Down in the basement of the University of Washington Medical Center, there's a windowless room with two "Knock before entering!" signs on the door. It's where men are paid to jack off. It's a very clinical room, with fluorescent lighting and a butcher-paper-covered examination table. In a discreet drawer there's a stash of porn, and just outside the door there's an office and a small lab whose walls are lined with banal binders titled "Testosterone '92." This is the birthplace of what could be the next contraception revolution: the male Pill.
"It's a very social interaction; you know, chatting about the neighborhood and then, 'When was the last time you ejaculated?'" Scot Augustson explains over a cup of coffee. Augustson, a 42-year-old gay playwright, was one of the 50 test subjects the recent UW male-contraception trials. Doctors are investigating the effect of hormones to create a pill that could temporarily create sperm-free ejaculate. Initially, getting off in that clinical basement room was a challenge for Augustson—the contents of the discreet porn drawer were distinctly hetero—but soon head researcher Dr. John Amory wised up and went to Broadway News to purchase a Playgirl in the name of science. (After a black patient complained, he bought African-American porn, too.) The trials Augustson and Amory are working on are the first and, currently, only human tests of a male-contraceptive pill in the world. Non-oral male contraceptives (like gels and vaccines) have been tested for years, and an English team made headlines earlier this week with its lab tests of a male Pill, but the UW researchers are the closest to actually developing an effective product.
Amory and the other contraceptive researchers are motivated by righteous humanitarianism and scientific curiosity. Developing male contraception isn't a high priority on the current administration's funding list, and it's tough to find pharmaceutical investors, so there's very little money in the field. A tiny percentage, .000429 , of the Fed's National Institute for Health research budget goes to male contraception studies, and the $4 million at the UW Clinic is an estimated half of all the dollars spent on this research in the U.S. annually. On one office wall, a giant overpopulation diagram hangs as an inspirational poster. The doctors are inclined toward phrases like "global sustainability" and "change the world for the better." "The last technological advance in male contraception was the condom," says one researcher, Dr. Stephanie Page, "and that was at least 300 years ago." More options, the researchers hope, would decrease the number of unplanned pregnancies and result in fewer mouths to feed worldwide.
The nitty-gritty of Page's job involves opening bottles of semen that test subjects ship through the U.S. Postal Service in special biohazard envelopes and counting the number of sperm within. She says she doesn't mind; it's all just science. But researching sperm is tough work—if the UW doctors keep their funding and the trials go as planned, it will still be 10 years before the male Pill hits drugstore shelves.
The development of a male Pill has been, uh, longer and harder because men's fertility is more difficult to rein in. "With women, you've only got to stop one egg a month," says Page. "With men, you've got 1,000 sperm an hour." The female Pill mimics a natural event, creating the hormone balance that causes women to become infertile while breastfeeding. There is no biological necessity for men to be infertile. Also, screwing around with hormones is difficult, since each person's body chemistry is unique and slightly unbalanced doses can cause major side effects. Last year, Augustson felt lethargic and had no sex drive for days after UW researchers shut off his testosterone for a study. His partner, also in the study, had hot flashes.
After decades of research, several doctors have created vaccines and gels that cause temporary male infertility, some of which are up to 80 percent effective. But that's still too low for a widespread contraceptive, and besides, most men say they'll only use a contraception drug if it's a pill.
Even with the development of an easy and effective Pill, many question whether men will take it. Some believe that men won't reliably use the Pill, especially if it seems like a drug that will hurt their virility.
But the UW doctors are optimistic. Of all Americans using birth control, a third are men, despite having only condoms and (scary!) vasectomies as options. Also, 75 percent of men surveyed expressed interest in taking a contraceptive pill. The UW Pill only has to be taken once a day, and men's ejaculate still looks the same (taste is unconfirmed)—it just doesn't include any sperm. It helps that the Pill is testosterone, which has an image of sexual potency and actually increases muscle mass. Says Amory, "We have no problem recruiting for trials. Men are more interested in having sex than they are in having children." If they can market it right, sexually active men will bite.