First off, this thread seems to bring out the most "reddit-like" posts on HN. If you've come here to shoot a funny one-liner comment, please reconsider - the point is discussion, not karma farming.
Now, on the topic itself - I really wonder about the safety profile of these. While this selectively inhibits only RARα and is thus "biased" towards mostly acting on testes, it could also have side-effects - and while the effect might not be pronounced yet, with long term use it definitely could be, especially if all the RARα receptors get inhibited (will beta and gamma pick up the slack? what is it going to cause?).
Considering the 99% effectiveness claim and the method of action, I wonder if the embryos in that 1% case can even survive.
1) Long-term effects are surely a topic but as with female birth control and the risks connected to it, as well as female-male couples where the female has an incompatibility with birth control, the male partners might take the risk of using it
2) Does it matter if the embryo will survive even in the 1% case? Somebody who uses birth control would not want a child anyway, right?
2) but it can still be very traumatic. Miscarriages are traumatic. Getting abortions is traumatic.
And many people are opposed to abortion for moral reasons.
As they have the right to…for themselves.
Yes, and this is why the fact that hormonal birth control can be abortifacient is often downplayed, hidden, or denied.
Many things in life are traumatic. Me leaving the Catholic church was traumatic for my parents. My years-long girlfriend cheating on me was traumatic for me.
Does trauma for the 1% outweigh the benefits of the 99%?
Did I say that it does? The post above mine asked if it mattered. It matters, but it is one factor among many that goes into family planning or sexual relationships.
https://news.ycombinator.com/newsguidelines.html
Let dang do his job
I was curious about the mechanism.
https://www.nature.com/articles/s43856-025-00752-7
> YCT-529 works by interfering with vitamin A signaling necessary for sperm production and fertility.
> The importance of dietary vitamin A and retinoid signaling for male germ cell development and differentiation has been recognized for many years6. All trans-retinoic acid (Fig. 1a) is an active metabolite of vitamin A that exerts its function, at least partly, by binding to retinoic acid receptors (RARs). The RARs α, β, and γ, are encoded by the Rara, Rarb, and Rarg genes in mice, and Rarα and Rarγ have been validated as contraceptive targets by genetic knockouts resulting in male sterility7,8. Notably, the effects on spermatogenesis in the absence of RARα most resemble the loss of RAR signaling in vitamin A deficiency, and the mice are otherwise normal7,8. Further, the effects on spermatogenesis in animals treated orally with the dual RARα/RARγ antagonist BMS-189453 (Fig. 1a, b) closely phenocopied the absence of RARα function. Importantly, the resulting male sterility is reversible9,10,11. We, therefore, wished to identify RARα−selective inhibitors for potential male non-hormonal contraception. Our study describes the development of YCT-529, a highly selective RARα antagonist that reduces sperm counts in mice and non-human primates. Mating studies with male mice treated with 10 mg/kg/day for 4 weeks show that YCT-529 is 99% effective in preventing pregnancies and that the mice fully regain fertility after drug cessation.
We had alpha-blockers for a long time now, which prevents ejaculation but not orgasm; read: it can completely block the emission phase of ejaculation, while orgasmic function is retained.
Example: Silodosin.
You need to experiment with it. Sensitive clinical trials measured rates as high as 90-99%.
It is entirely non-hormonal. It does not affect libido (rarely), while hormonal male contraceptives do, and it is reversible upon cessation, without any delay, unlike hormonal male contraceptives.
Closer to 90%, and generally the side effects are a bit annoying too. Circulatory ones. Sometimes even to floppy. (Like 1% dosage dependent)
Plus the thing does not stop the drip so you do have to pull out sooner rather than later or else. It does not stop sperm production.
Also dry ones tend to result. They're sometimes uncomfortable.
Tamsulosin is I believe the modern one but all of them are for long term. Probably least side effects.
Otherwise if taken as a single dose fresh, side effects like orthostatic hypotension are vastly increased.
Circulatory side effects like dizziness or orthostatic hypotension do occur, though they tend to be mild and dose-dependent.
You're right that it doesn't stop sperm production, just emission. As for "the drip"; that's pre-ejaculate, which doesn't contain sperm inherently, but can pick up residual sperm in the urethra from a prior ejaculation.
And that's true, anejaculatory orgasms can feel strange or less satisfying for some, but it is not universal.
> Otherwise if taken as a single dose fresh, side effects like orthostatic hypotension are vastly increased.
That is true.
Edit: I / We will have to research the side-effect profile and mechanisms of the mentioned pill (in the submission). I have not yet done so. They mention no side-effects but it might be too early to tell.
> You're right that it doesn't stop sperm production, just emission. As for "the drip"; that's pre-ejaculate, which doesn't contain sperm inherently, but can pick up residual sperm in the urethra from a prior ejaculation.
I’d like to stress that point a bit.
I had a vasectomy about a year ago, and being the weirdo that I am, I figured I’d see how much sperm remained in my ejaculate (and for how long) after the procedure.
I waited maybe two or three days after the procedure, and then for the next three days, I’d collect three samples per day and take a look under my microscope. In the first four or five samples, the swimmers were swimming hard. Told my brother (who had been trying for a kid for a couple years, and had observed his own samples trying correlate diet and other factors to improved motility) about the straight laser beams I was seeing in the scope — he nearly had a fit when I described how long it took them to go from one side of the slide to the other under the given magnification.
It was the ninth sample when there were very few observable sperm, and what remained looked kinda drunk and unmotivated.
All of that to say: if you’re going to get a vasectomy, when your doctor tells you to abstain from condom-less/birthcontrol-less sex until you come back for a sperm count, take that seriously. It’s amazing how motile they are even when kinda old, and also amazing how many hang around downstream of the vas deferens after many ejaculations. And, while rare, sometimes the vas deferens do manage to reconnect.
And a bonus tip along these lines: testosterone replacement, even without hCG, is not a reliable form of birth control. I’m on (and was on) TRT, without hCG, and the concentration of sperm under the scope looked higher than any YouTube video I could find at the same magnification (meanwhile my bro is taking silly amounts of hCG and struggling). I hear a lot of people joke about TRT having the beneficial side effect of infertility, but that’s far from a certainty.
Relatedly, this is also why the “failure” rate for vasectomy isn’t vanishingly close to 0%: it’s almost all dudes having unprotected sex in the first month or so after the procedure.
Spontaneous reconnection happens but is extremely rare. If you can follow the doctor’s orders for a few weeks, vasectomy’s failure rate may as well be 0%.
Thank you for sharing this!
> Both mice and non-human primates fully regained fertility after stopping the drug. Mice regained fertility within six weeks, and non-human primates fully recovered their sperm count in 10-15 weeks.
Hard pass on messing with my fertility like that, too, TBH.
You realize female birth control drugs have the same lingering effect on fertility too right?
> clinical trials measured rates as high as 90-99%.
This is in the same range as, like, pulling out, for what it's worth.
The similarity is not the same.
If no semen is emitted, the chance of pregnancy is null (more about it in my other comments).
Plus 90–99% suppression of ejaculation has been recorded and suggested that it has a potentially high contraceptive efficacy, so that is way better than withdrawal.
Experiment, maybe it affects you in a way that you get 99%, which would make it a very efficient hormone-free male birth control pill.
Side-note: personally I prefer IUDs, and/or a medication that has been extensively studied, so this pill can wait.
The "as typically used" quoted figure for pulling out ("withdrawal") is 80% success, but the ideal use figure is 96-98%. If you know a little bit about yourself and also aren't going back to back without peeing, you can do a lot better than the 80% figure. (Also yeah, it's amusing that both of these figures are more or less identical to male condoms.)
(Meta-comment: probably best to keep everything in "success" percentage figures for direct comparison, instead of switching to failure percentages for some figures.)
I edited my comment.
Yea similar with tracking ovulation dates. Seems like pretty bad EV for messing with my nervous system.
I have always been amazed at how effective the pull out method was. I had sex for years with my wife and always pulled out. 2x a week for probably 10 years. After we decided to have a kid, she was pregnant in a month.
Really incredible how effective such a simple solution is
What? This is the definition of anecdotal evidence. It’s not very effective at all in practice, statistically.
> For every 100 people who use the pull out method perfectly, 4 will get pregnant.
> But pulling out can be difficult to do perfectly. So in real life, about 22 out of 100 people who use withdrawal get pregnant every year — that’s about 1 in 5.
https://www.plannedparenthood.org/learn/birth-control/withdr...
These are not hard stats to look up.
Yeah same experience as that, and being a bit more careful around fertile times of her cycle.
Was completely effective for us.
To be fair, I think most normal people in a relationship use this method, but if you tell people on the Internet about it, they get upset for some reason.
Most normal people? The implied judgement aside, that is wildly untrue. Most people (80+ % who are not trying for a child) use birth control, this is an easy stat to look up. Maybe people “get upset” because you’re making things up?
I haven’t pulled out in 25 years. What’s the point in sex if you can’t keep going to completion?
Preventing ejaculation sounds awful.
As compared to ... unplanned pregnancy?
As compared to, why have sex if you don’t finish ?
Not having sex is a great birth control yes, but birth control is for sex to be safe not to remove it entirety
If it's never ejaculated, what happens to the fluid?
The body has several well-regulated mechanisms for handling it.
If semen isn't ejaculated, the body reabsorbs the sperm in the epididymis and recycles the cellular material. Seminal fluids, which are produced during arousal, are either reabsorbed or, in cases like retrograde ejaculation (e.g., with alpha-blockers), pass into the bladder and are later urinated out. The system self-regulates; there's no harmful buildup to worry about. :)
So, TL;DR: You will just urinate it out in our case.
What do you think happens with a vasectomy? It gets reabsorbed.
Vasectomies don't prevent ejaculation. The semen is just sperm-free (after a brief period of time).
With a vasectomy, you still ejaculate. Most of the fluid in an ejaculation comes from the prostate, which isn't affected by severing the vas deferens
it's been a few decades, but i don't recall sperm in seminal fluids being entirely limited to the grand finale, only mostly.
Sperm is virtually entirely absent from pre-ejaculation fluids if you've peed since the last time you ejaculated. Almost all of the "sperm can be in pre-ejaculate" effect is from having sex a second time in a row without anything flushing out the tubes.
Fair, and it needs clarification to avoid conflating pre-ejaculate, seminal plasma, and sperm emission.
It may be confusing, so to clarify: "seminal fluids" is a term typically used to refer to the fluid released during ejaculation, not throughout the arousal phase. The idea that sperm would be in the mix before the emission phase goes against standard reproductive physiology.
Sperm are only actively introduced into seminal fluid during the emission phase of ejaculation; the so-called "grand finale." :D. Before that, in the arousal phase, the fluids released (like pre-ejaculate) typically contain no sperm unless there's residual contamination from a previous ejaculation.
It's funny that residual contamination, in the right context, might lead to the world's best magic - life.
I know, especially if you think about it! It is indeed "magic", to me, too. :)
(And FWIW, if one might wonder: thankfully this aforementioned "residual contamination" poses no health risk or birth defects.)
Retrograde ejaculation is a weird thing to experience. It's the physical manifestation of the sound of a slide whistle both ways.
Alpha blockers also give one hell of a stuffy nose. Worst sleep ever after taking one.
Take it a step further into 'Demolition Man' territory to get the orgasm without any physical contact. Certainly would be good for reducing STDs though no doubt would come with a whole range of societal impacts.
In all honesty, orgasm without physical contact is entirely possible already (mental orgasm / psychological stimulation), but it is not common and not easy.
Fantasy, meditation, hypnosis, Kegel exercises... They could lead to orgasms and sometimes even ejaculation (which would be bad in this case).
Some medications rarely may cause spontaneous orgasms, even, without physical contact, arousal or stimulation.
We're basically there with VR porn and ever more realistic toys.
Not parent but made a comment to parent, and damn, completely forgot about that! You are right.
One concern I might have is that I’ve heard (and Wikipedia confirms, though with caveats[1]) that ejaculation can help avoid prostate cancer.
“These [studies] suggest that frequent ejaculation after puberty offers some reduction of the risk of prostate cancer.”
I think we need more/bigger studies to get a handle on how big the effect is though.
[1] NSFW warning - this is a Wikipedia article with a picture of a guy ejaculating riiiiight at the top: https://en.m.wikipedia.org/wiki/Ejaculation#Health_issues
It inhibit the sperm not ejaculation
Do their stats include the guy who forgets to take it every third day, or is that part of the 1%?
Like Richard Hammond said, if I was a woman, I'd be pregnant a lot.
I'm terrible at remembering to take pills. Maybe it's because they're pretty low stakes?
It's not hard to set up nearly fault proof routines and reminders.
For example, I have a pill container for the days of the week. Pills go directly into my pocket and don't come out unless they're going in my mouth (almost always during breakfast.) The pocket to mouth routine makes sure I don't set them down somewhere and the pill box gives proof later that I took them.
I know plenty women who also forget to take it every day.
It's a mouse and NHP (non-human primate) study
This is why it won’t succeed. The person getting pregnant is going to want some proof that the contraception is being used properly. And that means something that they can see or something that they do themselves.
Exactly. I'm confident women worry a lot more about getting pregnant than men worry about getting someone pregnant.
You don't think men worry about having a kid with someone they don't want to, being responsible for 18 years of child support, making hard decisions about whether they want to be involved in the kid's life, etc.?
Men are terrified of getting someone pregnant. At least women have a choice as to what to do about it. If they don't want to keep it, they don't, assuming the law permits it or the law is easy to get around. Men don't ever have that choice.
RARα pathway operates in cell development eg of blood cells and in apoptosis, implicated in some cancers.
Long-term safety seems doubtful. Offspring could be affected. In a rational world there would be no volunteers for the trials.
Could also positively affect offspring if spermatogenesis is blocked at the right step, stopping the gamete progenitors from accumulating somatic mutation. The majority of rare genetic diseases arising from de-novo mutations has its origin in the fathers gamete formation (with increasing risk (i.e accumulation of mutations) at older paternal age). Maybe this could block/slow down this process (i.e cell division) and in 20 years all males that still may want to have kids will take a RARα blocker.
This is important, as women coercing men or ignoring their consent regarding pregnancy is not uncommon.
Uhh this is important because the onus and health risks of contraceptives have been entirely shouldered by women. Not because a very low percentage of men have been “coerced” into fatherhood.
There’s lots of comments in this thread on the risks of cancer and this and that risk with male contraceptives. meanwhile, these are already real issues women have to consider when using modern day hormonal contraceptives. The discourse in this thread is so dude-centric tone deaf.
> Not because a very low percentage of men have been “coerced” into fatherhood.
This dismission is in bad taste and detracts significantly from the rest of your points made.
> Both mice and non-human primates fully regained fertility after stopping the drug. Mice regained fertility within six weeks, and non-human primates fully recovered their sperm count in 10-15 weeks.
Great recurring source of revenue for the drug company!
Though I'm more interested in feral animals like dogs. It looks like this drug may work on dogs too? If so, it would be a huge boon for cities and villages in India.
Why would Cities and Villages in India want a reversible dog contraceptive? They want a cheap, easily deployable, indefinite one.
For India the best option is castration and hysterectomy
I'm saying that a dog contraceptive is what those places need. That fact that it's reversible is a downside.
Seems like neutering them would be cheaper and there’s no risk of the dogs missing a drug cycle.
Having people go out and give a pill to feral dogs daily or near daily seems like a waste of time. Just go out and shoot them, or capture them and put them down. Its a cheaper and more permanent solution.
Wtf? This is ridiculous. Who the fuck is going to be giving feral dogs a pill everyday? And why would you want a reversible contraceptive for feral dogs? You want a one-and-done irreversible one, which neutering is.
Neutering is not possible in villages. You'd be hard pressed to find a vet anywhere nearby.
Whoever invents a drug to eliminate male refractory period, will make all the money. All of it.
This is like removing the rev limiter on your engine. Your engine can now go beyond redline, but not for long because it melted itself.
Meh, there are people with low to no refactory period already and they don't seem to have any real issues.
Offset it with a restrictor plate.
restrictor + microtransactions -> profit!
"Insert coin to continue"
Cabergoline. Lowers prolactin which peaks after ejaculation. Can reduce or eliminate the refractory period. Problem is there is risk of significant cardiovascular side effects, including valvular disease. And they appear to be cumulative: the more pills you take, the higher the risk.
I can't wait until this stuff hits the water supply /s
I got the /s
Europe is struggling with low birth rates. They wouldn’t do it here, as is right now it’s already a calamity.
What would that look like? Women complain it's unfair they have to be responsible for birth control in relationships. Now there's the ability for men to shoulder the responsibility too. Will voters, male and female, be ok with not taking the egalitarian path? Obviously governments are concerned about falling birthrates but they already have shown a willingness to continue policies that get them re-elected, even at the expense of birthrates.
I hope you replied to the wrong comment, I don't think women complaining about paying for birth control is a valid reason for sterilizing a population. Also condoms exist.
While there are complaints about cost depending on location, most of the complains are about the side effects of the pill, which women endure and men don't.
Ok, I'll just ignore the rest of the context of this thread.
> the side effects of the pill, which women endure and men don't.
women are free to choose to not take the pill or take it and accept the consequences. Also, there are many alternatives to the pill.
Either way, I don't understand what point you are trying to make. You are just making random statements and ignoring the context of the discussion.
"women are free to choose to not take the pill or take it and accept the consequences. Also, there are many alternatives to the pill."
Yes, but some people want all the benefits with none of the side effects. Of course there is no perfect solution.
> Yes, but some people want all the benefits with none of the side effects
Life is about making tradeoffs. There is no such thing as a free lunch, except while you are still a child.
> Life is about making tradeoffs
Progress is about eliminating them. We don’t need to trade off seafaring against scurvy, for example.
I would highly doubt this pill will eliminate tradeoffs. I'm sure the studies will find tradeoffs (side effects) just like virtually all medications.
> would highly doubt this pill will eliminate tradeoffs
I would, too. But it increases the pool of options, which means that for some people it really is a win-win. Get the same as you’re getting now, but with fewer (or less meaningful to you) side effects.
We didn't have this covered with Magic: The Gathering, LARPing, cryptocurrency speculation, and Funko-pop collections already? /s
MtG is not effective. Married an MtG player and had 3 kids.
I'm following your path, my fiancee is obsessed. No crypto speculation thank god
For best results, I believe you're supposed to combine all of the above. Like condoms, they don't always work perfectly.
Imagine if you never had played MtG.
This pill is definitely good for you, with no unmeasured and unexpected side effects!
What is the purpose of this comment? This is reporting on a phase 1 trial, which is when side effects and potential toxicity are evaluated. Of course there are no known side effects yet, that's what the trial exists to identify.
I'm sure it's illegal for a woman to secretly swap out her boyfriend's medicine for a placebo, but good luck proving it happened in court.
You realize that without the pill it’s drastically easier to baby trap right?
This would make it a lot harder... they can already do that with their own pills, after this, they would have to find an exact match for the men's pills and somehow replace them without the guy noticing, which would be realatively harder.
?
Women could baby-trap their boyfriend into marriage by swapping out his pills for placebo, then blame the pregnancy on the pills not working.
Most women would never do this, but a few definitely would.
They could poke holes in condoms too. If the male doesn’t trust the female then they probably shouldn’t have sex.
So why are you making it a gender politics issue if it isn’t even a common enough behavior among women
You guys are reading from my comment some sort of aggressive anti-pill stance that isn't there. I'm just predicting something that will happen, because predicting the future and seeing if reality later plays out that way is fun.
It's way easier to do that for her own pills. You still want the condom to be more certain...
You'd likely want condoms anyway, unless you are in a stable long-term relationship with somebody highly trustworthy.
birth-control pills (male or female) are powerless against sexually-transmissible diseases.
And men with a pregnancy fetish can do the same. What’s your point?
Not every discussion is about making a point.
he's referring to sperm jacking.
99% effective. So if you have sex once a day, you'll only produce 3 kids a year.
Birth control effectiveness is typically reported for one year of use, so 100 years of use would produce 1 pregnancy on average
Or, one year of use by 100 men would result in an average of one partner pregnancy per year for this group.
As someone who's currently producing 365.25 kids a year, I'll take it.
> In male mice, the drug caused infertility and was 99% effective in preventing pregnancies within four weeks of use.
I don't know if they mean 99% reduction compared to normal or 99% of mice did not cause a pregnancy. Either way this does not mean that every intercourse has a 1% chance of causing a pregnancy. Also you are assuming an unconditional probability. It could very well be a conditional probability. It might completely work for 99% that do not cause any pregnancies at all and not work for 1% that cause pregnancies as without the drug.
Anyway I am looking forward to getting the perl index for humans from clinical trials.
Edit: fixed wrong wording
Female birth control states the same, as nothing is ever 100%
With the female contraceptive pill 0.3% of women get pregnant within a year if taken perfectly (which is rarely the case, but the figure here is also from lab conditions). This drug leads to 1% pregnancies in 4 weaks, which is much worse.
That said this is still great news especially as the condom is also much less safe then the female contraceptive pill.
Condoms are extremely effective also, if used perfectly, which is rarely the case. Statistics should be based on real-world experience not theoretical best case.
Wikipedia gives a 2% pregnancy rate for condoms within one year with perfect use which is much worse than 0.3%.
We only have the numbers for the lab environment with I assume perfect use for this new drug, so we can only compare perfect use.
I've always been intrigued by where those 2% come from, since condoms are a physical barrier... Teleporting sperm?
Mostly misuse. The studies are all nonsense AFAIK, they rely on the participants to use the condoms correctly, which predictably doesn't happen. Problems the studies mention, like slippage and breakage are the result of misuse, probably due to choosing the wrong condom size.
The only reason for a properly used condom to not work would be a manufacturing defect, which should be extremely rare, certainly not 2%, that's plainly ridiculous and immediately disqualifies any study that claims so.
The statistics show that the 2% comes from breakage/slippage, micropores and manufacturing defects:
https://www.contraceptionjournal.org/article/S0010-7824(04)0...
The statistics are based on real world experience rather than theoretical best case. Not to pick on you but really surprised to hear people confidently express so much misinformation on this topic when it's not even particularly hard to find information on it:
https://en.wikipedia.org/wiki/Comparison_of_birth_control_me...
What throws me off about this, is it's not difficult to use perfectly. Condoms are the only method I trust. Pull-out? Can screw it up. With birth control you're (until now) relying on your partner to use it perfectly.
It's worth measuring both ideal and real world use, IMO.
Sometimes life, uhh, finds a way.
But yes, if they said something is 100% effective and it wasn’t, I would imagine they would be sued into bankruptcy pretty fast.
How much would an accidental child cost these days?
That's not how birth control effectiveness is measured. It's not measured per act of intercourse.
Birth control effectiveness is measured by calculating the number of pregnancies per 100 women using a specific method for a full calendar year.
https://www.who.int/news-room/fact-sheets/detail/family-plan...
>Effectiveness of methods is measured by the number of pregnancies per 100 women using the method per year.
Is that adjusted for frequency of intercourse? Can’t really compare a woman who has sex 10 times a year to one who’s having sex 20 times a month.
I assume the "per 100 women" part suffices to regress towards the mean
you really have to take that pill as soon as it enters the market (/s)
Coming to a tap water near you.
From big pharma, yes.
But their so called "solutions" seem to become ever more destructive long term.
Neem is a natural alternative that has been used for a long time.
> Neem is a natural alternative that has been used for a long time
It is [1]. But it also trashes your liver if used chronically [2].
[1] https://pubmed.ncbi.nlm.nih.gov/34092456/
[2] https://ui.adsabs.harvard.edu/abs/2018JPhCS1025a2043J/abstra...
How about we nationalize the drug companies AND shoot blanks
This is one of the annoying things about life. Testosterone effectively already does this and is quite safe. It's just that society is not comfortable with men taking steroids for no particularly good reason.
> is quite safe
Taking outside sources of testosterone permanently alters your body's ability to make testosterone naturally, to the extent that many people who previously took steroids find they have be on testosterone therapy for the rest of their lives.
I wouldn't call "creating a lifelong requirement to take artificial hormones in order to function at your previous baseline" qualifying as "no particularly good reason".
Most people who go on Testosterone can go off it just fine. Here's a random study:
>Ever since that study, testosterone has undergone extensive clinical trials as a hormonal method of male contraception and many have found testosterone to be efficacious, reversible and safe with minimal short-term side effects
https://pmc.ncbi.nlm.nih.gov/articles/PMC6305868/
It's not super reliable but it's also easily testable if it's working or not.
To be clear, the snippet you quoted is your study summarizing the claims of other studies which are among the cohort analyzed.
Let's quote the short, succinct conclusion of the study you picked:
> Testosterone therapy is a contraceptive, albeit a poor one. Men of reproductive age with low testosterone should be counseled on the adverse effects of TRT on fertility. Obtaining a semen analysis and possible cryopreservation of sperm should be offered if TRT is prescribed to men interested in preserving fertility. Options such as clomiphene citrate and hCG along with a referral to a reproductive urologist should be considered to naturally increase testosterone levels in those men with low testosterone who want to avoid TRT.
Whether a contraceptive that is sufficiently irreversible that men using it are advised to freeze sperm if they ever want kids should be considered "reversible" is left as an exercise to the reader.
You're misunderstanding what they're saying here. They are saying TRT will have an impact on fertility while they are on TRT. The prospects for when they go off TRT are fine:
>If a patient currently desires fertility, TRT should be avoided or discontinued immediately. A semen analyses should be performed if the patient has discontinued TRT. Azoospermia or severe oligospermia may be seen in these patients, but most men should return to baseline semen analyses in 6 to 9 months after cessation of TRT [13,14,15]. A 2006 integrated analysis showed that 90% of patients were expected to return to baseline sperm concentration values 12 months after cessation of treatment and 100% after 24 months [50].
I'm not misunderstandings, you are conflating several different things: TRT, testosterone as a contraceptive, and testosterone as a body building steroid.
TRT is a very low dose of testosterone, used to supplement the body when it doesn't produce enough. It is reversible as you say, and has a negative effect on fertility but not enough to be reliably effective as a contraceptive at TRT dosages.
Testosterone as a contraceptive or steroid is a far higher dose. This is the one that has permanent effects.
It also causes temporary shrinkage in the high overdose needed for any reliability, as opposed to normal dosage.
Pharma companies would think that is a great reason.
According to Sapolsky, testosterone amplifies current behaviors. If you’re already aggressive, you become more. If you’re already X, it amplifies. Just because it’s safe doesn’t mean people want to be in affected states permanently.
Roid rage is probably a myth. The causation likely goes the other way. Meaning aggressive people are more likely to use steroids than steroids are causing them to be aggressive:
https://www.discovermagazine.com/health/the-myth-of-roid-rag...
While I disagree with your claim that steroids are a viable form of birth control, I do agree a bit with this, though not for the stated reason.
What many people don’t realize (probably in large part because they see testosterone and estrogen as diametrically opposed things) is that testosterone levels impacts estrogen levels. Why? Because the body produces estrogen through the aromitization of testosterone. Increasing testosterone will increase estrogen.
A common struggle for those on TRT (both those at true replacement levels, as well as those taking supraphysiological doses) is elevated estrogen. I know that when my estrogen levels have gone too high, I become more neurotic than I usually am.
If you couple increased neuroticism with an elevated sense of dominance (especially at bodybuilding doses), and top that off with a general lack of poor management of one’s emotions (which I suspect is common amongst bodybuilders), what you likely get is a very volatile person. Not because of testosterone, but because of the elevated estrogen and their existing psychological issues.
I agree, and not even just that, it is associated with hair loss, among many other things. In fact, psychiatric medications are less effective (sometimes completely) if your T is high.
Supraphysiological doses of testosterone are not considered safe, and frequent (weekly+) intramuscular injections are not convenient.
https://pmc.ncbi.nlm.nih.gov/articles/PMC6305868/
"Testosterone as a contraceptive can suppress spermatogenesis and lead to azoospermia in 65% of normospermic men within 4 months of use"
Does this sound like a convenient and effective contraceptive? Where are you really coming from with this statement?
This is what I mean. Why is everyone so weird about it? It's hormonal birth control for men. Even if it works for only 65% of them it's better than nothing since it can be tested to see if it's working easily.
Woah, now. You are dangerously mistaken here.
As I wrote over in: https://news.ycombinator.com/item?id=43746406
I’m on TRT, without hCG. I went and had a vasectomy a year ago. Because I’m weird and infinitely curious, two or three days after the procedure, I took three samples per day, and looked at each under the microscope. What I saw put to shame just about any video I could find online of a “good” sperm sample. Straight laser beams, zipping from one side of the slide to the other. If you were to scale Micheal Phelps down to these swimmers, he’d stand no chance. And the concentration was ridiculous, too. And this all 2-5 day old (at least) sperm!
TRT is not a reliable form of birth control.