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Comment by projektir | Hacker News Reader

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.

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> 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...

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.)

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