As an OB-GYN training to be a complex family planning subspecialist at UC San Diego, I have seen misinformation about hormonal birth control circulating widely across the internet. Popular TikTok videos describe unwanted (and I would be remiss if I didn’t say medically inaccurate) side effects including cancer and infertility.
These social media trends have me reflecting on my own practices. Every day I see people of reproductive age who desire to prevent pregnancy. My number one goal is to help my patients make an informed decision and feel comfortable with the birth control method they have chosen. But am I part of the problem? Do I sometimes focus so much on reassurance that I miss opportunities to address rare side effects? Should I instead be addressing this misinformation directly even if patients don’t bring it up on their own?
Although this spread of inaccurate information and shift away from highly effective and safe birth control is alarming, studies show many people rely on friends, family and social media to make decisions about what birth control they use. And, unfortunately, many patients report feeling that questions about side effects are not fully addressed by their providers, specifically that possible side effects are not discussed and are dismissed. This lack of trust and erroneous information about the harms of birth control online is likely what is persuading some people to go hormone-free.
In my current practice, I start by asking my patients if they want to talk about birth control during their visit. If the answer is no, I let them know I’m available at any time to discuss their options, but end the conversation there. If they are interested in a discussion of their options, I start by asking what birth control they have tried before. If they didn’t like a certain method, I ask why not, and I ask what the most important aspect of a birth control method is for them. These simple questions help me to individualize my counseling for each patient, meeting them where they are at in this moment.
My hope is for all my patients to understand that birth control has been studied extensively and is safe and effective at preventing pregnancy. That being said, it’s important to recognize that there is not one birth control that fits all. Additionally, part of my role is to address misconceptions people hear about on social media by sharing data on potential side effects and explaining what someone can expect when starting a new birth control. For example, there is also a clear relationship between certain types of birth control and a lower incidence of ovarian, uterine and colon cancer. Multiple studies have shown birth control use is not associated with infertility, and for people desiring an IUD, there are many effective options to help manage discomfort with the insertion.
To patients, I encourage you to talk to your health care provider about your concerns and specifically address what you have read and heard about. For example, consider scheduling a telehealth visit to discuss pain management options during an IUD insertion before coming to clinic for the insertion.
To my colleagues, take the time to talk to your patients about their concerns and potential side effects. Ask them what they have heard about on social media and clarify myths about birth control. Our patients are asking to be heard. Ultimately social media is not going away, and this is an opportunity for us, as clinicians, to revisit how we approach birth control counseling.
Greiner is an obstetrician-gynecologist and complex family planning fellow at UC San Diego Health and UC San Diego School of Medicine.