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Taking something for 12 weeks is very different than years. Also when you look at men on trt they have a much higher risk of cardiovascular events than matched individuals who opted to not take trt. This is pretty well established at this point.

Not to mention we have the epidemiological data that men don't be live as long as women.

And they've also found similar issues with HRT for women in menopause.(increased risk of stroke)

But 10-12 years is probably a gross exaggeration. I wouldn't be surprised if this result is plagued with confounds( I don't think they did a survey of everyone). And these kids experienced a ton of non-doping related trauma.

Not to mention the individual interviewed sounds more like an advocate than a scientist.

I mean, all you’re saying here is that there are disadvantages to being male / masculinized. All you’re doing by signing up for TRT is signing up for the longevity of the average man vs. the longevity of the average woman or eunuch.

Are you suggesting that everyone who naturally produces testosterone (i.e. is on a constant dose of “endogenous anabolic androgenic steroids”) would be better off if they stopped doing so? If not, then there’s got to be a genetic profile + dose level at which the advantages of TRT outweigh the costs.

Forgive me if I'm wrong, but I thought that cardiovascular risk is far from established fact. I'm seeing the opposite findings in recent research.

[1] https://www.mayoclinic.org/healthy-lifestyle/mens-health/exp...

[2] https://jamanetwork.com/journals/jamainternalmedicine/fullar...

I think this is a point worth making, there could be a lot of confounding variables in this case.

> But what do you think is in birth control? Most birth control is a pill full of estrogen and progesterone, two other bio-identical sex hormones.

Birth control has a lot of bad side effects and many women actually avoid it because of them.

But they don't die ten years earlier even if they take it for most of their fertile years, or do they?

Hormonal birth control does terrible things to your health. But pregnancy is deadlier and harder on the body, and hormonal birth control is generally more reliable than other forms of birth control. So women who know it is really wracking them up do it anyway because it is better than having ten kids and being trapped in permanent poverty because of it, dying in child birth, being repeatedly maimed by the process of bringing a child into the world, etc.

https://hormonesbalance.com/articles/pill-can-seriously-affe...

http://goingoffthepill.org/hormonal-birth-control-risks-side...

How do both of these compare to the long-term effects of an early-life hysterectomy?

I don't actually know. I have never looked into that. But I have read of some cases where an early hysterectomy robbed the individual of their sex drive and their energy levels, among other things. And with any major surgery of that sort, you can always die from it or have complications.

My personal opinion: The least invasive tubal ligation you can arrange is probably the least worst answer in most cases where permanent birth control is desired because it doesn't interfere with the body's own hormone production and less invasive is less risky. Second best would be a hysterectomy that leaves the ovaries in place.

But what’s the best solution when the goal is not prevention of pregnancy, but rather to reduce the symptoms of “choppy” hormone production, or hormone imbalance (e.g. PCOS)?

AFAIK, the “best” solution for that (that is rarely pursued) is complete hysterectomy + HRT; with regular dual-hormone birth control pills or patches being a distant second, and nothing else helping at all.

I'm not an expert on PCOS. I don't actually know the answer to that.

(Assuming you are looking for personal advice, which you may not be:)

I am someone who has pursued a lot of "alternative" health stuff. I had terrible PMS and awful, painful periods in my youth and I accidentally discovered that cleaning up my diet mitigated it. I wasn't trying to mitigate it. When my husband was given orders for a war zone on short notice and we did a lot of eating out and stuff and generally partied before he left, my symptoms came back. That proved to me how much of an effect diet can have.

If I had PCOS, I would start a food diary, especially get picky about meat and dairy products because those can contain animal hormones, research which plants also have hormonal impact (I believe soy can do so) etc.

Diet would be the first thing I would work on and see how much it does. There is really a lot of info out there and if your goal is to alleviate your own symptoms and that's all you care about and you don't care what other people think, there are quite a lot of people getting remarkable results for various health issues by doing their own research, keeping their own records and so forth. It only is problematic if you then try to argue it in a forum. ;)

I would also join a chelation group. My recollection is metal poisoning interferes with hormonal stuff as well.

I would also look for literature from other countries. At one time, I had a book about women's health written by a woman who, IIRC, had fibroids and had lived in both France and America. Treatment options in France were vastly different from the US and she preferred how they handled it. They were willing to surgically remove fibroids in France, even quite large ones, where in the US they basically tell you to suffer or get a hysterectomy. (Again: IIRC.)

> Birth control has a lot of bad side effects and many women actually avoid it because of them.

Side effects like lower cervical cancer rates and reduced menstrual cramping?

Of all the women I know the reproductive habits of, I know of many who choose a hormonal birth control because of the benefits. I know of exactly zero who choose otherwise because of negative side effects.

But, that's anicdata. So in all seriousness, what side effects? I’m curious.

Mood changes, personality swings and the like are what I saw happen to my friend, it almost destroyed her multi-year relationship. Switching to the ring for birth control was like night and day, plus its still very effective.

Decreased libido in 15%[1] of users, for one

[1] https://www.webmd.com/sex/birth-control/features/the-pill-an...

I see this more and more in the fitness community of people thinking it is perfectly normal to be on TRT after 30. I personally think it's insane, a normal healthy male doe not have his libido disappear after 30 and does not need TRT.

There was recently a post here about that most ED cases are psychological (stress etc. ) and not necessarily a problem with hormones.

Decline in T causes you to become more sensitive to stress with respect to erectile function. It’s entirely possible that both are correct.

A sixteen year old going through puberty with hormones through the roof has no problem getting it up, stress or not (even when they don't want it, as every teenage boy knows). A 30 or 40 year old will have lower T levels, enough so that psychological issues can take the forefront and cause ED. It is still fair to ask if raising T levels can cause them to still perform while working stressful jobs, as we all have to do.

Normal and healthy are different. In an environment full of xenoestrogens, TRT is possibly the only way to attain “normal” levels of T measured against a non-xenoestrogenic environment. That doesn’t imply it’s a good idea, but it might imply you should do it anyway.

Or, to put that another way: in an environment that causes >20% of the population to be near-sighted, are glasses “normal”? Are they “healthy”? Do either of these questions even make sense?

The real questions there, of course, are whether nearsightedness is “normal” and/or “healthy.”

And so: is having (diagnosed) low testosterone normal? Healthy?

In consideration of the confidence with which you're asserting your claims are "well-studied", I think you should cite some of the specific research you're thinking of.

In particular, I don't find your arguments, "because of bad media" and "But what do you think is in birth control?" very convincing.

What birth control is made of: https://en.wikipedia.org/wiki/Combined_oral_contraceptive_pi...

Affects of high dosage testosterone for short intervals in healthy young men: https://www.physiology.org/doi/full/10.1152/ajpendo.2001.281...

Testosterone levels and mortality rates: http://jaha.ahajournals.org/content/ahaoa/2/6/e000272.full.p...

There is plenty out there, you just have to look around

That birth control pills contain hormones is not exactly a revelation. Another very common term for them is "hormonal contraception". They are not benign; their side effects can be pretty brutal, and they alter cancer risks (some forms increased, some decreased).

(Some women are also prescribed hormonal contraceptive pills to mitigate problems like endometriosis.)

Here is nice review papers:

Medical Issues Associated with Anabolic Steroid Use: Are They Exaggerated? https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3827559/

Anabolic-androgenic Steroid use and Psychopathology in Athletes. A Systematic Review https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4462035/

TL;DR it's not settled issue but many adverse effects seem to be transitory. Long term usage has risks. Abuse and dependence is an health issue of course.

ps. As a interesting side note. When you visit hospitals, pay attention to the musculature of male doctors. I'm sure they are gym rats with good genes, but many of them are muscular and low fat above age 40 in a way that requires something extra. They have ways to get quality stereoids and they can monitor their liver enzyme levels etc. If anyone can dope safely, it's MD.

Only on Hacker News can you find someone using the axiomatic method to derive a conspiracy theory of doping among hospital doctors.

Funny though, I remember hearing that their were rumours a while back about female junior doctors drawing their own blood as a way to control their weight.

Have a look at the female doctors too, I think they are in on it as well. How deep does this go?

For the side effects you're talking about, what are the relative and absolute increases or decreases in risk? Do you have any recommended reading? My wife uses hormonal contraception so I have a vested interest in this research.

We are not just talking about healthy young men when it's about GDR doping victims. You really think the benefits you'd consider "highly beneficial" in a man in his 20s are useful for girls and boys starting to take this stuff from 10-15 years old on? Liver failure, infertility, overly masculine features (more a problem for the women of course), injuries due to non-muscle parts of the body not being appropriately developed for the weight-lifting the muscles now can sustain, ...

You can not use claims that steroids can be safely used to argue that "it wasn't so bad" for victims of criminal misuse of them, and your post dangerously sounds like trying to downplay it that way.

I think the concerns are more about lowering the need of the testes to produce testosterone, leading to atrophy.

Of course, it can be beneficial if you want to keep a baseline that's important for your health.

Otherwise, something that's very risky if taken in the younger years.

> You probably think it's bad to take, because of bad media.

Yes, I think giving birth control to non-consenting people, especially children, is just as bad.

But I didn't need the bad media to come to that view.

Teenagers given the pill have a significantly lower lifetime risk of HPV and cervical cancer.

I meant -- in parallel to what we discuss here -- giving it surreptitiously. But you surely knew that.

How is the last point relevant? Many people take a different sex hormone so this one might be okay too?