Birth Control TikTok Is, Unsurprisingly, a Hotbed of Misinformation

Whether you love TikTok or feel it signifies the downfall of civilization, one thing is hard to deny: Those posts are persuasive, occasionally teaching you lessons you didn’t know you needed and course-correcting decades of ignorance in mere seconds. Case in point: Right when you’ve accepted that you’re just not someone who can handle putting on a duvet cover without emitting an unbroken 45-second string of curse words, TikTok serves up the burrito-rolling method that changes everything. Or you’re just scrolling about your day when a random mom comes along to show you that you’ve spent your entire life replacing your kitchen trash bags incorrectly. (Who knew that was even something you could get wrong?) 

When it comes to life hacks, TikTok has proved uniquely suited to educate us in ways that plain old text-and-photo articles or even YouTube videos can’t. There’s something about that alchemy of peppy background music, dynamic text snippets, and videos shot in hyperlapse that our brains can’t get enough of. Which is cool, as long as we’re talking duvet covers or trash bags. The trouble can come when trending hashtags cover more complex topics—weight loss, nutrition, birth control. Yes, even birth control is viral on TikTok these days, and in many posts the life hack is…to stop using birth control. Down the birth control rabbit hole, TikTokers are romanticizing a “return to nature” movement in which women “break free” of hormonal birth control methods. Pushing back against these highly effective birth control methods—which some TikTokers feel doctors dole out without sufficient discussion of their potential side effects and risks—is framed by many influencers as a powerful way to “reconnect with their periods” and “rebalance their hormones.”

“My cycle is a superpower and my body is my birth control,” one “fertility awareness educator” posts, sunshine on her skin and sexy Latin jazz in the background. Lip-synching or dancing to hold our attention and piling on the happy-sparkly emoji, influencers detail the ups and downs of their #comingoffbirthcontrol journeys, often claiming benefits like weight loss, less bloating, and improved sex drive. Only some of them preface their posts with a disclaimer that they’re not health care providers and that their personal experience might not apply to everyone. Some openly share that posts by other TikTokers are what inspired their own lifestyle shift: “Seeing other people’s journeys on TikTok was a huge reason I decided to go off” is an oft-heard refrain. It seems “breaking free” of birth control has gone viral not just on TikTok but IRL. 

How, then, are people preventing all the pregnancies these days, especially at a time when abortion access is hardly a given? Well, this TikTok movement relies heavily on what’s called natural birth control and fertility awareness methods (or FAM, for short). Modern evolutions of the old-school rhythm method or calendar method, they involve mapping your ovulation cycle, often using a fertility-tracker app; monitoring your cervical mucus (yup, you regularly have to inspect a sample and chart whether it’s sticky or cloudy); and tracking your temperature daily with a basal body thermometer. Combined, this trio of biomarkers can help you ID your fertile days each month, and on those days you avoid sex or use condoms. A hormone-free blend of tech, nature, and common sense, FAMs have obvious appeal; it’s no surprise that #fertilityawareness and #naturalbirthcontrol have gotten more than 191 million and 60 million views, respectively.

Yet anyone who’s ever been or met a teenager can instantly spot the problem: FAMs require a ton of self-discipline and consistency, not things that all young people (or even all grown people) have exactly mastered. While FAMs can be 98% effective at preventing pregnancy when practiced perfectly—similar to hormonal contraceptives—they’re only 76% to 88% effective when practiced typically, the way most fallible humans do. That means approximately 12 to 24 women out of every 100 using FAMs will get pregnant, according to the American College of Obstetricians and Gynecologists. (See how the effectiveness of other forms of birth control—including hormonal and nonhormonal options—stack up here.)

Then there are the crucial caveats that don’t lend themselves to quick TikToks. Before relying on a natural birth control method, you should first track your period for at least six months. You should reconsider if your period is irregular, if you got your period for the first time within the past two years, if you’re entering menopause (usually around your mid-40s), if you’ve just gone off the pill, if you recently gave birth or are breastfeeding, or if you have a thyroid disorder. “To be honest, it’s not the best birth control method for anybody from a reliability standpoint,” says Tamika Cross, MD, a board-certified ob-gyn in Houston who specializes in adolescent gynecology. She views debunking social media myths as an important part of her job these days. “Even if you meet all the criteria, if you have a stressful month at work and your period’s off, you might get pregnant because you ovulated at a different time than you thought you would,” she says. The technological aspects of these methods are as vulnerable to variables as the biological. For example, taking your basal temperature is a very precise task—it should be done right when you wake up and at the same time every day, “before you talk, eat, drink, have sex, check your phone,” Planned Parenthood cautions—and the results can be thrown off by factors including stress, tiredness, smoking, drinking alcohol, and jet lag; being sick can also cause temperature fluctuations.

In the land of short-form video content, though, such nuances are often glossed over, and on the surface FAMs can make an easy sell: no side effects, low cost, restored connection with your body. Some TikTokers elevate rejecting hormonal birth control to an act of “sacred self-reclamation.” Watch a few such videos with messaging along those lines, and it’ll be hard to stop. Music and visuals aside, another reason TikToks can be so persuasive is trust. You’re staring intently into another human being’s eyes as she sips hot cacao and shares her personal experience. At a time when many health care providers are stretched to the brink and may have only 10 minutes for a visit, it’s no wonder some women feel more seen by a warm and highly engaging TikTok cycle awareness coach or period coach.

Of course, at this point, most of us know better than to trust that influencers are posting with only their followers’ best interests at heart. But even if you’re scrolling with your BS meter on high, it’s difficult to sort out who on social media is genuine, who’s knowledgeable, who has an agenda, and who’s just trying to make money. Questionable FAM-fluencers, including several Bravo-lebrities and Bachelor alums, have caught flak for casually providing discount codes for a fertility tracker app in the same way they might for a fashion retailer in an #OOTD post. Meanwhile, a UC Berkeley investigation established links between TikTok birth control disinformation and antiabortion organizations. Yikes.

Authenticity notwithstanding, videos about the downsides of hormonal birth control get clicks and are likely to be among the top results for anyone who’s on social media searching for birth control information. A recent study in the journal Health Communication found that most of the social media videos posted on the topic of birth control are actually about stopping hormonal birth control. Similarly, a recent Duke University study published in the journal Obstetrics & Gynecology found that a TikTok search for #IUD surfaced about 38% posts with a negative angle versus 19% positive; it also noted that about 24% of posts contained scientifically inaccurate information, and about 28% expressed distrust in health care professionals. 

Clearly, open discussion about the potential side effects and risks associated with any form of birth control is important. The issue is that, as with most topics, social media is apt to amplify negative anecdotes. The Duke study found that among videos relaying patient experiences with IUDs, nearly all (almost 97%) had a negative tone, highlighting pain and other side effects from IUD insertion and removal. Ask a gynecologist instead of social media search bar, and you’ll hear about the plus side of IUDs and other long-acting reversible contraceptives (or LARCs) too. “IUDs are 99% effective and you don’t even have to think about them—they’re fabulous,” Dr. Cross says. “But if someone has a negative experience, like an IUD falling out or needing to get a perforated one removed, and posts that and it goes viral, suddenly everybody’s thinking that IUDs are horrible. I’ll have patients coming in saying, ‘I’m scared of this.’” That’s the best-case scenario—at least with patients who bring concerns into Dr. Cross’s office, she’s right there to remind them about the 99% of people who have IUDs and never experience the negatives. “I’m okay with people learning about different birth control methods on TikTok, but it’s still important to talk to your health care provider about them,” she says.

To help balance the results that pop up for birth-control-related searches and increase the flow of accurate information, Dr. Cross and more of her ob-gyn colleagues are getting creative about posting on social media themselves. “Social media is relatable and can reach a bigger audience and get the word out better than any other marketing tactic that health care professionals have had before,” she says. “At the same time, people should take it with a grain of salt that not everybody on TikTok who is providing information is a physician or any kind of health care provider, and that there’s definitely a lot of misinformation going around.” Think of it like natural childbirth: What is a back-to-nature, spiritual experience for one person can be life-threatening for another—and for many, modern medicine is the most empowering choice. 

Petra Guglielmetti is a health, wellness, and beauty journalist who taps into a broad network of doctors, scientists, and medical experts to write in-depth service articles for leading publications like Glamour, Health, Real Simple, and Parents.