I’ve been a sex educator for six years. Why did I start doubting my contraception choices?

Six Years as a Sex Educator: A Shift in Contraception Confidence

Milly Evans, a seasoned sex educator, possesses greater knowledge about contraception than many others. Yet, as she prepared to undergo a hormonal intrauterine system (IUS) procedure, she found herself grappling with unfamiliar uncertainties. Social media, once a source of reliable information, had become inundated with content casting doubt on hormonal contraception. This led her to question whether the potential risks were justified. For six months, the 26-year-old hesitated before scheduling her appointment, her confidence wavering under the weight of persuasive arguments. “Some of the claims I saw were so compelling that they made me question what I already know to be true,” she explains.

A Digital Undercurrent of Doubt

Evans is not alone in her apprehension. Among young women in their 20s who are heavily engaged with online platforms, discussions about hormonal methods like the pill, coil, and implant have surged. These conversations often fall into two distinct categories: personal stories of side effects and strategic sharing of misinformation, frequently tying hormones to ideological narratives. The latter has sparked particular concern, as Evans highlights. The content, she notes, often carries a “right-wing, religious, largely American element,” framed around concepts such as “clean living” and “divine femininity.”

Real-World Impacts of Online Narratives

Lauren Haslam, a 25-year-old resident of Manchester, also feels the ripple effects of these online debates. She follows numerous fitness and wellness influencers, some of whom portray hormonal contraception as “unnatural” or damaging. Haslam, who has relied on the combined pill for four years, credits it with transforming her life. The pill has helped manage her premenstrual dysphoric disorder, which previously caused severe cramps and unpredictable emotional shifts. Yet, she admits that the negative posts make her positive experience feel “invalidated,” prompting her to reconsider her choices.

From Viral Posts to Clinical Conversations

Across the Atlantic, the United States has seen a rapid spread of anti-hormonal messages on platforms like Instagram. A recent post from a new mother, holding her unplanned child, drew over 800 likes for a comment declaring, “Birth control is so bad for you.” Another user lamented, “Contraception sucks,” while a third linked the pill to depression. Even qualified professionals, such as psychosexual therapist Evie Plumb, report that misinformation is proliferating in online spaces and podcasts.

Expert Perspectives on the Debate

Dr. Fran Yarlett, medical director at the Lowdown women’s health platform, acknowledges that while some claims are outright incorrect, others stem from small studies with “questionable methods.” For instance, the assertion that the pill can “shrink your clitoris” is often cited without context. Meanwhile, London GP Jenny Dhingra observes a growing trend of patients expressing “aversion” to hormonal methods, citing fears about side effects after exposure to social media content. “Some were scared after seeing those posts,” she says.

Quantifying the Trend: NHS Data and Research Insights

The NHS outlines common side effects of hormonal contraception, including headaches, nausea, mood changes, weight gain, breast tenderness, and acne. However, these typically improve over time. It also notes that while hormonal methods can slightly elevate risks for blood clots and breast cancer, the likelihood remains “very low.” Despite this, data suggests a shift in UK usage patterns. A 2023 study, analyzing information from tens of thousands of women seeking abortions in England and Wales, found a decline in the proportion using hormonal contraception between 2018 and 2023. Furthermore, a recent review revealed that negative side effects are more frequently highlighted online than the benefits.

Challenges in Measuring the Impact

Professor Jenny Hall of UCL points out that NHS data may not fully capture the nuances of contraception use. It excludes those who obtain pills via pharmacies and overlooks the fact that some devices are now prescribed for extended periods without replacement. Nevertheless, the data hints at a broader trend: a growing hesitation toward hormonal methods. “It’s hard to say how much these online conversations are influencing real-world decisions,” Hall says, emphasizing the complexity of tracking the phenomenon.

“The reality is that scary stories tend to gain more attention and go viral.”