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我们不知道为什么这个形状会成为爱的普遍象征 We're not sure why this shape became the universal symbol of love.
但一个主要的理论 是它来自于罗盘草荚果 But one leading theory is that it came from the silphium pod,
在古地中海非常珍贵 so valuable across the ancient Mediterranean,
这种水果只生长在一个地方 当地货币上就印着这种形状 it was printed on the currency of the only place they grew,
那个地方叫希腊殖民地昔兰尼 the Greek colony Cyrene.
它出口到该地区用于各种医疗用途 It was exported around the region for all kinds of medical uses
尤其是其中一个地区 and one in particular.
以弗所的索拉诺斯 是那个时代最重要的妇科医生 Soranus of Ephesus, the foremost gynecologist of his time,
建议女性每月喝一次罗盘草果汁 advised women to drink silphium juice once a month,
因为它不仅能阻止受孕 since it not only prevents conception,
还可以毁掉任何已受孕的胎儿 but also destroys any already existing.
也就是说 现代人看到的心脏形状可能源自一种古老的“事后避孕药” Which means, our modern heart shape may derive from an ancient kind of morning-after pill.
但是在大部分人类历史中节育远没有那么精细 But for most of human history, birth control was a lot less refined.
早期有由动物肠制成的避孕套 There were early condoms made of animal intestines
可以被清洗和重复使用 that were washed and reused.
这是早期的避孕膜 And diaphragms, early versions,
就是女人在阴道里放各种东西 were just women putting various things up their vaginas:
羊毛、丝绸 碾碎的植物或动物粪便 wool, silk, crushed plants or animal dung,
取决于可用的动物 depending on the available animal.
在埃及 人们用鳄鱼粪 In Egypt, it was crocodile dung.
在印度 人们用大象的粪便 In India, dung of the elephant.
我们永远不知道罗盘草是否好用 We'll never know for sure how well silphium worked,
因为它已经绝种了 because it went extinct.
但是对可能是其同类植物的研究 But research into its likely relatives,
像野胡萝卜花和阿魏 like Queen Anne's lace and devil's dung,
显示它或许能有效控制 suggest it probably manipulated the hormone levels
受孕所需的激素水瓶 involved in getting pregnant.
科学家终于在20世纪50年代 在实验室里发现如何做到这一点 Scientists eventually figured out how to do that in a lab in the 1950s.
从那以后 几乎每一种 新的节育方式都起了作用 And it's how nearly every new type of birth control has worked ever since.
但是这种方法并不完美 But this method isn't perfect.
体重增加、抑郁、痤疮 Weight gain, depression, acne...
我不断流血 几个月来情绪低落 I was just bleeding and bleeding at a low level for months.
我会为那些毫无意义的事情哭泣 I would just, like, cry over, like, things that didn't make any sense.
切着一根黄瓜 我想：“为什么？” Cutting a cucumber, and I was like, "Why? Like, "Is this, like--?
“这是我有史以来切过的 最烂的蔬菜” This is the worst, like, vegetable I've ever, like, cut up before."
自从我们发明激素节育 至今已有六十多年了 It's been over 60 years since we invented hormonal birth control.
现在不是更好吗？ Shouldn't it be better by now?
这个白色的小药片比炸药的威力更强 This little white tablet is more explosive than dynamite.
药商已经开始宣传 Sermons have been preached on it.
男人和女人为此争论不休 Men and women have argued over it.
玛丽和她的团队只是做了简单的解说 听众也只是点头回应 Mary and her team merely explain the pill,
但不代表所有人都同意 and they nod back, but it's not consent,
毕竟她们必须获得丈夫的允许 方可使用 because it's their man who decides yes or no.
医生自己可能对副作用也知之甚少 The doctors themselves may not be well-informed about the side effects.
除了用女人自己作为实验物很难想象还有哪些方法 It's hard to see what more we could do without using women themselves as the experimental model.
如果你有一只宠物猫 If you have a pet cat,
你可能记得它什么时候 开始交配 well, you may remember when she started going into heat...
例如它的排卵期 ...as in, when she started ovulating, producing eggs.
在排卵期间 And for those few days when they're fertile,
它们真的很想交配 they really want to mate.
在排卵期间 大多数雌性哺乳动物的举动不同于往常 Most female mammals look and act different around the days they're ovulating,
这种情况叫做“发情”发出想要交配的信号 called "estrus," signaling that they want it,
所以过来 来吧 so come and get it.
雌性黑猩猩会出现生殖器肿大的现象 Female chimpanzees get huge sexual swellings,
山羊摇尾巴 goats wag their tails,
马眨眼 and horses wink their vulvas.
但是像人类这样的高级灵长类动物 则与众不同了 But higher primates, like humans, are pretty unique.
发情期间 我们没有任何外在迹象 We don't show outward signs that it's our fertile few days of the month,
无论是否处于排卵期 我们都会对性邀约保持开放态度 and we're continually receptive to sex, whether we're fertile or not.
科学家称之为隐性排卵期 Scientists call this concealed ovulation,
直到20世纪90年代 科学家终于破解了其原理 and it took them into the 1900s to figure out how it worked...
并且如何控制这种情况 and how to hack it.
排卵主要涉及四种激素 Ovulation mainly involves four hormones,
这些激素在一个月内 会经历上升和下降 which rise and fall over the course of a month.
其中两种从大脑中释放出来 Two of them are released from the brain,
两种来自卵巢 也就是雌激素和黄体酮 and two come from the ovaries: estrogen and progesterone.
一开始 这两种大脑激素 To kick things off, those two brain hormones
向卵巢发送信号 那里大约有12个卵泡 send a signal to the ovaries, where roughly a dozen follicles,
每个都含有一个未成熟的卵 each containing a single immature egg,
一直耐心等待此刻 have been patiently waiting for this moment.
争夺有限激素供应的斗争 是一场赢家通吃的竞争 It's winner takes all in the fight over the limited hormone supply,
争输的卵毛囊会死去 and the loser follicles die off.
接下来 获胜的卵泡 将释放出大量雌激素 Next, the winning follicle emits lots of estrogen,
开始让子宫内膜变厚 which starts to thicken the uterine lining
然后打开子宫颈 and opens up the cervix,
子宫颈现在已经涂上了 充满营养的液体 which is now coated with a nutrient-filled fluid
保护任何进入子宫的精子 that protects any incoming sperm on their journey up to the uterus.
然后卵泡破裂 释放出成熟的卵 Then the follicle ruptures, releasing the matured egg,
此卵被附近的输卵管抓住 which is snatched up by the nearby Fallopian tube.
精子去抓卵的时间窗很短 否则它会死掉 The sperm has a short window of time to get to the egg, or it dies off.
但是如果一个精子到了那里 那就意味着成功受精了 But if one gets there, that's fertilization.
随着孕酮水平的上升 卵一直往下游 The egg keeps traveling down the Fallopian tube to the uterus
沿着输卵管移动到子宫 as progesterone levels rise,
子宫颈关闭后 液体就会转变成黏性保护层 which close the cervix and turns that fluid into a sticky shield,
阻止任何新精子进入 blocking any new sperm from getting in.
黄体酮还会不断地把子宫内膜 堆积成一个温床 The progesterone also keeps building up the uterine lining
在那里卵子可以黏在上面 into a warm, snuggly bed where the egg can stick.
只是没有那么温暖舒适 But it's not that warm and snuggly.
这也是一个致命的战场 It's also a lethal testing ground
但不是每个受精卵都能存活 that not every fertilized egg can survive.
如果受精卵成功植入 即意味着成功受孕 If a fertilized egg does successfully implant, that's a pregnancy.
这时雌激素和孕酮水平保持在高水平 Estrogen and progesterone levels stay high,
卵巢也不会释放更多的卵子 and the ovaries won't release more eggs.
但是如果受精卵被拒绝 或者从未受精 But if the fertilized egg is rejected or there never was one,
雌激素和黄体酮就会直线下降 estrogen and progesterone plummet.
从子宫中流出来的 就是月经 And out comes that lining: your period.
循环会重新启动 And the cycle reboots.
激素避孕法的套路 Hormonal birth control's main cheat
让身体以为自己怀孕了 is altering the estrogen and progesterone levels in the body,
因此不会再释放卵子 so it thinks you're already pregnant.
子宫颈保持堵塞 So, no new eggs are released.
子宫内膜仍然很薄 The cervix stays plugged up, and the uterine lining remains thin.
避孕丸发行于1997年是按照此套路研发出的第一种药物 "The pill," released in 1957, was the first form of this hack.
这种每天服用一剂的 合成雌激素和黄体酮药丸 A daily dose of both synthetic estrogen and progesterone,
在美国以“伊诺维德”的名义销售 在英国则称为“恩纳维德” marketed as Enovid in the US and Enavid in the UK,
但只是为了治疗“月经问题” but only to treat menstrual problems,
令人觉得奇怪的是 突然有很多女性 发现自己有这个问题 which an unusually large number of women suddenly found they had.
当避孕药在20世纪60年代 作为节育产品上市时 And when the pill hit the market as birth control in the 1960s,
它改变了世界 it transformed the world.
更多女性能够留在学校 组织规模较小的家庭 More women were able to stay in school and have smaller families,
也帮助了数百万人脱贫 helping to lift millions out of poverty.
我们可以看到孟加拉乡郊地区的情况 从20世纪80年代起 You can see that kind of profound impact in rural Bangladesh,
出现了很大的改善 starting in the 1970s.
孟加拉国刚立国 很穷 Bangladesh had just become a country. It was very poor.
宗教保守 Religiously conservative.
大多数孟加拉妇女 都活在女性隔离政策下 Most Bangladeshi women were practicing female seclusion,
甚至不能公开露面 where they would not even go in public.
所以去诊所是这些女人的一大诉求 So, going to a clinic was a big ask of these women.
但在1978年 卫生局职员 But then in 1978, health workers went door-to-door
开始挨家挨户 到70个随机选择的村庄 in 70 randomly selected villages every two weeks
进行一系列的节育措施 with an array of birth control options,
包括注射避孕药物 这是最受欢迎的选项 including injections, the most popular choice,
毕竟这些女性个性保守 这些注射型药物效果能维持几个月 because they were discreet, and one shot lasted for months.
二十年后 效益相当显著 Two decades later, the results were transformative.
与其他相同的村庄相比 Compared to an otherwise identical village...
节育村的家庭 受过更多的教育 families in a birth control village had more education,
拥有更高的收入 更有价值的房子和更多储蓄 higher incomes, more valuable homes and savings,
更容易取得自来水 and better access to running water.
这些女性的身体质量指数也比较高 Those women also had a higher body mass index,
当中有百分之二十的女性活到老 and as a result, they were 20% more likely to survive into old age.
但是 激素节育给全世界妇女 带来的进步 But the progress hormonal birth control brought women around the world
并不是没有代价的 didn't come without a cost.
从第一颗药丸开始 Starting with that very first pill.
你看 当你吃药的时候 See, when you take the pill,
它把那些合成激素放进你的血液里 it puts those synthetic hormones in your bloodstream,
贯穿全身 so they travel all over the place.
激素水平的变化会导致头痛和恶心 The changing hormone levels can cause headaches and nausea,
影响头发生长 并增加保水性 affect hair growth, and increase water retention,
体重也可能增加 so you can gain weight.
这些激素也起到 调节性欲和情绪的作用 And these hormones also play a role in regulating sexual desire and emotions,
因此你可以体验到激烈的情绪波动 so you can experience changes to your very sense of self.
虽然风险非常小 And while the risk is extremely small,
雌激素会增加 血液凝结成块的机率 estrogen increases the chances that your blood will thicken into a clot,
血块会流到肺部 阻碍血液循环 which can travel to your lungs and block blood flow,
足以致命 which can be lethal.
第一颗药丸 And that first pill,
它所含的激素分量 比避孕所需的激素分量 多出十倍 it contained ten times the amount of hormones needed to be effective.
50年代 这种高剂量药物的测试地点 主要集中在波多黎各 That high dose was primarily tested in Puerto Rico in the '50s,
被选中是因为那是个贫穷国家 chosen because it was poor,
美国政府担心其“人口过剩” and the US government worried about its overpopulation.
因此受政府委任的州长 批准了一项绝育计划 The US-appointed governor endorsed a sterilization program.
到了1954年 绝育率几乎翻了三倍 By 1954, sterilizations had nearly tripled,
这些女人经常被迫绝育 the women often coerced.
所以当研究人员 带着可逆节育措施出现时 So, when researchers arrived with a reversible birth control option,
这些女人接受了 these women took it.
但是她们不知道自己是实验的一部分 But they didn't know that they were a part of an experiment
直到一个纪录片制片人 几十年后告诉她们 until a documentary filmmaker told them decades later.
服用那些药丸的女人 The women who took those pills
是世界上第一批试服该药物的人 were the first in the world to try them.
你知道吗 多娜玛丽亚？ Did you know that, do?a Maria?
不知道 No.
他们在我们不知情的情况下 They were experimenting with us,
拿我们做实验 without us knowing what they were doing.
数百名女性面临严重的副作用 Hundreds of women faced serious side effects.
至少有三人死亡 尽管该事件从未被调查过 At least three died, though it was never investigated.
花了十多年时间 推出了几种新配方 It took more than ten years, several new formulations,
全世界已经有数百万女性 服用过避孕药后 and millions of women around the world taking birth control pills
美国国会终于 为避孕药副作用举行听证会 for the US Congress to finally hold a hearing on their side effects.
当初是因为一位参议员读了 《医生反避孕药实例》 It was called, after one senator read the landmark book,
这本标志性作品后 呼吁举办听证会 The Doctors' Case Against the Pill,
作者是采访记者芭芭拉西曼 by the investigative journalist Barbara Seaman,
她的报告显示女性经历了 who reported women experiencing
心脏病、中风 血液凝结和癌症这些副作用 heart attacks, strokes, blood clots, and cancer.
仅在美国 就有数千人死亡或受伤 Thousands had died or been injured in the US alone.
听证会的头五天 For the first five days of the hearing,
由全男代表组成的法官团 只传召男性出庭作证 the all-male panel only invited men to testify.
而女性必须自个儿传召 女性证人出庭作证 So, the women, they invited themselves.
今天由于一群女性 在法庭上引发一阵骚动 An outburst by a group of young women today
法庭宣布暂停 有关避孕药安全性的听证会 temporarily halted the Senate hearing on the safety of the birth control pill.
我想知道为什么 科学家和制药公司非常愿意 I'd like to know why is it that scientists and drug companies are perfectly willing
把女人当成豚鼠测试避孕药中的雌激素成分 to use women as guinea pigs and experiment testing the high estrogen,
是不是太高或太低 low estrogen content of the pill.
在接下来的几年里 这些药丸中的激素剂量降低了 The doses of hormones in the pills were lowered in the following years,
副作用如头疼、作呕 reducing the chance of side effects like headaches, nausea,
毛发暴长、体重暴增的机率也减少了 excess hair growth and weight gain.
一些新的药片更能减少抽筋和粉刺 And some new pills were better at reducing cramps and acne,
多亏了孕酮的新合成形式 thanks to new synthetic forms of progesterone.
许多潜在的副作用仍然存在 A lot of potential side effects still remain.
但对于全世界数亿女性来说 But for hundreds of millions of women around the world,
只要不怀孕 让自己有点不舒服没什么 not getting pregnant is worth making yourself a little sicker.
就像早期版本一样 And just like with those early versions,
女性 有时甚至她们的医生 women, and sometimes even their doctors,
都不知道 她们会有多不舒服 don't actually know how much sicker they'll get,
毕竟我们起初都不知道 至到很多人开始服药后才会意识到 because you can't always know until a lot of people start taking a drug.
一种叫“悦姿锭”的避孕药 One of those synthetic forms of progesterone, DRSP,
其重要成份是复合型黄体酮 叫做“屈螺酮” was a key component in a pill called Yaz,
这种成份在21世纪大量推出市面 不仅用于节育 which was heavily marketed in the 2000s as way more than just birth control.
“悦姿锭”是唯一一种能有效 Yaz is the only birth control
改善情绪和经后综合症症状的避孕药 proven to treat the emotional and physical premenstrual symptoms
这些症状都足以影响生活作息 that are severe enough to impact your life.
它还有助于保持肌肤光滑 It can also help keep your skin clear.
“悦姿锭”也含有一种新型激素 能增加人体钾含量 Yaz contains a different kind of hormone that may increase potassium.
广告宣传成功了 The ad campaign worked.
两年来 “悦姿锭”成为美国最受欢迎的避孕药 For two years, Yaz was the most popular birth control pill in the United States.
许多不需要节育的年轻女性掏钱购买 And many young women who didn't need birth control
是因为广告声称 能使经前综合症症状消失 bought it on its own claims that it made PMS symptoms disappear.
接下来 副作用的投诉开始散播开来 Then reports of side effects started to spread.
从血栓到器官衰竭到中风 From blood clots to organ failure to stroke,
成千上万的妇女说她们在服用 thousands of women say they got sick
一种叫“悦姿锭”的避孕药后 感到不舒服 after taking a birth control pill called Yaz.
由于此药可能导致严重健康问题 Now under scrutiny
因此受到了审查 for possibly causing serious health problems.
服用此药可能会引发严重的副作用 Using it can increase the risk of dangerous side effects
甚至可能导致死亡 that may even cause death.
服用避孕药导致血栓形成的风险 高出三倍 Birth control pills roughly triple the risk of getting blood clots...
但是研究后来发现“屈螺酮”也足以让血栓形成的风险 增加三倍 but studies later found that DRSP can as much as triple that risk.
风险虽然不大 And while the risk is still small,
但如果数百万女性同时服用这种药丸 那么这一数字将达到数千 it adds up to thousands of women if millions are taking that pill.
截至2015年 “悦姿锭”的制造商 As of 2015, the maker of Yaz,
拜耳制药公司已经解决了近1万起 Bayer Pharmaceuticals, has settled nearly 10,000 claims
女性血栓问题索赔官司 赔偿额总计约20亿美元 from women who got blood clots, totaling around $2 billion.
但是到那时 一种不同的节育方式越来越受欢迎 也就是宫内节育器 But by that time, a different type of birth control was growing in popularity: the IUD.
这是激素节育器 This is the hormonal version.
另一种采用铜制成 There's also a different kind, made of copper.
医生可以把这两种节育器植入子宫 Both types are inserted into the uterus by a doctor,
根据品牌的不同 它可以在子宫内停留三到十年 where it can stay for three to ten years, depending on the brand.
我们不完全知道它们是如何起效 We don't totally know how they work,
但我们知道它们会把子宫 变成无精子区 but we do know they turn the uterus into a no-sperm zone.
作为子宫中的异物 As a foreign object in the uterus,
宫内节育器会引起炎症 the IUD causes inflammation,
触发白细胞冲进去吃掉精子 triggering white blood cells to rush in and eat the sperm.
激素宫内节育器也会持续释放 The hormonal IUD also continuously releases a tiny amount
少量合成黄体酮 药片也有很多相同的效果 of synthetic progesterone, so it has a lot of the same effects of the pill,
只是副作用更少 but with fewer side effects.
含铜宫内节育器不使用激素 The copper IUD doesn't use hormones at all.
其套路是铜是精子氪星石 Its trick is that copper is sperm kryptonite,
科学家也不理解为什么 for reasons scientists don't understand.
我喜欢宫内节育器 I love having an IUD.
我不用担心忘记吃药 I don't worry that I forgot to take my pill.
没有遗漏 没有月经 I don't spot. I don't get a period.
我想在过去的七年里 我只用了两个卫生棉条 I think I've used two tampons in the last seven years.
我决定买含铜宫内节育器 因为我妈妈和她姐姐 I decided to get the copper IUD because both my mother and her sister
患有雌激素相关的乳腺癌 had estrogen-related breast cancer.
所以 医生建议我 So, I was advised by doctors
采取非激素节育法 to get on a non-hormonal birth control option.
宫内节育器百分之99有效 The IUD is 99% effective,
大部分是因为植入体内后 就什么也不用做了 in part, because you can just set it and forget it.
一般来说 节育的效果越差? In general, birth control gets less effective
人们就越需要记住该做些什么 来让它发挥作用 the more humans have to remember to do something to make it work,
尤其是在做爱的时候 especially if it's during sex.
这就是为什么 另一个最有效的方法是结扎术 Which is why another of the most effective methods is sterilization.
对男人来说 “结扎”是一个小手术 For men, "the snip" is a minor procedure
只要切割或夹紧 将精子输出睾丸的输精管 to cut or clamp the tubes that carry sperm out of the testicles.
对女人来说 “结扎”则是一个更具侵略性的手术 For women, "getting your tubes tied" is a more invasive procedure,
毕竟要堵塞或切割输卵管 which blocks or cuts the Fallopian tubes.
这实际上是世界上 最受欢迎的节育方式 That's actually the most popular form of birth control in the world.
但是女性通常在生下小孩后 才做这种手术 But women usually only get it when they've already had kids.
与此同时 节育器和节育术的效益相等 也可以随时取出 Meanwhile, the IUD is as effective and can be taken out,
但是只有百分之12的美国女性 使用宫内节育器 but only 12% of American women using birth control have one.
这是因为一起轰动一时的集体诉讼案 And that's largely because of a huge class action lawsuit
为一种叫“达康盾”的节育器提出抗议 against one IUD, the Dalkon Shield.
这种灾难性事件 被《周六夜现场》拿来当笑话段子 Such a disaster, it was a joke on Saturday Night Live.
如果你不同意达康盾推出的鳟鱼饵 If you don't agree that the Dalkon Shield trout lure
是你用过最厉害的鱼饵 is the most amazing trout catching phenomenon you've ever tried,
那就起诉我们吧！ well, sue us!
但不是鱼饵的形状给达康盾 But it wasn't the fish-bait shape
带来了麻烦 that caused problems for people who got the Dalkon Shield,
以洛蕾塔罗斯为例 like Loretta Ross.
我用它的头两、三年很好 My first two or three years with it were fine.
但是后来 我开始出现轻度感染迹象 But then, I started developing very low-grade infections.
她去了妇产科医院 医生说她有性病 She went to an ob-gyn, who said she had an STD.
如果我是黑人或女性 阴道出现感染迹象 If I was black and female presenting with an infection,
在他看来 一定是性病 it had to be an STD, in his opinion.
尽管所有的测试呈阴性 Even though all the tests were showing up negative.
他依然坚持往更矫情的方向去检查 He just kept searching for something more exotic, more exotic, more exotic.
没有一种治疗有效 六个月后… None of the treatments worked, and six months later...
一天晚上 我陷入昏迷 I lapsed into a coma one night.
当我醒来时 我已经做了全子宫切除术 When I woke up, I had a total hysterectomy.
医生应该做的第一件事是 The first thing that doctor should have done
移除达康盾 was remove the Dalkon Shield.
原来 达康盾有设计缺陷 It turned out the Dalkon Shield had a design flaw.
它的编织线太粗了 Its braided string was too thick,
它就像梯子一样让细菌爬进子宫 and it acted like a ladder for bacteria to climb into the uterus.
在达康盾推出不到四年内 Within four years of the Dalkon Shield's release,
它就被清出市场了 it was taken off the market.
那一刻 全球已经有三百三十万女性 植入了这种节育器 By that point, it had been inserted into 3.3 million women around the world.
至少导致18人死亡 At least 18 died.
成千上万的妇女 Hundreds of thousands of women
起诉达康盾的制造商A.H.罗宾斯公司 sued the maker of the Dalkon Shield, A.H. Robins,
导致该公司破产 bankrupting the company.
后来发现 罗宾斯公司高层在达康盾面市六个月前 It later came out that Robins officials knew about the wicking problem
就知道了芯有问题 six months before the shield went to market.
现在市场上的宫内节育器非常安全 The IUDs on the market now are extremely safe.
最常见的缺点是什么？ The most common drawback?
很难被放进去 Horrible to get put in.
极度地疼痛 Excruciating pain.
每个节育措施都有一个缺点 Every birth control option has a drawback,
这就是为什么三分之一的美国女性尝试过五种或更多种节育法 which is why a third of American women have tried five or more kinds.
我先用药丸 然后我用节育环 I started with the pill, and then I went to the ring.
然后我又回到药丸上 And then I went back to the pill.
两种药丸 Two forms of the pill,
有趣的是 阴道避孕环 the Nuvaring, um, which was interesting,
会在做爱时掉出来 but that would come out during sex.
我试过三种不同的药丸 I've been on three different types of the pill.
我试过宫内节育器 现在我用皮下埋植避孕法 I tried an IUD. And now I'm getting an arm implant.
很多女人完全不使用节育措施 And a lot of women don't use birth control at all,
即使她们不想怀孕 even though they don't want to get pregnant.
只有百分之五的女性未采取避孕措施说原因是没有获得避孕措施的途径 In one survey of developing countries, just 5% of women not on birth control said the reason was access.
百分之26的人说是因为担心副作用 26% said the reason was side effects.
实际上有一种避孕药 是不使用激素的 There is actually a birth control pill that doesn't use hormones.
它是以“萨赫里”的名字推出市面 It was launched as Saheli,
它已经面市差不多30年了 and it's been on the market for almost 30 years.
它的活性成分就是所谓的… Its active ingredient is what's called
“选择性雌激素受体调节剂” a "selective estrogen receptor modulator."
不是雌激素 Not estrogen,
而是一种对子宫雌激素受体 产生反应的化合物 but a compound that acts on estrogen receptors in the uterus.
其作用是让雌激素不能发挥作用 So, the estrogen there can't do its job,
并通过产生一层温暖的子宫内膜 确保受精卵不能依附在子宫里 building up that warm uterine lining so no fertilized eggs can snuggle in.
由于它实际上并不影响雌激素水平? Since it doesn't actually affect estrogen levels,
因此不会影响体内激素平衡 the balance of hormones in your body stays the same.
其副作用也比激素药丸少些 So there are fewer side effects than hormonal pills.
只需要一周吃一次 And you only have to take it once a week.
但如果能在印度以外的地方 找到萨赫里就算走运了 But good luck getting Saheli outside of India.
印度是这种药物的发源地 That's where it was invented
跟多数国家出售药物前一样 经过大量人体用药实验 and went through the large human trials most countries require to market a drug.
这是其中一款有幸推出面市的药 And it was one of the lucky ones.
在实验室开发的每5000种药物中 Out of every 5,000 compounds developed in a lab,
只有五种通过了人体试验 其中只有一种进入市场 only five make it to human trials, and only one of those gets to market.
因此找到新的方法来释放 我们已知有效的激素 So finding new ways to deliver the same hormones we already know work
其实更快、更便宜、风险更小 is faster, cheaper, and less risky.
（拜耳停止销售备受争议） Birth control has sparked thousands of lawsuits,
因为大多数健康女性 正在服用这些药物 because mostly healthy women are taking these drugs,
所以她们更容易注意到 起诉严重的副作用 so they're more likely to notice and sue over serious side effects.
由于女性必须购买这些药厂的产品 There's also little incentive to innovate
这些药厂的创新动力也不大 since women are buying their products anyway.
情绪波动很糟糕 The mood swings have been bad.
最初很容易作呕 但是我想 会慢慢习惯的 The nausea has been bad initially, but then you just get used to it, I guess.
那几年磕磕碰碰 付了好几年的医疗费用 Years worth of drama in my life, years worth of medical bills,
旅行时战战兢兢 drama while I'm traveling,
做爱时神经兮兮 drama that I have to think about every time I have sex,
月经来潮时紧紧张张 every time I get my period.
为什么要经历这些？我猜是因为避孕套很烂 Why go through that? I guess 'cause condoms suck, but...
节育行业有巨大的潜在市场 And there's a huge potential market
几乎完全没有开发 the birth control industry has left almost entirely untapped.
作为一个男人 我一点也不满足于自己的节育选择 I'm not at all satisfied with the options of birth control
因为我觉得不够 for myself as a man because I feel like there aren't enough.
作为男人我唯一的选择 My only option as a guy is to use condoms, uh...
是使用避孕套或是体外射精 ...or to-- or to pull out.
所以我唯一的选择是使用避孕套 So, really, my only option is to use condoms.
如果有市场销售男性避孕药 If there was a commercially available male birth control pill,
我绝对会尝试一下 I would definitely, definitely, at the very least, try it.
几十年前 科学家们找到了侵入男性生殖系统的方法 Scientists figured out how to hack the male reproductive system decades ago.
20世纪70年代的大规模试验 显示出一些希望 And large trials in the 1970s showed some promise.
几十年来 男性节育措施 The perfection of male birth control
趋向完善指日可待 seemed right around the corner for decades.
中国人已经研发了 The Chinese have developed what they say
据称是安全有效的男性避孕药 is a safe and effective birth control pill for men.
医学研究人员今天指出 Medical researchers reported today
他们发现了一种化学物质 可能是男性避孕药的关键所在 they have found a chemical that may hold the key to a male birth control pill.
国际研究小组正在研究 一种可注射的… International research teams are working on an injectable...
避孕药… ...birth control pill for...
…男性首次参与 一项新型节育方式的试验 ...men are taking part in the first trials of a new form of birth control.
-对于男人… -说到男性节育 对于… -For men... -Birth control for men...
-男性节育… -男性节育… -Male birth control... -Male birth control pill.
男性节育可能离现实又近了一步 Male birth control may be one step closer to becoming a reality.
但它从未实现 毕竟试验经常中断 But it never arrived, since trials were often cut short
原因是男性出现太多副作用 because men faced too many side effects.
这些副作用并不陌生 Side effects that might sound familiar,
比如情绪波动、长痘痘和性欲减少 like mood swings, acne, and a loss of libido.
批准药物时 When approving a drug, the FDA weighs its risks
食品和药物管理局通常会 以服不服用该药物的风险为前提 against the risks of not taking that drug.
男人不像女人 不必亲自面对 And men, unlike women, don't personally face
怀孕和分娩带来的风险 the risks that come with pregnancy and childbirth,
例如出现血栓 like blood clots.
激素避孕可能会使 一个人患上血凝块的风险增加两倍 Hormonal birth control might triple a person's risk of blood clots,
但是怀孕期间 风险是原来的两倍 but during pregnancy, the risk is double that,
分娩后的几周内 又增加四倍 and in the weeks after childbirth, quadruple.
经历无数次诉讼纠纷后 拜耳公司在辩护期间 And that was part of Bayer's defense in court documents
提出了这份证词 in the wake of all those lawsuits.
这就是为什么“悦姿锭” 还在市面上的原因 And it's why Yaz is still on the market,
其他含有屈螺酮成份的药物也一样 as are a bunch of other pills using DRSP.
男性节育必须达到更高的标准 Male birth control just has to meet a higher bar,
所以现在最有可能获得认可的 so the kind that has the best shot at approval right now
就是不使用激素的节育法 doesn't use hormones.
也就是非手术输精管切除术 It's a non-surgical vasectomy.
它的操作原理是把一种凝胶 注射进精子输送管 It works by injecting a gel into that sperm carrying tube,
凝胶停留在输精管 趁精子离开睾丸之际杀死精子 where it stays, killing sperm as they leave the testicles.
第二支注射液正在研发中 它可以分解凝胶 A second shot is in development that would break down the gel.
目前仍在印度等获批准 It's awaiting approval in India...
早期试验显示百分之98有效 where early trials have shown it's 98% effective,
没有重大副作用 has no major side effects
并且可以持续超过十年 and can last over a decade.
但它没有在其他国家进行过人体试验 But it hasn't gone through human trials anywhere else,
制药公司也不置可否 and drug companies aren't sure
男性节育是一个值得开拓的市场 male birth control has a market to make that worth it.
我愿意尝试 I'll be open to it.
至于会不会减少我的男人味 Does that make me less of a man?
我不知道 但我愿意尝试任何节育法 I don't know, but I'm open to anything, honestly.
如果男人可以选择承担那样的责任 If guys had the option to sort of take that level of responsibility,
不是只选择使用安全套 like, leveling up from just using a condom,
我认为这会是一种公平的做法 I think that would make it a fairer conversation.
意外怀孕是双方的责任 It takes two people to accidentally get pregnant.
2002年一项调查发现百分之55的男性 A 2002 survey found that 55% of men would be willing
不介意尝试男性激素节育法 to try even a hormonal male birth control.
但放眼世界各地 But everywhere in the world,
女人结扎的人数比男人结扎的人数多 women get their tubes tied more often than men get the snip.
男人不认为是他们的责任 They don't think it's their responsibility.
我总是那个保护自己的人 I would probably personally always want to protect myself.
我得为自己的事负责 I have to be responsible for my own shit.
如果事后确实发生了什么事情 At the end of the day, if something did happen,
我自己必须承担后果 the consequences would lay on me.
全世界的大多数女性都认同 意外怀孕的后果非常严重 And most women around the world see the consequences of an unplanned pregnancy as so serious,
但选择不难 that the choice is easy.
这就是为什么在美国 Which is why in the United States,
有超过三分之二的女性伴侣 采取节育措施 more than two-thirds of partnered women use birth control.
萨尔瓦多有百分之68的女性 采取节育措施 It's 68% in El Salvador,
而肯尼亚有百分之58 58% in Kenya,
中国则有百分之80 and 80% in China.
但不是每个人都有相同的选择 But not everyone gets the same choices.
1999年 一件大事被列入国会记录 In 1999, it was included in the Congressional Record.
A.H.罗宾斯公司在20世纪70年代初期 that A. H. Robins had "conspired in the early 1970s
密谋将数十万个… to dump hundreds of thousands
危险致命、未经消毒 of dangerous, unsterilized contraceptive devices--
在美国滞销的避孕装置 带往发展中国家脱售 unmarketable in the United States-- into the developing world."
那些装置就是达康盾 Those devices "were Dalkon Shields."
洛蕾塔罗斯去了其中一个国家 Loretta Ross traveled to one of those places,
也就是采取种族隔离政策的南非 apartheid South Africa, and shared her story.
分享她的故事 但是当地许多女性 依然选择使用达康盾 But many women still chose to get one.
她们能取得的避孕措施不多 There were so few contraceptive options available to them,
她们认为有必要使用宫内节育器 they thought that they needed to accept the IUD
毕竟这是解放她们的方式 because it's what freed them up
让她们有教育和改善经济环境的机会 for educational and economic opportunities.
我觉得这是一件悲惨的事 And I felt it was tragic.
选择虽多 但了解风险也一样重要 Having a variety of options is just as important as knowing the risks.
这就是孟加拉计划如此成功的原因 That's what made the Bangladesh program so successful.
我们可以在孟加拉看到 What you see in Bangladesh is the commitment
政府承诺为女性提供各种节育措施 to offer them a full range of services.
在一个没有道路、冰箱和电供的地方 Getting a cold storage supply chain for injectables
找一个冷藏服务供应商 来保存这些注射器 in a place where there are no roads or fridges, or electricity,
在当时可是一件大事 that was a very big deal at that time.
招募当地妇女 And, you know, the task of recruiting local women
与妇女谈论生活 to talk to women about their lives,
了解她们的需求、渴望 以及愿望 their needs, their desires, their aspirations,
是一个相当重大的责任 was a pretty big commitment.
有一件事我们在妇女健康运动中 One thing we in the women's health movement
从来没有坚持过 have never insisted upon
那就是追求一个零风险的避孕法 is a perfect contraceptive with no risk.
毕竟每次往体内植入异物 because every time you put something in your body,
我们就是在经历某种改变 you're changing something.
我们只是要求在完全透明化的情况下 采取节育措施 What we ask is fully informed consent.
我们要为自己做… We need to determine for ourselves
…是否要承担相关风险的决定 what risk we're willing to undertake or not.
而不是让别人为我们做决定 即便没有风险 Not have someone determine that for us, regardless of risk.
字幕翻译：Daniel