Unfortunately for me, most permanent or semi-permanent options are not available. I have pelvic organ prolapse, so there is no surgical option that would not leave me without having to having a bladder sling or pelvic mesh, etc., none of which are an option due to the fact that none are good surgical practice, I'm young enough that I would be looking at "update" surgeries every 10 years or less, and all of the above would dramatically impact my ability to enjoy intimacy with my partner. My partner is not willing to have a vasectomy due to familial habit of severe and painful complications.

Additionally, I don't believe for me that the birth control pills have negatively affected my hormones. Or if the have had negative effects, the positive results I have seen have far outweighed the negative ones. In fact, after taking them for a little over two years now, my hormones are all in normal ranges for the first time in more than a decade! I know that there are many side effects to taking them. I am on high blood pressure medication now almost exclusively because of the hormonal impact here. However, I don't have the crazy-wide mood swings I had before getting back onto the medication. I don't have to deal with cycles for the most part, as I am on continuous meds, unless stress pushes through (though this is getting less and less). And I'm at significantly less risk for unplanned pregnancy. So, for me, at this juncture in my life, they are a better option (I won't say best, because there is always the opportunity for improvement).

As a side note, I wasn't aware that insomnia was a PMS issue. I have difficulties sleeping anyway, and sometimes, seemingly randomly, it kicks up a notch. I bet this could be the cause, because I know even when my cycles are hormonally suppressed, I still have a "cycle" underlying everything, it is just pushed to the background. I'll have to do some research to see if I can uncover my underlying natural cycle...

Thanks so much for letting me know it isn't just me... I'm so happy for people who have more options than I do. Oh, and almost every single health issue I currently fight surfaced AFTER I started losing weight. It seems so unfair that the healthier I try to be, the worse my overall health gets. But, have started 3 new meds in the past two weeks, one two weeks ago, the other two this past weekend, so I am looking forward to continuing the improvements that have already begun.

OMG, the cysts. Lucky for me, mine ruptured every time I ovulated... Not lucky. Once, the pain and such was so bad, I almost passed out. In the middle of my daughter's school field trip. When I was a parent sponsor. It scared the hell out of me. Then, my daughter started her hormonal cycles and totally blasted and reset mine. I worry a bit because her strong hormones lead me to believe she might have inherited my issues (how old does she need to be start testing for this stuff??). But, in most ways, it helped me. The cysts stopped completely. The moodiness subsided some. My cycles got more regular. I finally lost some weight.

Then my relationship status changed, and I got back on the pill. It has helped hormone levels balance, but messed with my blood pressure. At least the latter is more manageable than the former.

Thank you everyone, for making me feel less crazy... Yes, people neglecting their health because the side effects are more convenient than really life hurt my head... My sis has the endometriosis, but I never did. We apparently have different sides of things. I might mention this all to her (she's much lighter and healthier than I am, so she has less issues, and is now in the military...). Save her some steps if she ever decides to have kids.