Misinformation about perimenopause circulating on social media is leading to a rise in unintended pregnancies, with experts warning that women are wrongly concluding they are no longer fertile and stopping contraception too early.
Dr Paula Briggs, a consultant in sexual and reproductive health who works in an abortion service, said she is seeing more women over 35 who believed themselves to be menopausal and are “gobsmacked” when they discover they are pregnant. “Everyone thinks they’re menopausal,” she said, noting that younger and younger women are asking for hormone replacement therapy (HRT) when what they actually need is hormonal contraception because they remain fertile.
Much of the confusion stems from a misunderstanding of perimenopause – the transition phase before menopause, during which hormone levels fluctuate over months or years. Symptoms such as changes in menstrual patterns, hot flushes and difficulty sleeping can emerge, but ovulation can still occur. Experts point out that messaging around fertility declining with age has led women to assume they cannot conceive naturally. Dr Channa Jayasena, a consultant in reproductive endocrinology at Imperial College London, said: “I think we’ve got a real awareness about the timelines for optimum fertility and optimum response for IVF. 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.”
According to the British Menopause Society (BMS), more than 80% of women will be menopausal by the age of 54 – defined as having had no period for 12 months or more – while about 5% reach menopause before 45. The average age of menopause in the UK is 51, and an estimated 13 million people in the country are currently perimenopausal or menopausal, accounting for roughly a third of the female population. Up to 90% of women experience some menopausal symptoms, with a quarter describing them as severe and debilitating.
Experts have also raised serious concerns about the wider impact of misinformation, particularly on platforms such as Instagram. Briggs said she is “horrified” by posts telling women in their 30s to demand HRT for sleep problems or migraines and to switch GPs if refused, and others encouraging testosterone treatment. “I’m not anti any of these things in the right person, but females produce their own testosterone lifelong, even women without ovaries, so the idea that everybody has to demand testosterone is bonkers,” she said. Professor Janice Rymer, chair of the BMS, stressed that women having regular periods naturally are not perimenopausal. “End of story. You’ve got good hormone levels,” she said. She added that any symptom between the ages of 40 and 60 is increasingly being attributed to perimenopause or menopause, leading to unnecessary use of HRT, which can cause heavy bleeding in those who do not need it.
Jayasena warned that the focus on perimenopause risks mislabelling women with other underlying health conditions. “It’s great that there’s better awareness … but the flipside is some women are being mislabelled as having perimenopause when they have other things that are wrong,” he said. Dr Zara Haider, president of the College of Sexual and Reproductive Healthcare, pointed to the lasting impact of outdated studies on risks such as breast cancer, which has made some women cautious about hormones. “We still see women stopping contraception too early because they assume they can’t get pregnant, when in reality contraception is needed until menopause is confirmed or until age 55,” she said.
Contraception and when to stop
Experts emphasise that pregnancy remains possible throughout perimenopause until menopause is confirmed, and that women should not rely on age-related fertility decline alone. Dr Haider noted that contraception is needed until either menopause is confirmed or the woman reaches 55, after which natural conception becomes rare. For women over 50 who have had no period for a year, contraception can be stopped, provided they are not using hormonal medication or a hormonal intrauterine system (IUS). Women under 50 should wait two years after their last period.
There are a range of contraceptive options suitable for perimenopausal women. Briggs pointed out that many progestogen-only contraceptives can be used alongside HRT to protect against pregnancy while managing symptoms. Modern combined pills containing a natural form of oestrogen are safer for women experiencing perimenopause than traditional combined pills. Jayasena described them as “a mini pill plus a bit of HRT”. The Mirena coil offers dual benefits of contraception and management of heavy bleeding, and can be used with HRT. The copper coil, which can last up to ten years, can be left in place after menopause if fitted after age 40, though it may increase period heaviness. Non-hormonal methods do not interfere with hormone levels and are safe with HRT, but they do not help with menopausal symptoms. However, combined hormonal contraception cannot be used concurrently with HRT due to higher hormone levels; it can act as a replacement for HRT instead.
Despite growing demand for HRT, driven in part by high-profile campaigns such as Davina McCall’s documentaries, experts note a concurrent pushback against hormonal contraception, particularly among younger women. Misinformation online, including posts amplifying outdated or flawed studies, has fuelled caution. A significant study found that 93% of major menopause content creators on social media had direct or indirect conflicts of interest, often linked to private clinics, supplements or coaching. Controversially, a recent Panorama documentary examined the “menopause industry” and raised concerns about over-prescribing at some private clinics – something McCall has expressed worry about, fearing it may deter women from necessary HRT.
Contraception does not affect the timing or duration of menopause, but it can mask symptoms, making it harder for women to track the transition. Experts stress that accurate, evidence-based information is essential to avoid unintended pregnancies, unnecessary medication and missed diagnoses.