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I don't mind firing blanks

When he heard that guinea pigs were needed for trials of a men's contraceptive, Clint Witchalls couldn't wait to sign up. But he's still a real man...

Monday 09 August 2004 00:00 BST
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Male contraceptives are rubbish. Condoms aren't the real deal, no matter how "gossamer" the latex. Coitus interruptus is unreliable and unsatisfying, and the idea of being sterilised with a scalpel makes me feel like half a man. Some people cite abstinence as a form of contraception, but they're just being silly. In February, I read that phase II clinical trials for a new form of male contraceptive had begun. The contraceptive was hailed as the "male Pill". At last. Then, in May, the BBC announced that the trial was in danger of collapsing because not enough volunteers had come forward. The researchers needed 30 to 40 volunteers for the trial, and they only had half that number. I was disappointed. I called Dr Pierre-Marc Bouloux, the man leading the study in the UK, and asked if I could join the trial. I was given an emphatic "yes".

Male contraceptives are rubbish. Condoms aren't the real deal, no matter how "gossamer" the latex. Coitus interruptus is unreliable and unsatisfying, and the idea of being sterilised with a scalpel makes me feel like half a man. Some people cite abstinence as a form of contraception, but they're just being silly. In February, I read that phase II clinical trials for a new form of male contraceptive had begun. The contraceptive was hailed as the "male Pill". At last. Then, in May, the BBC announced that the trial was in danger of collapsing because not enough volunteers had come forward. The researchers needed 30 to 40 volunteers for the trial, and they only had half that number. I was disappointed. I called Dr Pierre-Marc Bouloux, the man leading the study in the UK, and asked if I could join the trial. I was given an emphatic "yes".

The new contraceptive, I learnt, is not a pill. It's actually a rod that's inserted under the skin in the upper arm. Which is just as well, because I'd prefer to say "I'm on the rod" than "I'm on the Pill". A rod is suggestive of stiffness and virility... just the sort of verbal scaffolding you need when you've been chemically neutered. The rod contains etonogestrel (a drug similar to the naturally occurring hormone progesterone), which is slowly released into the blood stream. Etonogestrel reduces the production of two hormones: follicle stimulating hormone (FSH) and luteinising hormone (LH), both of which are necessary for sperm production. However, when you switch off LH, you also switch off testosterone production. To compensate for this, test subjects are to be given a testosterone injection every 10 to 12 weeks (depending on which treatment group we're assigned to). With testosterone, men are pretty unbearable, but without it we're worse. We become irritable, tired, depressed, and, to top it all, we can't get it up.

Prior to joining the study, I had scant idea of what it meant to be involved in a clinical trial. I knew the theory behind the treatment, but that was about it. On my first visit to the Royal Free Hospital in Hampstead, Dr Andrew Solomon, one of the doctors conducting the study, explained the protocol. I hadn't realised that it was part of a pan-European study, involving 350 volunteers. The trial is now in phase II, which involves fine-tuning the doses of etonogestrel and testosterone. There are six treatment groups, each receiving slightly different doses of the two hormones, and a control group that receives the placebo. But before I could be assigned to any group, I would have to pass a stringent health screening. Being a committed hypochondriac, I couldn't turn down the offer of free medical tests. But Dr Solomon suggested that I first read the information pack and discuss the treatment with my wife. After that, if I still felt the urge to sign up, a date for the medical examination could be booked.

A week later, I turned up for my medical. Unfortunately, I was mentally unprepared for the intimacy of the examination. I assumed my blood pressure would be measured and a few blood samples taken. I was slightly unnerved, though, when Dr Solomon began to palpate my testicles with his right hand while running worry beads through his left hand. I thought he was being a tad cavalier, until I realised that the "worry beads" represented different testicle sizes. (I later discovered that one of the side effects of the treatment is a shrinkage of the gonads, hence the "before" measurements).

I was then given a digital rectal examination to assess the size of my prostate. After that violation, Dr Solomon handed me what looked like a plastic urine pot and asked me to produce a sample. He pointed to a metal filing cabinet next to the window. "You'll find some, um, material in there," he said, with a coyness not usually found in doctors. It was then that I realised what sort of sample he was after. During the course of the study, I'll need to produce 17, um, samples. Unfortunately, the erotic potential of hospitals is lost on me. A bunch of well-thumbed wank mags only added to the unerotic nature of the situation. I'm surprised I managed to produce a sample at all, but thankfully I did. I left the sample "in a prominent place", as instructed by Dr Solomon, and darted out of the room like a married man leaving a Soho strip joint.

My altruism waned significantly after the medical examination. I had also learnt that Organon/Schering, the companies who developed the treatment and are funding the trial, had a rush of volunteers after the BBC's announcement. I no longer felt that my contribution was important. Also, by now, I was aware that there could be side-effects to the drugs - aside from the before-mentioned nut-shrinkage, I could also put on weight, get acne, lose bone density, experience a drop in libido, become a moody sod, and get night sweats. All of that would be added to my already extensive list of health anxieties.

But Dr Solomon explained that the risks are slight, and my health would be thoroughly assessed throughout the trial period. If I wanted to drop out at any point, that wouldn't be a problem. And just because there had been a rush of volunteers, it didn't mean any of them would be accepted for the trial.

A good reason for me to stay on the trial is that, if all the regulatory hurdles are achieved, I'll be first in line to receive the treatment. I'm sure there are many men in long-term, monogamous relationships who would gladly go on the rod, if they had the choice. The argument that men can't be trusted to take the Pill is negated by the fact that there is no pill. It's a myth that men aren't interested in contraception. A third of all contraception is accounted for by men, and maybe if we had more choice, that figure would be higher. The rod offers a very attractive alternative to condoms and vasectomies. Dr Bouloux believes the rod will be on the market in four to five year's time. For men who are being urged by their partners to have the snip, that time can't arrive soon enough.

I don't want to suggest that this contraceptive is appropriate for men who are not in a monogamous relationship. With the huge increase in STIs in the UK, men and women would be daft to abandon condoms. But there must be a huge market for married men - at least, that's what my straw poll indicates. Studies have shown that the majority of men and women feel that men should play a bigger role in the choice and use of contraception. The rod offers an alternative that earlier trials have indicated is more effective than condom use at preventing pregnancy.

After three screening visits, I finally began treatment 10 days ago, but not before giving more blood, a semen sample, and answering a sexual function questionnaire ("How many times in the past week have you had a full erection on awakening?" etc). I was given a testosterone injection in my derrière, then my upper arm was anaesthetised so that the rod could be inserted. The rod is slightly larger than a matchstick and is introduced via a needle the size of the Dartford Tunnel. "Are you OK? You look a bit green," said the nurse, when the procedure was done. I think it was the anticipation of pain that made me wince, because I didn't feel the rod being inserted at all.

One of the things about being on a clinical trial is that you don't know if you're assigned to the control group or the treatment group (all of us continue with our usual contraceptive methods - the results are not assessed by the number of additions to the family). As 86 per cent of the volunteers are assigned to the treatment group, there's a good chance that my sperm numbers are plummeting as I write this. I haven't had any side effects. My libido is fine and I haven't grown breasts or developed a fine soprano voice. In fact, I feel great. If this is the future of male contraception, I'm all for it.

If you wish to join the trial, call the department of endocrinology at the Royal Free Hospital on 020-7472 6190

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