose significantly above baseline by 2 h and continued to rise up to 24 h after Nes‐T gel application. Nes concentrations were not detectable in the T group. Serum total T concentrations rose and were significantly higher in the T gel group compared to the Nes‐T group at 24 h on day 1 and days 11, 14, and 21 (p < 0.01). There were no serious adverse events in either group. About 80% of the subjects reported satisfaction with both gels. Conclusion: Daily Nes‐T gel effectively and safely suppresses serum gonadotropins and is acceptable to most men. It should be studied further in efficacy trials of hormonal male contraception.






Nestorone®/Testosterone Transdermal Gel for Male Contraception