Barely a week after Trump was reelected to the White House, for many in the U.S., access to birth control is seeming shakier than it did at the start of this month. But is it possible that young women are more dubious about birth control than past generations?
The last few years has seen a rise of social media influencers—many of them Gen Z—putting forth false and misleading claims on TikTok and YouTube about the safety and efficacy of hormonal birth control. A 2023 study found that a growing number of online influencers are telling followers that birth control leads to a range of issues from cancer to depression to weight gain.
Many of these influencers push “natural” alternatives to hormonal methods like fertility tracking or the “rhythm method.” A majority of medical professionals say the rhythm method—which involves keeping track of period dates to try to identify when a woman is at the most and least fertile points in her cycle, often using period-tracking apps—is not as effective as hormonal birth control and can lead to unplanned pregnancies. (Meanwhile, with the possibility of a nationwide abortion ban looming and concerns about private medical information falling into the wrong hands, some women are warning others not to put any personal data about their menstrual cycles into an app.)
It’s true that women’s health is severely understudied, and influencer warnings about “trusting the establishment” might in some way represent an attempt to take their reproductive health into their own hands. However, after Trump’s election and more than two years after the fall of Roe v. Wade, it’s more crucial now than ever that women online have access to reliable information about birth control, especially young women who may be learning about birth control for the first time on social media.
According to Dr. Raegan McDonald-Mosley, CEO of the nonprofit reproductive health organization Power to Decide, it’s important for providers and educators to counter misinformation by creating resources “in the places where young people are consuming content,” like TikTok and Instagram, and offer “evidence-informed information about contraception and birth control to meet people where they are.”
Bedsider’s TikTok account has a series of #AskDrRaegan videos where viewers can send in questions about reproductive health.
In honor of Thanks, Birth Control Day on Nov. 14, I spoke with Dr. Raegan about some of the most common social media misconceptions when it comes to birth control. Here’s what she said about separating the facts from the fiction.
1. MYTH: Some kinds of birth control are better and others are worse.
FACT: There’s no one-size-fits-all approach to birth control.
According to Dr. Raegan, hormonal birth control methods like pills, IUDs and implants are most effective. However, which method someone picks often depends heavily on personal preference. For example, while pills work well when you follow directions and take them at the same time every day, someone who doesn’t want to have to think about taking a pill every day might want a longer-acting option like an IUD.
“There isn’t one specific method that’s best for everyone,” Dr. Raegan said, “and that’s exactly why everybody should have access to the full range of methods.”
The website Bedsider.org breaks down different birth control options and lets users compare them side by side to find the one that works best for them.
2. MYTH: Non-hormonal methods are safer than hormonal birth control.
FACT: Fertility-based methods (like menstrual tracking apps) are less effective than hormonal birth control.
Although fertility tracking can work for people with regular menstrual cycles of a consistent length, “for most people, it’s not particularly effective, and the failure rate is quite high,” Dr. Raegan said. She explained that she would counsel a patient that there are more effective options available.
However, if a patient wants to use a cycle-based tracking method, she would recommend also using a barrier method like condoms to reduce the possibility of an unintended pregnancy at the point in a woman’s cycle when she’s more at risk for one.
3. MYTH: Birth control causes health risks.
FACT: Birth control is extremely safe.
Like any medication, birth control can come with side effects. However, for the vast majority of patients, birth control poses no health risks. In our call, Dr. Raegan debunked several of the most common misconceptions about birth control side effects, including claims that birth control can cause cancer and future infertility.
Dr. Raegan explained that birth control actually lowers the risk of cancer by providing protection against some forms of cancer, including ovarian cancer, uterine cancer and colon cancer. Hormonal birth control can cause a slight increase in the risk of breast cancer; however, taking everything into consideration, “the overall risk of cancer for all birth control users is actually lower.”
According to Dr. Raegan, using hormonal birth control also poses no threat to a woman’s future fertility. “For common methods of birth control, once someone stops that method, their fertility almost immediately returns to what it was before,” she said. The only exception is injectable birth control, which can stay in someone’s system for three to six months after they have their last shot. However, it doesn’t change their long-term fertility.
4. MYTH: IUDs are painful, and doctors won’t warn you about it.
FACT: IUD insertion can be painful, but providers can offer pain medication.
One of social media’s biggest trending topics around birth control has been the incredible pain associated with having an IUD inserted, with one woman on TikTok describing the procedure as “the worst pain imaginable.”
IUD insertion can certainly be uncomfortable depending on the person, and patients’ experiences can range from the mild discomfort of a period cramp to pain that makes some patients pass out. The fact that the CDC only recently updated its recommendations for IUD pain management after several women on TikTok spoke out about how painful insertion can be certainly speaks to a culture of medical sexism and doctors underestimating women’s pain.
However, it’s important to understand that experiences vary widely from person to person. At the same time, providers can offer many options for pain management, including a topical anesthetic to the cervix. “Some providers will offer an intracervical injection of lidocaine or a numbing medication,” Dr. Raegan explained, “and some providers may even provide mild sedation or pills.”
Meanwhile, she said it’s important to talk ahead of time with a provider “to understand what the range of pain is, and to be able to make an informed decision about what you might need if you want to get an IUD.”
5. MYTH: Birth control causes weight gain.
FACT: There is no evidence that most birth control methods cause people to gain weight.
Despite weight gain being one of the most common fears about birth control (often coupled with more general sexist, fatphobic messages that women shouldn’t gain weight), there’s no basis for the idea that birth control methods like pills, the patch and the ring make people gain weight.
The birth control injection Depo-Provera and, to a lesser extent, the contraceptive implant are associated with weight gain for some patients, about 20 percent. However, according to Dr. Raegan, “it doesn’t happen with everyone,” and if someone starts one of these methods and finds themselves gaining weight, “they can absolutely talk to their provider about switching to another method.”
For more information on choosing a birth control method, you can watch Dr. Raegan’s video on misinformation around birth control or the #AskDrRaegan TikToks from Bedsider.
