Farai Chideya: Well, when it comes to sex and reproduction, men have a few power moves on their side. It's their genetic contribution that decides if the baby is a boy or a girl, and of course, if there's a technical failure of the contraception, it's always the woman who ends up pregnant. Unless it's the cross-gendered man who had a baby, but that's not where we're going with this.
John Hockenberry:That's a big story--
Farai Chideya: We want to ask, if there was a way for men to use hormonal birth control, and the pill is a form of hormonal birth control, would men actually do it? Would women trust the men to do it right? New research from China's National Institute of Family Planning indicates we're one step closer to a viable form of male contraception. It's a testosterone shot taken once a month, and we've got Dr. John Herr, he's a professor at the University of Virginia, director of UVA's Center for Research in Contraceptive and Reproductive Health. We also have Susie Bright, author of The Sexual State of the Union and the host of In Bed with Susie Bright on audible.com. Hi guys.
Susie Bright:Hi, how're you doing?
Farai Chideya: I am doing great, Susie, great to talk to you. It's been a while. Dr. Herr, let me start with you though. We've been hearing about male contraception for years, and it hasn't exactly caught on. Why not?
Dr. John Herr:Well I think this particular paper that's just come out really represents a steady advance along the path to the contraceptive. Developing a contraceptive is really, pretty complex. You need to test different kinds of drugs and test them in different ways with different delivery systems, and then you also have to test for drug safety and efficacy, and this present report just is an incremental step on this path.
Farai Chideya: Now, explain for me the science behind this. Testosterone is what makes men virile, so why does it prevent them from being fertile?
Dr. John Herr:Well the mechanism, what we'd call the mechanism of action here is a feedback loop. You'd give the testosterone and it basically fools the brain, part of the brain called the hypothalamus into thinking that the testes are functioning properly. And that causes the hypothalamus to shut down producing a releasing hormone that shuts down the pituitary gland, and the pituitary gland stops putting out its hormone, and in effect then spermatigenesis, or sperm production, testes ceases. So it's a systemic effect of the administration of the testosterone on the entire feedback loop in the brain, and the whole axis of the pituitary gland and the testes.
John Hockenberry:Doctor, that's just a technical way of saying "I feel great!," right?
Dr. John Herr:Well you know, it's interesting, some of the men on the male contraceptive do report that they do feel pretty good. The effect of the pill is mood change, and most men report that it's pretty positive.
Farai Chideya: Alright, I'm going to go to Susie in a second, but just give me a very quick sense of whether or not this is something which is, I guess socially acceptable? I mean, is there any sense of, aside from the hard science, whether or not people are actually interested in this?
Dr. John Herr:Well I think there's been six or seven papers published in the last four or five years that have assessed male interest in contraception in countries all across the globe, and there is a range of, some countries it may be 10% of the men are anxious for a new contraceptive, and in other countries it may be as high as 65 or 70%.
Farai Chideya: Ok, well let me go to Susie.
Susie Bright:Well that question, when you ask me that, I mean if you look at how many men are indeed interested in vasectomies, go through with it, all the men using condoms right now, I mean the numbers are enormous. Of course men are interested, but like women, they're picky. You're not just going to poke me with god knows what, you want to know what's going to happen.
Farai Chideya: Yeah, well you know the men want to know what's going to happen, and also the women, because you know the men don't get pregnant.
John Hockenberry:Let's do a little experiment then. How does this work for you, Susie? I took my shot.
Susie Bright:Right...
Farai Chideya: So what would you respond to a guy who said that to you?
Susie Bright:To a guy who said that to me? Well I think that is the kind of sexy daydreaming where you imagine this sexy, handsome stranger you meet in a bar, and he says to you "oh, I'm on the pill." And you're like, "oh, you're my dream man, and I trust you!" It's like a telenovella.
John Hockenberry:I took my shot.
Susie Bright:Yeah, you took your shot, sure. Seems like a joke right there. You're the cad, you're the stud, you'll say anything to get in my pants. But the sort of unsexy, plain old bread and potatoes truth of this, is that it's married people and people in long term relationships who get pregnant the most. They're the ones having sex in one day and out the next, I mean, they're the frequent sex users. And they have a strong mutual interest in a birth control that would be easy on both of them, that would work. Many time husbands have an intense interest in their wives discomfort with the present birth control method she's using, they both decided they don't want anymore accidents, any surprises. This is something that, you know, doctors and clinics hear about all the time, couples saying "is there anything we can do now?" Especially as they get older, women say enough already.
John Hockenberry:I have four kids and I have my own room now.
Farai Chideya: Let me go back to Doctor Herr though. When you talk about responsible behavior, you know AIDS researchers have been saying why can't people just use a condom? And having trouble getting people to do it. You know, it's like some nights, most people don't, some people will forget to floss their teeth. What if a guy forgets his shot? Medically what happens, and what about behavior?
Dr. John Herr:Well I think that one of the things this study that recently came out shows is that once the man begins to take the contraceptive, it does take them about 100 days on average to reach a safe level of sperm. And if they miss one of those, in this case monthly shots, if they do miss one monthly shot, they may get a little blip in the sperm production, it may come back. So it is important in male contraception to have a companion diagnostic test that can be used to monitor sperm levels, and it's important to note that recently the FDA has approved something called sperm check. And this is the first home test to detect low concentrations of sperm.
Farai Chideya: Alright, we have to, any time you say "sperm check" on the air, it's--
John Hockenberry:Honey, where'd you put the sperm check!? Sweetie?!
Farai Chideya: We just can't, we have to stop here, but you know what? We might have to discuss this more. Dr. John Herr, University of Virginia; Susie Bright, author of The Sexual State of the Union, thanks so much.
