Social media influencers are becoming a common source of health information, including information about contraception and sexual health. Young people in particular frequently get this kind of information from influencers. Although pregnancy is a common topic among influencers, not much is known about how they discuss birth control.

Researchers at the University of Delaware recently did a content analysis of 50 YouTube video blogs (vlogs) from influencers with between 20,000 and 2.2 million followers. They found influencers mostly discussed their discontinuation of hormonal birth control and may provide inaccurate information about sexual health.

Tracking monthly cycles is not as effective for preventing pregnancy as hormonal birth control. In 2019, the study on which the tracking app Daysy based its effectiveness was retracted.

In their vlogs, the influencers shared their experiences with hormonal and nonhormonal birth control methods. “YouTube is a better social media platform for videos about sharing experiences because influencers can upload a 20- or 30-minute video explaining their experience with birth control,” Emily Pfender, corresponding author on the study, told TheDoctor. The format of other platforms doesn’t allow for such a long video.

Although more than 90 percent of influencers said they were using or had used hormonal birth control, almost 75 percent said they planned to discontinue or had discontinued its use. The most common type of hormonal birth control that was discontinued was birth control pills.

One often-cited reason influencers gave for discontinuing hormonal birth control was its effect on their mental health. However, the researchers point out that the connection between depression and hormonal birth control is still not clear. Influencers also cited their desire to be more natural. They said they wanted to stop introducing what they would call chemicals or unnecessary hormones into their body.

Forty percent of influencers reported using nonhormonal birth control in their vlogs. The most popular nonhormonal method was the fertility tracking app Daysy. Influencers said they liked nonhormonal methods because it prevented pregnancy, and was natural and cost effective. These methods also have no side effects. Tracking monthly cycles is, however, not as effective for preventing pregnancy as hormonal birth control. In 2019, the study on which the tracking app Daysy based its effectiveness was retracted.

What followers don’t see in vlogs is the effort it takes to accurately track fertility cycles. “To use the cycle tracking method as intended, women must take their basal body temperature and measure the viscosity of their cervical mucus every day at the same time, track cycle lengths and calculate their fertile window, and refrain from having sex on specific days of their cycle,” said Pfender, a PhD student at the University of Delaware.

The current study is the first phase of Pfender’s doctoral dissertation. It looks only at what is in a video; it does not examine what, if any, effect the video has on followers’ behavior. The next phase is an experiment to see if influencer videos about discontinuation of hormonal birth control actually affect viewers’ intentions to discontinue hormonal birth control or discuss discontinuing hormonal contraception with their doctor or with family or friends. “I am looking to see if this information actually affects behavior,” she said.

Also in the works is a similar content analysis study about influencers and nutrition to determine if they are promoting weight normative behaviors, which emphasize weight and weight loss in relation to health and wellness, or negative talk about food.

The study is published in Health Communication.