Misinformation about perimenopause circulating on social media is driving women to stop using contraception prematurely, leaving them at risk of unintended pregnancies, experts have warned. The trend is emerging as a growing number of women mistake normal symptoms for menopause and seek hormone replacement therapy (HRT) when they are still fertile.
Unintended pregnancies on the rise
Dr Paula Briggs, a consultant in sexual and reproductive health, said she is seeing more women over 35 attending abortion services who are “gobsmacked” to discover they are pregnant. “Everyone thinks they’re menopausal,” she said. “So we are seeing younger and younger women asking for HRT when what they need is hormonal contraception, as they’re still fertile.”
Dr Zara Haider, president of the College of Sexual and Reproductive Healthcare, confirmed that women are stopping contraception too early because they assume they cannot get pregnant. “In reality, contraception is needed until menopause is confirmed or until age 55,” she said. Official NHS guidance states that women over 50 can stop contraception one year after their last natural period, while those under 50 should wait two years. After age 55, natural conception becomes rare and contraception can be stopped regardless of period status.
The confusion is partly driven by messaging around declining fertility. Dr Channa Jayasena, a reproductive endocrinologist at Imperial College London, said awareness of fertility windows and the limits of IVF has led to a dangerous assumption. “IVF stops working well beyond the age of 42. It’s easy to translate that to an assumption that you can’t get pregnant naturally, when actually you can,” he said.
A separate pushback against hormonal contraception is exacerbating the problem, particularly among younger women, even as demand for HRT grows. Briggs noted that many progestogen-only contraceptives can be used alongside HRT to protect against pregnancy while managing perimenopausal symptoms. Modern combined pills containing natural oestrogen are safer for women in perimenopause than traditional formulations. Jayasena described such options as “a mini pill plus a bit of HRT”. The hormonal intrauterine system (IUS), such as the Mirena coil, can also provide contraception, help manage heavy bleeding, and serve as the progestogen component of HRT.
What is perimenopause?
Perimenopause is the transition period before menopause, during which hormone levels fluctuate and symptoms such as irregular periods, hot flushes, and difficulty sleeping can occur. According to the British Menopause Society (BMS), more than 80% of women will be menopausal – defined as having had no period for 12 months or more – by age 54, while about 5% reach menopause before 45. But menopause is a gradual process, not a sudden switch, and fertility does not stop abruptly.
Prof Janice Rymer, chair of the BMS, stressed that women who still have regular periods are not perimenopausal. “If you are having regular periods naturally, then you’re not perimenopausal – end of story. You’ve got good hormone levels,” she said. She added that there is a widespread perception that any symptom affecting women between 40 and 60 is due to perimenopause or menopause and requires HRT. While HRT can be wonderful for those who need it, Rymer warned it is “not for women who don’t need it” and can cause heavy bleeding inappropriately.
Jayasena echoed the concern, saying some women are being “mislabelled as having perimenopause when they have other things that are wrong”. The risk of missed diagnoses is serious because underlying conditions such as thyroid disorders or depression can be overlooked when symptoms are attributed to hormonal changes.
The misinformation landscape
Social media platforms are awash with misleading claims, often pushing HRT and testosterone treatments well beyond official guidance. Briggs said she has reviewed Instagram posts and is “horrified” at what she sees: women in their 30s being told to demand HRT for sleep problems or migraines, and to switch GPs if refused. Others are urged to seek testosterone treatment despite the body’s natural production. “Females produce their own testosterone lifelong, even women without ovaries, so the idea that everybody has to demand testosterone is bonkers,” she said.
Research published in BMJ Open found that 67% of social media posts about HRT were misleading, with two out of three claims exceeding recommendations from the National Institute for Health and Care Excellence (NICE) and the British National Formulary (BNF). Furthermore, 93% of major content creators had direct or indirect conflicts of interest, such as selling private clinic services, supplements, or skincare products, and fewer than a third disclosed these ties.
The increased public conversation around menopause, partly driven by Davina McCall’s documentaries – often referred to as the “Davina effect” – has raised awareness and reduced stigma. But it has also created a fertile environment for misinformation. A survey by the period-tracking app Clue found that 44% of British women do not fact-check medical information online, and more than half of Gen Z and millennial respondents rely on unverified social media sources for reproductive health advice.
Outdated or flawed studies about hormone risks, particularly regarding breast cancer, continue to influence decisions. Haider noted the “lasting impact” of such research, making women “cautious about hormones”. The BMS, NICE, and BNF all provide evidence-based guidance on HRT, which carries risks including breast cancer, stroke, thrombosis, and cardiovascular disease depending on the type, dose, and timing. However, modern body-identical HRT is considered safer than older synthetic versions, and the breast cancer risk is minimal compared with lifestyle factors such as being overweight or smoking. There is no arbitrary time limit for HRT use; it can be continued as long as benefits outweigh risks, and it can be started during perimenopause.
The British Menopause Society is actively working to combat misinformation and ensure healthcare professionals have access to accurate, evidence-based information, aiming to counter the flood of misleading claims that are leading women to stop contraception, miss real health problems, and take unnecessary medication.
