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

Abstract

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.