Contraception tips from influencers? – Bremen gynecologist warns of trend

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Fewer and fewer young women are being prescribed the pill. There are many reasons for this. According to gynecologists, one trend is striking: on social networks such as Tiktok, Instagram or YouTube, influencers share personal stories under hashtags such as #stopthepill, #hormonefree or #naturalbirthcontrol – how they stopped taking the pill and apparently switched to natural alternatives such as the so-called calendar method of contraception without any problems. The menstrual cycle and the fertile days are essentially observed – using a calendar, sometimes in combination with a thermometer, using cycle apps on the smartphone or fertility trackers.

Gynecologists warn against relying on personal tips and reports from influencers when choosing a contraceptive method.

How many young women take the pill?

The importance of the pill as a contraceptive for young women and girls under 22 years of age continues to decline: This is the result of a recent analysis by the health insurance company AOK based on prescription data. While in 2020 more than one in three (35 percent) in this age group had the pill prescribed, last year it was only one in four (25 percent). For those under 22 with statutory insurance, the health insurance company covers the costs of prescription contraceptives. Among all contraceptives that can be prescribed, which also include the IUD, vaginal ring and hormone patch, the contraceptive pill remains the frontrunner, according to the AOK.

What is the most popular contraceptive?

There is a new frontrunner: the condom has replaced the pill as the number one contraceptive. This was shown by a representative survey by the Federal Center for Health Education (BZgA), for which 1,001 sexually active adults aged 18 to 49 were questioned last year. 53 percent of respondents prefer condoms, while 38 percent use the pill. The use of the pill is also declining in this age group, as the data shows. Analogous to the AOK analysis, this trend is particularly evident in the young age group of 18 to 29 years: while 72 percent of young women used the pill in 2011, according to the BZgA survey, this figure is now only 46 percent – ​​not even one in two.

Why is the pill becoming less popular?

“An adverse attitude towards hormonal contraception is increasing across the sexually active population,” reports the BZgA. 61 percent of women and men agree with the statement that hormonal contraception has “negative effects on the body and soul” – in 2018, 48 percent said this. 15 percent of women who use contraception justify their choice of contraceptive with a general rejection of the pill or hormonal contraception (2018: one percent).

Younger respondents in particular are critical of hormones, the statement says. The rejection of the pill is particularly pronounced among 18 to 29 year olds. Within twelve years, the proportion in this age group has fallen from 72 to 46 percent.

The ninth wave of the BZgA survey “Youth Sexuality” shows: One third of sexually active girls under 18 are worried about physical and psychological damage caused by the pill.

How safe is the pill as a contraceptive?

According to Pro Familia, the pill is still considered one of the safest contraceptives, with a so-called Pearl Index of 0.1 to 0.9. This means that one to nine out of 1,000 women became pregnant within a year while taking the pill. For condoms, the index is two to twelve. The lower the index, the safer the contraceptive is. Pro Familia gives a value of nine for the calendar method.

What side effects can the pill have?

“In the first few months, the body has to get used to the hormones. Intermenstrual bleeding, breast tenderness, or nausea can occur. Mood swings and headaches are also possible,” says the Techniker Krankenkasse. After two to three months, the initial side effects should improve. Monthly bleeding is usually a little lighter and shorter. “It has also been proven that the pill can relieve pain before and during menstruation,” says the insurance company. One of the most serious possible complications when taking the pill is thrombosis. However, this is rare and the likelihood varies depending on the preparation. According to the Federal Institute for Drugs and Medical Devices, five to seven out of 10,000 women are affected by older variants, and eight to eleven out of 10,000 by newer variants, reports the Redaktionsnetzwerk Deutschland.

How do gynecologists view contraception tips on social media – for example from influencers?

Bremen gynecologist Kerstin Schwarzer is critical of contraception tips from influencers on social media: “If a woman reports that she feels better without the pill or with natural family planning, that may be true for her. But that does not mean that it is the same for everyone else.” “There is no differentiated view, and personal experience cannot replace professional, objective advice,” emphasizes the chairman of the Professional Association of Bremen Gynecologists (BVF).

Natural family planning is much more challenging, for example because of a fluctuating cycle. “If you don’t know what you’re doing, things can go wrong very quickly. It’s never as safe as the pill,” says Schwarzer.

“In our consultations, we always observe that young women in particular are confronted with a wide range of information via the Internet and are often extremely biased when they ask about reliable methods of contraception,” confirmed Cornelia Hösemann from the BVF board in a statement.

The trend is towards contraception without hormones, with many women foregoing prior specialist advice and instead relying on methods such as measuring temperature or cycle apps. This development has been further fuelled by the ongoing “hormone bashing” on social media. “When it comes to the topic of ‘the pill: yes or no’, women should not rely on the sometimes radical and one-sidedly negative social media comments,” emphasises the association. The experiences are often not transferable and they do not do justice to the range of different hormone preparations.

What advice does the Bremen gynecologist give to young women who are unsure about hormonal contraception?

The Bremen gynecologist also found in her consultation that young women come with the concern that the pill is primarily harmful. “It is important to have a detailed consultation in which questions such as: What is the specific concern? How does the pill work, how do other contraceptive methods work, how safe are they? What additional benefits does it have, for example on period pain or the skin?” “The pill? Is an alternative a good alternative,” says Schwarzer. “Sometimes it turns out that the pill might be a good choice after all. It is important to have professional and detailed advice.”

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