I've never regretted running my own server, nor have I ever contemplated moving to a hosted solution. Spam is not a problem either, Spamassassin in combination with a greylist make for a nearly spam-free experience. The whole setup has been migrated from the original Pentium-66 via an aBit-BP6 (SMP for the masses , retired in 2009) to the current Intel SS-4200 (upgraded to a dual-core Pentium but still limited to 2GB). In practice a Raspberry Pi would be enough to run a viable mail server so even this rather anaemic setup does its job without breaking a sweat.
The whole setup consists of Debian (Sid) running Exim through a smarthost, feeding through Spamassassin + greylistd into Dovecot. Apart from some auto-manual intervention to cope with Microsoft/Google/... not coping with the greylisting and thus needing whitelisting it more or less just works. In other words, just go ahead and run your own server.
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