Silodosin-induced anejaculation: a promising agent for male oral contraception

Aneyaculación inducida por silodosina: un agente prometedor para la anticoncepción oral masculina

Background: The objective of this study was to investigate the feasibility of utilizing silodosin as a non-hormonal, reversible, oral contraceptive for men, alongside elucidating its mechanism of action pertaining to ejaculatory dysfunction. Methods: This is a non-controlled open-label study. Thirty-five sexually active male volunteers, aged between 50 and 70 years and experiencing lower urinary tract symptoms associated with benign prostatic hyperplasia, were administered an 8 mg dose of silodosin. Semen analysis was conducted before and two weeks post-administration of silodosin. To examine sperm in urine, 10 mL samples were obtained via suprapubic bladder aspiration (SBA), with post-ejaculatory urine (PEU) collected from each participant. Additionally, participants completed the IPSS (International Prostate Symptom Score), IIEF (International Index of Erectile Function), and MSHQ (Male Sexual Health Questionnaire Ejaculatory Dysfunction) questionnaires both pre- and post-silodosin treatment. Results: The study involved 35 sexually healthy patients with no prior history of ejaculation complaints who had not previously used silodosin. Of the 33 participants who fulfilled the study requirements, none were able to provide a semen sample. Furthermore, neither SBA nor PEU samples revealed sperm. There was no a prominent decline observed in orgasmic function throughout the duration of silodosin use. Conclusions: Silodosin leads to anejaculation, suggesting its potential as a reliable non-hormonal, reversible and barrier-free oral contraceptive option for men, with minimal impact on orgasmic function.

Resumen

Antecedentes: El objetivo de este estudio fue investigar la viabilidad de utilizar silodosina como anticonceptivo oral reversible no hormonal para hombres, además de dilucidar su mecanismo de acción en relación con la disfunción eyaculatoria. Métodos: Se trata de un estudio abierto no controlado. Se administró una dosis de 8 mg de silodosina a treinta y cinco voluntarios varones sexualmente activos, de entre 50 y 70 años de edad y que presentaban síntomas del tracto urinario inferior asociados con hiperplasia prostática benigna. Se realizó un análisis de semen antes y dos semanas después de la administración de silodosina. Para examinar los espermatozoides en la orina, se obtuvieron muestras de 10 mL mediante aspiración de la vejiga suprapúbica (SBA), y se recogió orina post-eyaculatoria (PEU) de cada participante. Además, los participantes completaron los cuestionarios IPSS (International Prostate Symptom Score), IIEF (International Index of Erectile Function) y MSHQ (Male Sexual Health Questionnaire Eyaculatory Dysfunction) antes y después del tratamiento con silodosina. Resultados: El estudio involucró a 35 pacientes sexualmente sanos sin antecedentes de problemas de eyaculación que no habían usado silodosina anteriormente. De los 33 participantes que cumplieron con los requisitos del estudio, ninguno pudo proporcionar una muestra de semen. Además, ni las muestras de SBA ni de PEU revelaron esperma. No se observó una disminución importante en la función orgásmica durante el uso de silodosina. Conclusiones: La silodosina produce aneyaculación, lo que sugiere su potencial como una opción anticonceptiva oral confiable, no hormonal, reversible y sin barreras para hombres, con un impacto mínimo en la función orgásmica.

Alpha blockers; Contraception; Anejaculation; Silodosin

Palabras Clave

Bloqueadores alfa; Anticoncepción; Aneyaculación; Silodosina

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