Due to its progestogenic activity, levonorgestrel has antigonadotropic effects and is able to suppress the secretion of the gonadotropins, luteinizing hormone and follicle-stimulating hormone, from the pituitary gland. This in turn, results in suppression of gonadal activity, including reduction of fertility and gonadal sex hormone production in both women and men. The ovulation-inhibiting dose of levonorgestrel in premenopausal women is 50 to 60μg/day.
In men, levonorgestrel causes marked suppression of circulating testosterone levels secondary to its antigonadotropic effects. In healthy young men, levonorgestrel alone at a dose of 120 to 240 μg/day orally for 2 weeks suppressed testosterone levels from ~450 ng/dL to ~248 ng/dL (–45%). Because of its effects on testosterone levels, and due to its androgenic activity being only weak and hence insufficient for purposes of androgen replacement in males, levonorgestrel has potent functional antiandrogenic effects in men. Consequently, it is able to produce adverse effects like decreased libido and erectile dysfunction, among others. In relation to this, levonorgestrel has been combined with an androgen like testosterone or dihydrotestosterone when it has been studied as a hormonal contraceptive in men.