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ABOUT THIS EPISODE

They said it couldn't be done: The "male pill." Actuality asks why men haven't seen a new reversible contraceptive in centuries—and if we need one. We found out why Big Pharma gave up on a male pill, and meet people who want to make it happen anyway.Correction: In this episode we refer to "The Pill" by Jonathan Eig. The correct title of Eig’s book is "The Birth of the Pill."
English
United States
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TRANSCRIPT

00:00:04everybody I'm sorry been a short for Marketplace and I'm to burn holes from quartz and this is actuality what you're asking but I can't be that way you can't be done obviously could never be done and we're talking about an idea thought to be inconceivable male contraception see what I did there we all side is something akin to the female contraceptive pill it's simple it's reliable and it is reversible hasn't been a new form of male contraception on the market since since when the middle of the nineteenth century when they started doing vasectomies and now women have all kinds of reversible contraceptive options not all of them are amazing but there's nothing for men and it's sort of a mystery why is that an idea of how people feel about
00:01:04this subject we went out on the streets of New York City and it costed random people and ask them what they thought about a male birth control pill if there was a male pill would you ask your male partner to music for him to use it from too I guess it depends on who you're with I mean why would they trust men at all I have no desire to have a kid and if I had control of that I wouldn't I don't see why not yeah most safe and you know tested and everything and make sure it's long and no long-term effects for you than a man understand the hassle of female contraception like dealership field map
00:02:03we not they have no idea so that wasn't awkward at all talking to people about their contraceptive choices on the street during your lunch breaks. But generally the people who we manage to talk to the idea of the podcast Call Your Girlfriend actually planted the seed for this episode when she emailed us for the question to ask I want to know why there isn't a male contraceptive pill and the reason she asked this question is because pretty much any time you were in a gathering of more than three women who sleep with men like at some point someone's complaining about her birth control situation for saying here is this new thing that I'm doing but there are a lot of people for whom like the contraceptive pill or like the ring or other things that are hormone-based are fine there are other people for whom they cause major depression
00:03:03how many friends do I have her like I found myself crying at this American life again and I realized it's because it's because of the pill or her sex drive and then there are also some very real medical where are they say don't smoke and be on the pill at the same time because blood clots you know these are just questions that men don't have to ask and their questions that women ask themselves and talk about with each other frequently asked questions when we want to have to ask yourself some questions we should ask ourselves just in the basic interest of equity sharing this reproductive responsibility that sort of affects everyone even if it affects women more directly because literally people have said it could not be done Carl Jurassic he's the father of the female birth control pill predicted that we would not have a male pill by the year 2002 what we will get today is the why we don't have it the science the business behind it but more for man and when did it first
00:04:03go to you that this system is one-sided it was very apparent to me from the very beginning that this was a burden that was mine to bear I think none of us have lived in a world where there is an option for men to throw having equal stake in contraception but you know it's certainly true that the more I learned about how limited the options for contraception are for women that I started started asking questions about hey why are we looking at the opposite side of this it would seem like there's a lot of other space for Innovation here so why do you think there is no reliable reversible male contraception now knowing what I know about the development of the female birth control pill I feel like that was such a special perfect storm that was initiated for political reasons that led to the creation of the female birth control pill about this book called the chorus by Jonathan
00:05:03and The Story Goes Like This Margaret Singer who founded what would become Planned Parenthood decided or realized really that women needed something better than just condoms are diaphragms to control their bodies and their reproduction something that women's Partners won't know they're even doing to prevent pregnancy so say or goes out and finds herself a wealthy heiress to fund her and then she hires a couple of scientist was a scientist who have been kicked out of Harvard back in the 30s for growing rabbits in test tubes and classic and the other guy was treating infertility Doctor Who was ironically Catholic Church on Rock realize that the same hormones he was giving women to treat infertility could be administered differently and that that would actually stop ovulation and therefore where can I find a see what they found this hormone they actually have to go to Puerto Rico in order to do the human test trials to make sure it was safe and effective we are why did they go to Puerto Rico this is a bit
00:06:03traffic of an issue basically they couldn't find people in the US were willing to take the drug so they had to go to a place where they were poor women who either didn't understand or willing to take the risk in order to test it and luckily for them and for what else it worked they did find a few willing volunteers and those it worked and so those women started telling their friends hey this pill really prevent pregnancy and only then did they kind of have a true testing group I think Margaret Sanger was first like I want a pill to prevent pregnancy in like 1914 and we didn't get the pill till the mid-sixties is I think instructive because it happened under the radar it was it was privately funded it did not have a goal of making a lot of money on the open market it was just sort of like this is a thing that we believe women should have access to and you know in today I really think that the only way we're going to get a male pill is in some ways with a similar effort you know someone with an activist agenda working with private
00:07:03researchers and probably private money without too much of like a market-focused plan for the pill to just say like this is the thing that the world needs and you know it right now they're actually are people working to make male contraception happen and we went out and found them David Sokol is the chair of the male contraception initiative so David you're a longtime advocate of a new option for male contraception in a physician for 40 years are you surprised that there is nothing on the market yeah I'm surprised although Carl djerassi wrote a book in 1979 predicting that there would be no male contraceptive in 2000 wow he won that we've we've gone beyond that and they're still not much likely to be online in the near future
00:08:03why do we need another new product for men why basically have you founded this organization to promote this idea well men do not have a reliable reversible method condoms in typical use have a failure rate of about 1 out of 6 per year so it's like a roll up the dice women have injectables iuds they have a whole host of reliable reversible methods men have zilch so men need a pill or an implant or something that will give them some better options is there some sort of technical challenge involved in male contraception for women a small miniscule doses of hormones will convince the ovary that the woman is pregnant or in at least in early pregnancy and the ovary will shut down so the female system has an on-off switch several on-off switches that hormones can trigger
00:09:02but sperm production never naturally shuts down so you have to use very large doses of hormones to shut down the testes sperm production and those crossed side effect I mean is there any natural hair we're focusing on certain novel Innovative not hormonal approaches Geraci in his 1979 book mentioned that we at the time there's very little knowledge about how the epididymis works and the basic science of sperm maturation and a lot of that basic science has been worked out now so David broke down The Cutting Edge technology male contraception Research into three possibilities the first one is this this thing called Vaso Jell-O is a good example it's it would be a method of reversible vasectomy the way this one works is a polymer is injected into the vas deferens at one of the two and it solidified to block the sperm now I can see that becoming problematic
00:10:02at the decisive moment let's say you can still have a moment it only filters at the sperm like everything else can go through the liquid can go through it just a little guys can't go through but how could this be reversible the gel could be dissolved by a second injection this kind of like Drano censoring myself right now alright well we'll get to the concerns about marketing this later what are some of our other options okay there's also research in UNC Chapel Hill where they're looking at eppen antagonists that keeps the sperm from swimming so it turns out that the sperm don't just automatically starts women when they get in the pool they kind of need a little signal
00:10:50this technique turns out that signal
00:10:56but wait Tim there's more researchers in Japan found more ways to hobble a little friends they caused the sperm to mature with deformed Tails so they could move their tails a little bit but they couldn't swim properly so it started limping sperm we got you limping you got your lazy sperm most promising areas apparently of research and Academia but obviously they're not out in the market yet you know they say the best time to plant a tree is 20 years ago the next best time is today looks like David Sokol are planting but big Pharma he's not fertilizing
00:11:44so it seems like there should be a market for male contraceptives and the money to make that happen but there is no major pharmaceutical company is currently working on new forms of milk option why not that is so I was going to say million dollar question that is 50 billion dollar question maybe of the male contraception initiative she published a research paper about the developments in challenges and male contraception research it turns out that farmer has flirted with the idea before I was interested for several major pharmaceutical companies had active RND forecast for male contraception up until around 2005 to 2008 and then all of them exited Zaya roughly around the same time how they would approach that decision like what kind of factors they would consider consideration is that contraceptives especially costly and time-consuming to develop perhaps more so than drugs
00:12:44agents for other types of conditions another consideration is that there are so many female control options on the market and those have been on the market for some time which means issues with efficacy and with tolerability side effects of sorts of things they've had many years even decades to perfect so any new option for a man coming in at this time there be very high bar for what is what's an acceptable side effect profiler efficacy profile and there wouldn't be such a tolerance for sort of figuring those things out once the products got to Market why do you say the contraceptive are so technically challenging is there something about the biochemistry that makes it a hard nut to crack an entire year of well time sex to become pregnant so it to run a clinical trial that can prove the contraceptive method is effective
00:13:44it's a very long time to show that that's really preventing something there a dress up to front it is more challenging to contraceptive Man versus a woman who produces just one egg in a per month so you need to prevent one egg from getting to fertilization stage versus preventing millions of sperm sort of like trying to hunt down one elephant versus 10,000 infesting shrews in a barn
00:14:21yep that's about right. Simply because when we start fiddling around down there it's probably pretty easy for guys to take it as an attack on their virility on their masculinity even though we're talking about contraception it's a sensitive area so are there enough guys for your research who would be willing to buy milk on reception I think there are enough there lot of surveys that have been done on acceptability of both men and women women would you trust men would you be interested in men taking on that that Burnham of contraception and for many. Would you be interested in taking on that burden would you be interested in being the one using contraception the responses to Services of that nature are overwhelmingly positive
00:15:21why yeah she calculated the economic value of a really effective contraceptive 99% of the time compared to condoms which are only 93% reliable and it is based on the cost of child support after an accidental pregnancy so comparing condoms to this hypothetical male pill it would be worse than a while to pay up to that $11.80 per day then running the risk of 18 years of child care payments development roadmap that will exist in our lifetimes absolutely be a reality the roadblock is really the investment piece big firm is no longer in this game the current investment is all on the nonprofit and academic side one thing that we're currently conducting is some consumer research to try to understand what men would be looking for what formulation what side effects would they be willing to tolerate what efficacy profile would they say
00:16:21as you know what I major Improvement and what's already available these are the pieces that potentially could entice more Investments If there really was better evidence of a demand and of real interest in a particular formulation or type of contraceptive she is on the board of the male contraception initiative and also
00:16:46I think there's an interesting historical Arc that we can trace hear the reason why I think the female pill was the first to develop is because originally females have to bear the burden of pregnancy I mean they have to carry the thing around for 9 months and so it sort of makes sense that they would be the first to find a solution to that to that burden and guys conversely can just be like peace out I am a male in the 50s I don't care about the women Spartans so now I feel there is two things going on one there it does exist in Melbourne and now there's child support there's legal lawsuits eternity testing Hurley Tyson totally so I feel like the environment has changed the balance of Burden so what I think is really cool about this
00:17:46sorry is it's also a story of changing cultural norms now that people in Partnerships whether their marriages are just some kind of monogamy are expected to be equal partners and share in the various cast of daily life it seems like contraception and making reproductive decisions should be shared as well and that was kind of an undercurrent with a lot of the people we talk to you on the street and in the studio my dream world it would be a parallel to a lot of tough questions that a couples figure out together it's like are we going to move together to this like other City because you found work there are we going to together invest in a house or like have kids or who's supporting whose parents all these like big questions that you ask in my mind who is taking contraception so that we don't have babies when we don't want them is a I would like to see that sort of on the table among the many things that you negotiate in a cup equal partnership I think there's been an arc of change legally culturally and behind it all we also have all the scientific advances that we talked about
00:18:47well yes or no maybe there's been an arc of change but we still don't have a pill on the market no one's making one well that's right yeah I mean yeah yeah I think those changes are laying the groundwork for movement in the future I feel like we're slowly getting to a point where it's going to become a possibility Navy Yard podcast episode is going to igniter investment race be the first people to launch this product and then we'll pick out readers you're going to start a revolution
00:19:29thanks everybody for listening this is this is it for this season of actuality but will be back so subscribe and follow us on Twitter at actuality pod and we'll see you when we come back they stay in treatment for sending in this idea oh yeah I got in the middle of a pitch meeting and was like Manna From Heaven it was perfect thanks to our producer Clair tennis Gutter and the entity known as Levi sharp as well as studer ducky and Sitara novice and thanks to Jay Gorski theme song and is our engineer as well also I would like to thank my parents for not using any kind of contraception to bring me into the world or unless maybe they did and I was an accident

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