Comment by WA | Hacker News Reader

Comment by WA | Hacker News Reader

This is big. This is the future of contraception, because it works, it's incredibly cheap, it has (almost?) no side effects. All current solutions are a joke.

Hormone-based contraception feels like something from the middle ages. It has serious side effects, it has "harmless" side effects that aren't even related to the pill anymore after years of intake, but still an annoyance (migraine, headaches, yeast infections, high blood pressure, ...)

Non-hormonal contraception has its own negative aspects:

- Copper IUDs can cause a lot of pain, inserting them isn't that easy, they are ethically troublesome (eggs can be fertilized after ovulation, but the copper IUD prevents nidation)

- Natural family planning methods are way safer than many people believe (the sympto-thermal method), but don't allow unprotected sex during fertile days

- Condoms are way safer than many people believe as well (as long as you use the correct size) and won't go away because of STDs, but are a bit annoying in relationships

And there really aren't any other alternatives right now. The state of contraception in 2017 is incredibly sad and RISUG is the first attempt, which truly can disrupt (and I don't use this word lightly) the entire industry.

It will require some social shift. Men must be willing to take responsibility for contraception, but it's already happening: Recently, the pill for men was stopped because of side effects, but the men were disappointed. They WANT to have alternatives to condoms.

Bang on.

Me and my partner were planning on me getting a vasectomy in a year, when her implant runs out.

We've had to bring that forward a year because one side effect is also a symptom of cancer or polyps.

After removal, she experienced a huge lift in energy levels and greater stability of mood.

I have 2 children so a vasectomy isn't so bad an idea. Even still, it is an invasive and permanent treatment and I'd prefer something less so. Nobody likes the thought of a scalpel down there. Even a physician who wants to get it done.

> We've had to bring that forward a year because one side effect is also a symptom of cancer or polyps.

Can you please elaborate on this, or link me something? Without going into too much detail, my partner has an implant, and has been having a cancer scare recently. I would really like to know more about these side effects of the implant, which as you say, are also symptoms of cancer / polyps.

Vaginal bleeding, regular spotting, cramps and fatigue. Above and beyond the irrelugar periods implants cause.

It was only by the doctor's mention that we got the implant removed ASAP so we could see if it was that. If not, we could explore straight away.

Fortunately it was the implant. I'm not so sure about giving false hope as I don't know the ins and outs but it is possible.

The particular cancer is endometrial.

Thank you for that information.

I've relayed it to my wife, and hopefully that's all this is. She's seeing a doctor today, so the timing couldn't have been better.

Edit: I would reply to your below comment, but I can't for some reason. But, just wanted to say, thank you.

I hope it all goes well for your wife today. I know it must be a really anxious time for you both. The above happened to us in the last week so the terror of the prospect is still fresh.

As a father of two: Said procedure is incredibly harm- and painless.

I understand the fear, but I've seen people (even here) spread a lot of FUD about it. If you prefer something else: Sure! If you're merely uneasy about the process: Don't be, it's so common, fast and easy.

Thank you :) Don't get me wrong, I'm not frightened away from it. I have a GP appointment on Tuesday for a referral. I think it'll be some time on the NHS but no doubt less time than this contraceptive becomes available.

Isn't that a normal response to a voluntary procedure? Fear? Uncertainty? Doubt?

Mine hurt for more than a month. It's worth it and I'd do it again in a heartbeat, but hate it when people go around telling everyone that it will all exactly be the same. It ain't. Muzzle velocity is lower and the ammunition is visibly no longer standard issue. Further, the recoil action is quite a bit less intense. There's a lot of psychological stuff going on in this mind space, and discounting people's feelings about what is ultimately a primal urge is just foolish.

Pro tip: go to a place that does the no-incision variety and then make sure that's what you're getting. Just the first part isn't enough. Just because you read that they take the same amount of (doctor) time and so assume that any place offering them must only do those, and that if they didn't they would surely offer you a choice, don't neglect to double check.

Source: all too painful personal experience (guess what doesn't always work on the first try? That's right. Local anesthetic.)

Different people have different reactions. I've known guys who just shrugged it off, and others who were in a lot of pain for weeks.

My vasectomy a year ago left me in chronic pain on one side, and with a significant reduction in enjoyment of sex. I have spent thousands of dollars on treatment, and will soon go for a reversal, which will cost around $12k. I'm not sure what I'll do if it fails, but orchiectomy is on the table. Vasectomy was the worst decision of my life.

There is a real risk of chronic pain, which can be devastating, and it is much more common than the literature would have you believe.

Plus, unlike women, you/men can bank sperm in case you have need of it later.

That's not entirely true... I'm not saying it's even CLOSE to as easy or as cheap as collecting sperm, but woman are able to have their eggs collected and frozen for future use.

I think the GP mentioned that because this subthread discussed a "permanent" solution for men. Storing sperm might be a workaround for future "wouldn't it be nice.." regrets. An insurance.

I'm not aware of mainstream (or any, really) permanent solutions for women, at least not to replace contraceptives (medical reasons - like cancer - for an invasive surgery don't count).

So, if women usually don't decide to become sterile (?), the process to collect and store eggs seems less relevant.

I'm not sure what you're saying here. Women can have their eggs frozen and undergo tubal ligation. That's pretty analogous to vasectomy and frozen sperm, albeit quite a bit more invasive.

Biology question: does having a tubal ligation affect a subsequent IVF pregnancy at all? Are there records of such a case happening?

Looks like you can do it, but it also looks like they normally try to reverse the tubal ligation first.

True, but women have to take drugs to stimulate egg production for harvesting. These drugs have side effects. My sister in law went through hell during multiple rounds of IVF.

Spanking one (or many) out in a cup at a collection center has virtually no risk to the man.

Check into Ovarian Hyperstimulation Syndrome...

http://www.advancedfertility.com/ovarian-hyperstimulation.ht...

Hi. I'm against vasectomies and all contraception because my religion (Catholic) teaches they are gravely sinful, but aside from this, I've read that some very small percentage of men have recurring pain for years following vasectomies- something to Google/ think about if you're considering this. Like the top commenter said, another option is Natural Family Planning - the Symptothermal method taught by the Couple to Couple League, which sells a home-study course) boasts an effectiveness rate rivaling hormonal contraceptives for couples who follow the guidelines. This does require periods of abstinence, which sucks sometimes, but is otherwise free and side effects and free for both couples. Another Symptothermal way is Daysy, which my wife and I haven't tried but looks cool since it does all the charting/rules for you. God bless and best of luck.

Huh, you weren't kidding:

https://www.scientificamerican.com/article/periodic-abstinen...

although we do have this:

> "You really can't extrapolate from this paper," says David Grimes, an obstetrician-gynecologist and vice president of biomedical affairs at the nonprofit public health organization Family Health International. "Naive readers see these results, and they think [STM] is the greatest thing since laptop computers. The researchers on this paper went back and cherry-picked this data from an ongoing study from the past 20 years. They chose the users who were the best users for this method."

and there aren't any references there at all. Besides, the requirement that a couple perfectly adhere to the rules is pretty ... unergonomic.

(caveat: I'm of course not remotely anti-contraception, but it was a fun couple of searches)

When my wife and I decided to have our first child, we did basically the reverse of this method (ie, had sex exactly when this method would tell you not to). And we were expecting after the first month. So, the predictability is there; it's just the usability that makes this method not a reliable form of birth control.

> Copper IUDs [...] are ethically troublesome (eggs can be fertilized after ovulation, but the copper IUD prevents nidation)

That's only if you have some outdated religious beliefs (to put it kindly).

If you look at nature ~50% (various research points to 40% to 60%) of fertilized eggs are lost before a woman's menstruation cycle. So half are lost without attaching to the uterine wall and anybody noticing it.

There is also IVF that fertilizes many more eggs then end up being used / viable.

So the whole ethical concern about copper IUDs and preventing nidation is a misguided at best. And more realistically, it is a harmful and outdated belief clocked in arbitrary religious rules ... meant to exert control over women and families.

> If you look at nature ~50% (various research points to 40% to 60%) of fertilized eggs are lost before a woman's menstruation cycle. So half are lost without attaching to the uterine wall and anybody noticing it.

That strikes me as a bit of an unfair argument. I can't speak for all religious people, but for many there's a huge difference between losing fertilized eggs 'naturally' and inducing this outcome. Within their world-view, this distinction makes sense.

> So the whole ethical concern about copper IUDs and preventing nidation is a misguided at best. And more realistically, it is a harmful and outdated belief clocked in arbitrary religious rules ... meant to exert control over women and families.

While I agree on the arbitrariness, and while I'm not religious anymore, I once again don't think it's fair to argue that 'realistically' these beliefs exist to exert control. I'm sure many people have used religion to exert control, but most of the deeply religious people I know can do a decent job arguing why they believe what they do, I just disagree with their axioms.

> That strikes me as a bit of an unfair argument. I can't speak for all religious people, but for many there's a huge difference between losing fertilized eggs 'naturally' and inducing this outcome. Within their world-view, this distinction makes sense.

Why should that be that the case? Their intent is already to lower fertility, and with IUDs, sometimes that (unintentionally) happens with identical symptoms to naturally "failed" implantations. ;-)

Just adding on to this with an anecdote. My mother had something called norplant (https://en.wikipedia.org/wiki/Levonorgestrel-releasing_impla..., it has been rebranded recently and there were class action lawsuits filed in the late 90s and early 00s due to awful side effects that were not listed) and had ovarian cysts later in life due to this device (she also had emotional problems while she was on them). It became completely debilitating to her health and required extremely invasive surgery to rectify (and prevent from ever coming back). It was actually shocking how much different she was after the surgery. The cysts can be extremely painful for up to a few weeks if they don't burst (her's didn't burst at ALL). She is more energetic after her surgery than I've ever seen her, despite being almost 50. Please be careful if you are gonna use these kinds of things and understand the risks (I know my mom's case is exceptional and not necessarily indicative of normal problems/use).

Reply on news.ycombinator.com