The evolution that combined oral contraceptives (COCs) have undergone over the past five decades has consisted chiefly of the lowering of the oestrogen dose; the introduction of new progestins differing in potency, androgenicity, affinity for steroid receptors and interactions with oestrogens; variations in regimens of administration; and most recently, the replacement of ethinyl oestradiol (EE) with the natural oestrogen 17β-oestradiol (E2) or its valerate. Representative surveys conducted in industrialized nations have brought to light that a sizeable proportion of the population would be interested in using a pharmacological male contraceptive. A cultural environment must be created in which contraception is considered to be not only acceptable but also highly valued. In such a setting, couples allowed to use the method best suiting them, even if the latter is not associated with the lowest overall failure rates, will most effectively control their fertility.