CONTRACEPTIVES FOR MEN

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Dear members,GossypolGossypol is a chemical found in the seeds of cotton plants. Cotton plants produce gossypol in order to slow down the reproduction of the insects that eat cotton bolls and seeds; the compound also affects reproduction in mammals. Pressed cakes of cotton seeds, a byproduct of the cotton industry, are sometimes fed to livestock with unintentional contraceptive effects. The effect of gossypol on human male fertility has been known in China for many years. In 1929, a study of couples who used crude cottonseed oil for cooking showed that they had smaller than

average families. Specifically, researchers showed that the oil affected male fertility. Eventually researchers isolated the contraceptive compound gossypol from the cotton seed oil. This discovery led to large scale testing of gossypol as a male contraceptive in China during the 1970s. The studies involved over 8,000 men, and continued for over a decade. The researchers found that men taking a daily gossypol pill had reliable contraception and no complaints about change in libido. However, the studies revealed two serious flaws: disruption of potassium uptake and incomplete reversibility. Side effects :- - Abnormally high rate of hypokalemia among subjects, varying from 1-10%. Hypokalemia is usually the result of kidney malfunction, and can be caused

by excessive consumption of diuretics. Researchers do not understand exactly how gossypol affects the kidneys. Regardless of gossypol’s possible causal relationship with hypokalemia, researchers at the World Health Organization (WHO) have other concerns about side effects. Gossypol is a known toxin, and a toxic dose is less than 10 times the contraceptive dose. Some argue that this alone should disqualify it from further study. Reversibility:Lack of complete reversibility was the second major concern raised by the Chinese trials. Some men in those studies remained azoospermic after stopping treatment. The longer the men had taken the gossypol and the higher their overall dosage, the more likely they were to lose part or all of their fertility. Various studies

reported between 5 and 25 percent of the men remained infertile up to a year after stopping treatment. A long-term follow up study of men who had taken gossypol showed that 61% of the men regained normal fertility with "a median recovery time of 1.1 years" (Meng 1988). However, 22% remained azoospermic after 3 years. Present status of gossypol:In the late 1990s, the WHO's Research Group on Methods for the Regulation of Male Fertility reviewed the studies to date on gossypol and concluded that contraceptive research should be abandoned (Waites 1998). Some researchers have contested this, arguing that the data on hypokalemia were misinterpreted, and that diet and genetic predisposition are responsible for this side effect (Yu 1998). No one has contested the concerns over irreversibility, but

gossypol research has continued in China, Brazil, Kenya and Nigeria.  RegardsDr Sanjay Yallappa ChoudhariJR2,Dept of PharmacologyGMC, Nagpur RegardsDr Sanjay Yallappa ChoudhariJR2,Dept of PharmacologyGMC, Nagpur