Pfender is an associate fellow at the Leonard Davis Institute of Health Economics, a postdoctoral researcher at the Perelman School of Medicine at the University of Pennsylvania, and a research affiliate with the Center for Health Communication at the University of Delaware.
In a viral TikTok, a woman in the emergency room shares a message questioning why so many women in their 30s struggle with cancer and infertility, and suggests that birth control's long-term hormonal disruption is the cause. Another influencer mocks the FDA inserts that accompany birth control, unfolding the long lists of side effects in videos to humorously repurpose them as "blankets" for napping or as tools for helping men grasp the harsh realities their partners face to prevent pregnancies. That TikTok has received 2.6 million likes and 21,000 comments.
Such portrayals exaggerate side effects and are spreading misinformation that could lead to unwanted pregnancies and other problems. Contraception faces daily attacks on platforms like TikTok and YouTube, where influencers often highlight the perceived dangers of hormonal birth control, such as the pill, while urging viewers to discontinue effective care and return to a more "natural" state.
In a 2023 study that I did with a colleague, 74% of YouTube influencers sampled who spoke about birth control encouraged discontinuation of contraception. A 2024 TikTok study by my team found that nearly 50% of the posts about birth control that we analyzed promoted the same idea, with TikTok creators identifying 57 alleged negative side effects of hormonal contraceptives.
These claims are usually based on personal anecdotes, not scientific evidence. My latest research suggests that when women ages 18-29 perceive an influencer as more trustworthy or as having greater expertise, they are more likely to intend to use less effective non-hormonal options, like fertility tracking, aka the rhythm method, even if they are currently using hormonal birth control like the pill, IUDs, implants, vaginal rings, and injections. Today, the rhythm method often involves using period tracking apps to identify when they might be most fertile and abstain from sex then.
As a scientist and 15-year birth control pill user who has never experienced negative side effects, I was shocked to see this content on my TikTok and Instagram feeds. Although I've never relied on menstrual cycle tracking apps, I know several people who did, resulting in unintended pregnancies, including a friend's. Before using the tracking app, she used the birth control pill but wanted to find an alternative that didn't involve taking medication. An unintended pregnancy came as a serious shock to her and her partner. A scenario like this could be devastating for a single mother.
These apps, often marketed as "natural" alternatives, are not only unreliable but expensive to boot. Fertility thermometers alone can cost up to $300, with monthly app subscriptions running up to $12 per month, whereas most birth control methods are available for free through insurance and Medicaid.
While much of the birth control content on social media is negative, some have triggered institutional change. For example, videos describing painful experiences with IUD insertion have gained significant attention. Content creators have shared their personal stories, likening the pain to an "explosion of cramps" or feeling "cut or ripped open inside."
These viral stories drew attention to the lack of pain management during IUD procedures, which many providers underestimate. In response to this outcry, the CDC recently updated its guidelines to recommend offering pain management strategies, such as lidocaine for numbing the cervix, and discouraging the routine use of misoprostol, which is recommended only in specific cases. This shows how social media can spark changes, but it also demonstrates the danger of allowing misinformation to dominate these platforms. For example, posts about IUD insertion suggest that all women will experience severe pain, which isn't the case, and could scare many women away from using an effective contraceptive. As described in a recent New York Times opinion piece, the CDC directive is a good step forward but doesn't go far enough to address women's health concerns.
Beyond birth control, women's health as a whole faces significant challenges on social media. Recent research currently undergoing peer review indicates that many young women are recording their facial expressions during Pap tests to convey the discomfort and pain they experience. These videos often can heighten anxiety and discourage women from attending essential cervical cancer screenings, which are already declining across various age and racial demographics in the U.S.
To address these concerns, doctors and regulators should partner with social media influencers to disseminate evidence-based information. Research by Matt Motta and colleagues at Harvard University has shown that such collaborations can counteract misinformation about mental health on platforms like TikTok. A similar approach should be explored for more facets of women's health. For example, health care organizations or universities could partner with women's health influencers to address misinformation on hormonal contraception. Health care organizations could create a series of short, engaging videos that address common myths about hormonal contraceptives, such as misconceptions about the link between cancer and hormonal contraception. These influencers might be identified in the searches completed in my studies.
Social media can benefit us in many ways by being a health promotion tool. But we shouldn't allow this modern convenience to lead us backward in women's health by perpetuating fear and misinformation instead of empowering informed choices.