As a sex educator, Millie Evans knows more than most about contraception.
But in the run up to getting the hormonal coil (IUS), she was filled with unfamiliar doubts about whether it was right for her body.
Her social media feed was “flooded” with comments encouraging her to get hormonal birth control. He asked himself: was the risk of a bad experience worth it?
For six months, Evans, 26, had been putting off booking her appointments.
“Some of the claims I saw were so compelling that they made me question what I already knew was true,” she says.
It’s not an uncommon story – if you’re an older woman online in your 20s, you’ll see lots of conversations about hormonal birth control like the pill, coils and implants.
The chatter generally fits into two categories – women sharing side effects they’ve personally experienced, and men sharing deliberate misinformation, often linking hormones to ideology.
It’s the latter that worries her the most.
The content has a “right-wing, religious, largely American element,” says Evans, who has been recognized for six years, and is often framed in terms of “pure living” and the “divine feminine.”
Posts like these have even made their way onto Lauren Haslam’s Instagram feed. The 25-year-old, who lives in Manchester, follows a number of fitness and wellness influencers – and says she’s annoyed by some of them “donating” hormonal contraception and calling it “unnatural”.
Haslam, who has been taking the combined pill for four years, says it has helped ease her symptoms of premenstrual dysphoric disorder, a severe form of premenstrual syndrome that causes intense cramps and erratic behavior in the run-up to her period.
She says the pill has “honestly changed my life,” but the posts make her feel “invalidated” about her positive experience and question whether she’s making the right decision.
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In recent years in the US, material discrediting hormonal contraceptives has spread rapidly on social media.
A quick search pulls up a post of a new mom holding her unplanned baby, a 17-year-old asking Instagram for birth control advice. The comment below, liked more than 800 times, reads: Birth control is “so bad for you.”
Another called the contraceptive a “mistake,” before another user shared his distaste for the pill, saying it made them depressed.
According to psychologist and relationship therapist Evie Plumb, people are spreading misinformation online and on podcasts claiming they have medical qualifications.
Dr Fran Yarlett, medical director of women’s health platform Lowdown, says that while some claims are simply false, others are based on small-scale studies with “questionable methodology” and take information out of context – such as claims that the pill can “shrink your pelvis”.
But this attitude shift isn’t just happening online or in America. Sexual health experts in the UK say these conversations are becoming increasingly common in real-life clinics.
London GP Jenny Dhingra says she has seen a lot of “hate” among patients over the past two years, with some citing concerns about side effects and saying they are “scared” after seeing social media content.
The NHS says that commonly reported side effects of hormonal contraception include headaches, feeling sick, mood swings, weight gain, breast pain and acne, but that these side effects usually get better with time.
It also says that hormonal contraceptives may increase the risk of blood clots and breast cancer, but that the risk is “very low”.
It is difficult to say exactly how much these online conversations are really influencing contraceptive use in the UK. The NHS data does not include people taking the pill from pharmacies, or acknowledge that some devices have been prescribed for a long time without being replaced, says Jenny Hall, professor of reproductive health at UCL.
She says that overall, however, the data seems to sway people moving away from hormonal contraception.
A study published last year showed a fall in the proportion of women using hormonal contraception to prevent pregnancy between 2018 and 2023, based on information from thousands of women seeking abortions in England and Wales.
In addition, a review of several studies last year found that negative side effects are discussed “more often” on social media than the benefits of contraception.
Posts and comments on social media can spread false information about contraception. The NHS, for example, says the risk of breast cancer is “very low” for people on hormonal contraception. [BBC]
The reality is that horror stories get attention and go viral, Evans says, while someone who loves coils “with all their heart” doesn’t get ideas.
People “are pushed to really extreme negatives … where people say they’ve had a traumatic experience, in which someone’s blood clots,” she adds.
Sex educator Kerry Wolstenholme agrees that it’s those “horror stories” she hears that make young people decide contraception is “not for them”.
So if people are turning away from hormonal contraception, what are they using instead? Sexual health professionals say fertility tracking apps, unlike pills, coils and implants, can be advertised on social media in the UK because they don’t require a prescription.
Some women post promoting them as a “natural” alternative. Based on things like their last period and their temperature, the apps predict a likely fertile window when you should avoid sex or use protection.
But many of them are designed as period trackers or to help couples trying to conceive so should not be relied upon to prevent pregnancy.
Experts are clear that some people “can and will” experience side effects from hormonal contraceptives – that’s how the drug works. But they say people haven’t even heard of the benefits.
Kayla Haley, head of contraception at MSI Reproductive Choices, says that hormonal contraceptives can help ease symptoms of heavy periods or PMS.
It’s also common to prescribe hormonal options to help with symptoms of conditions like adenomyosis and endometriosis that can cause painful periods.
Amid the social media uproar, sex educator Evans says there are also “a lot of frustrated women” who want to share legitimate, negative experiences with hormonal contraception.
The problem is – experts say that even if these stories are valid, they’re not being shared without context about how likely these side effects are.
Some feel that concerns about side effects aren’t taken seriously and are burdened with the “contraceptive burden,” says Hall. There are currently no hormonal contraceptives for men, although some gels and pills are being tested.
And Evans worries “very real frustrations” are only feeding into stories spread online by anti-birth control campaigners, including some who see a key role for women to have as many children as possible.
In the end, Evans didn’t let the content on social media sway her, and earlier this week had a hormonal coil inserted.
She says she felt “confident” in her choice after discussing it with the healthcare professional who fitted it.
After she posted her experience on Instagram, she received messages from people who said they were relieved to see her post “because they were turned off by other content”.
