Concerns are growing over social media information emphasising negative experiences of hormonal contraception. Labelled as misinformation, the volume and accessibility of this content that is said to lack context, and may be wrapped up with worrying political and commercial interests, is thought to be deterring hormonal contraceptive use. But is social media information alone fuelling dissatisfaction with hormonal contraception? Our research with contraceptive users in Scotland highlights how and why they engaged with different sources of information.

A lack of options and information
Dissatisfaction with hormonal contraception can arise for a variety of reasons, and for participants in our research, this included side-effects, accessibility of appointments, negative interactions with healthcare professionals, and being persuaded to use a particular method. A key issue also raised was that the contraceptive pill was prescribed with little conversation or information provided of other methods that might best meet their needs:

I knew I could easily go to the doctor and get it (the pill), but there wasn’t a discussion of have you thought about anything else or…tell me a bit about you… we can talk through lots of things that might be best. It just didn’t seem to be much of a discussion (Sam, early 30s)  

This lack of discussion was felt especially by disabled participants and those with long-term health conditions. One participant with ADHD described why she felt let down after being prescribed the pill:

I have ADHD, and looking back, the pill wasn’t maybe the best option, because I was quite bad for forgetting to take it. I remember saying to my GP I was struggling, and he said, just get a dosette box, rather than saying, there’s actually other ones you don’t need to take everyday (Cara, mid 20s)

Social media was considered valuable due to its accessibility and focusing on lived experiences of different contraceptives, features deemed absent from consultations, causing participants to feel misled and lack trust in information from healthcare professionals:

What am I going to get from this that I couldn’t get in more depth online and from actual people’s experiences, rather than an abstract five-minute chat with somebody…what is even the point in booking an appointment because I don’t trust that it’s the best provision, information or options (Charlie, mid 20s) 

Navigating experiential knowledge
Consistent with feminist movements and healthcare activism, experiential testimonies raised awareness of contraceptive methods and care, as Jade (mid 20s) described, ‘finding real people’s stories about their effects…how the doctors treated them’. For others, social media supplemented medical information: ‘For information, I would go to more official pages: NHS, Brook things like that, but I would go to social media for anecdotes. So, that’s more about how it felt or experiences (Jun, early 20s).

After being prescribed the pill as a teenager to manage polycystic ovary syndrome, Nicole (late 30s) joined online forums and followed social media accounts that introduced her to different management strategies, and led to her trying the hormonal coil after years of being dissatisfied with the pill and information provided by healthcare professionals:

A lot of my information comes from Instagram, TikTok, which I’m very aware might not be valid or correct, or as well intentional. I take a lot of it with a pinch of salt, but currently it is probably the only place I’m actually getting any kind of depth of answers, whether they’re right or not I know is a different subject, but if you look for what I would call proper sources, there’s still a limited amount of information….There’s not really been any knowledge, it’s just been like, there’s the pill, just take that.

Nicole’s feelings about ‘proper’ sources resonated with other participants who described NHS online information as, ‘a clinical language; it tells you the basics but it doesn’t tell you the human side’ (Mel, early 40s). While participants appreciated relatable content on social media, they regularly told us they approached this, ‘with a grain of salt’ (Jun, early 20s) and were aware that, ‘you have a lot of people basically just spouting opinions’ (Sam, early 30s).

Although participants did not stop using hormonal contraceptives because of social media content, some did reflect on the role that other people played in their decision-making. Claire (early 20s) recalled, ‘all the negative stuff sticks in my head’ when explaining friends’ experiences with hormonal contraception, while Dahlia’s (early 20s), decision to stop taking the pill was partially influenced by a conversation with an older colleague who, ‘spoke quite frankly about her reproductive life’.

For those who discussed using non-hormonal methods with healthcare professionals, their decisions were often dismissed and reprimanded. Olive (early 20s) reflected on the tensions between medical and alternative approaches, and the equation of lived experience with misinformation:

I want to go to the doctors and engage with the medical community, but I also want to track my cycle and be in touch with my body. Those two things could coexist. But there’s a conversation about wellness which is making the compatibility of those two things harder, because I think the minute I walked in the door and said those things, I would be received as ‘hippy dippy’ and told to get on the pill!… I can see the medical community’s concern, but I resent that testimony is pushed aside…

Multiple factors and sources of information can shape contraceptive decision-making. Turning to social media does not necessarily mean a rejection of medical information, but can enable contraceptive users to find information that better meets their needs, allow them to make sense of and validate their experiences, while also supplementing medical accounts and friends’ stories. People have a right to share their contraceptive experiences, good and bad, just as these have always been shared, and while there is a need to remain critical of online information, it does not help contraceptive users to dismiss it entirely. Rather, as participants suggested, more could be done to provide contraceptive information in different formats with lived experiences integrated, alongside investing in healthcare and in developing new contraceptive methods.