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Comment by lordCarbonFiber | Hacker News Reader

As a middle aged man I assume you're not on birth control, a prescription drug whose side effects can include depression. I would not be surprised to find that prescription birth control makes up the lion's share of the third of the adults counted in the article.

Based on my family's anecdotes it seems even discounting even the contraceptive angle, hormonal BC seems to be the crude implement to treating a host of female health issues we don't under stand very well.

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Note, copper IUDs (which are non-hormonal) have worked well for all the women I know on it. I’m sure it’s not a panacea, but it’s effective, cheap, and essentially zero maintenance beyond verifying it’s still there.

I believe in some states in the US you can even get the state to pay the cost.

IUDs are associated with a lot of nasty high impact, low frequency side effects.

Birth control is a lot more predictable, especially now that dosages are lower.

Hormonal birth control may be more predictable, but it predictably has bad side effects (acne, weight gain, depression, and a host of other symptoms I’ve forgotten). There are also people where it straight up doesn’t work—one of the women to which I’m referring had two kids on hormonal birth control before connecting the dots and switching.

Overall, everyone has their own birth control needs. Most of the evidence I’ve seen has led me to prompt people having issues to consider the copper IUD because it does seem to work very well (when those complications you mentioned don’t show). A surprising number of people have misconceptions about insertion, periods, hormones, and efficacy, so I’m always happy to increase the amount of power people have over their own uterus by making them aware of their choices.

A certain, cynical part of my brain believes the reason the pill is popular is that there are many, many incentives to encourage people to go a route that returns recurring revenue, not helping women find what works best for them. It seems to be pretty common to simply prescribe the pill when people ask for birth control.

No matter what else is going on, Jimmy always wears his hat when he goes out. The only procedures guaranteed to permanently work as birth control 100% of the time are hysterectomy and bilateral orchidectomy. When you multiply failure rates together, they get smaller.

Don't ignore your inner cynic. Medicine is not the only industry trying to force everyone to a subscription model in lieu of one-time expenses.

When you ask doctors what birth control they use IUDs come out pretty high.

www.contraceptionjournal.org/article/S0010-7824%2815%2900072-4/pdf

Cheers!

What? No. LARCs FTW. Since 2009, ACOG guidelines state they are the first-line option for birth control.

The impact, even of a uterine perforation, is not that high (and the frequency is also lower than you suggest).

tl;dr, the above is FUD.

No doubt contraceptives are a part, but they are actually taken by a small minority of people. They are only applicable to relatively young females, those capable of having children. Younger children and older women aren't much of a market. Depending on what ages you want to pick, the applicable population is probably less than 1/4 the total, with a smaller subset of that actually taking.

A quick googling says that 28% of women of "reproductive age" use the pill, which by my math is about 14% of women overall and 7% of the total population.

What math are you using? By my understanding, women are able to reproduce for around or close to half their lives.

First result[1] I found while googling defines women of reproductive age as 15-49, and claims that group makes up 24% of the overall population, which would line up with my intuition.

[1] PDF http://www.who.int/management/UsingDataToImproveServiceDeliv...

EDIT: Ah, reread your comment, looks like your math lines up with mine, just misunderstood. Thought you meant 7% of the population were women of reproductive age, not that 7% of the population were women of reproductive age on the pill.

Although it also makes me wonder if a sizable percentage of women outside reproductive age are on the pill. Either because they are fertile longer than average, or as treatment for other conditions.

Hormone Replacement Therapy is similar.

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