He is 43, or 46. In reasonable shape. Practical, not panicking. He has noticed things changing over the past few years and has decided he would rather address it on his own terms than not address it at all.
The pill exists. He knows it. He is not interested in planning around it, managing side effects, or building a dependency he will need to handle for the next two decades. He wants something that works with his body, not something that overrides it for one night at a time.