Competing Narratives: Navigating Women’s Health in the Digital Age

Fundamentally, we value the opinions of the people within our social spheres, incorporating their advice as we distill information to navigate the world around us. Therefore, we are undeniably privileged that our ability to access information has very few limitations and that the capacity for connection is borderless. Within the medical field, our practice of providing care revolves around providing individuals with the tools necessary for informed decision making. However, there can be a perception of distance between us and those we care for. By nature of the patient-provider relationship, short duration of time together, and perhaps that, for the most part, we have not personally experienced the condition or concern we advise and treat our patients for.

Following the pandemic, and with ever increasing sensationalized politics, there is a wariness, and so far as to say—notions of distrust toward public health systems. A perceived threat to autonomy may push people to manage their own care, especially when factors like access, language, and time are contributing barriers.

Social media, in its most altruistic light, has let human connection span continents, allowing for regular dialogue between individuals who would otherwise never interact. Short form media has especially redefined how we share and consume content, be it entertainment, advertising, or education.

An ever-increasing turn to TikTok for health information and management has given the platform a unique role in shaping perceptions, especially in reproductive health. With strained access to consistent primary care, long waitlists for specialists, instances of invalidation, and perhaps embarrassment when trying to be forthcoming with sensitive health concerns—be it a result of stigma or mistrust, information seeking with confidentiality and immediacy becomes highly appealing.

There are many healthcare professionals who utilize the platform, creating content to engage and demystify medical jargon and practice for the public. However, it is equally a space for any person to share, regardless of background or credibility. The nature of interactive space makes TikTok a platform to facilitate dialogue, by “dueting” videos, commenting, and reposting. This means that original content can be distilled, diluted, and reframed—both supported and contested—ultimately creating an entangled web of ideas. In this environment, responsibility is shifted onto the viewer, regardless of the potential harm caused by oversimplified or commercialized health advice.

A popular topic of interest is Polycystic Ovary Syndrome (PCOS), with over 1.8 million views on TikTok and consistent high engagement across other media platforms. (1) PCOS is a common endocrinopathy, affecting around 10–13% of individuals of reproductive age globally, with a significant proportion remaining undiagnosed. The etiology is not fully understood, with diagnosis including the presence of polycystic ovaries, ovulatory dysfunction, and hyperandrogenism, as outlined in international guidelines. (2) Clinical presentation is heterogeneous, with symptoms such as irregular menstruation, acne, weight gain, and infertility being most prevalent.

Content creation around PCOS can resonate when focused on personal symptom burden, evidence-based treatment options, and lifestyle strategies. The sharing of individual experiences fosters community but may also propagate controversial or confusing advice. Ultimately, there is a caution against superficial content that promotes rapid weight loss, or “balancing hormones naturally” through unregulated supplements, teas, or restrictive diets, as these lack rigorous evidence and should not replace established medical care.  It should be noted that there are management options for PCOS that are not pharmacologic in nature.

PCOS management requires a personalized approach and sensationalized, or commercially driven advice can be discouraging and potentially harmful, especially when it prioritizes engagement over accuracy. Controversial content may contribute to fear-mongering and hesitancy toward first-line treatments such as combined oral contraceptive pills or hormonal therapies, (2) which are recommended for menstrual irregularity and hyperandrogenism. TikTok videos on contraceptive health received 4.85 billion views, with only 10% created by medical professionals, (3) and overall showed poor reliability, widespread misinformation, a preference for natural over hormonal methods without adequate risk disclosure, and growing distrust in health professionals. Viral content often capitalizes on user vulnerability, with financial conflicts of interest identified in 45% of TikTok posts and 89% of Instagram posts. (1)

The digital preference for brief, easily digestible information may increase exposure to misinformation, and while cursory knowledge is preferable to none, reliance on such sources can undermine informed decision-making and perpetuate health disparities.

How do we combat the pervasive impact of social media, not just when it comes to PCOS, but a myriad of health conditions? It is undeniable that there are benefits to connection and amplifying patient perspectives across platforms. But as discussed, a dually prevalent predilection to confusing and potentially harmful information. Rather than disengaging, healthcare professionals should actively and critically participate to improve online health information and support public health. Effective strategies include producing accessible, high-quality content, correcting misinformation, and promoting digital health literacy. Engaging communities in message development and using platform-specific tools can boost impact by enhancing relevance, trust, and the reach of accurate health information.

While often categorized under "women’s health," PCOS affects a diverse population, including transgender, nonbinary, and intersex individuals.

References:

1.     Naroji S, John J, Gomez-Lobo V. Understanding PCOS-Related Content across Social Media Platforms-A Cross-Sectional Analysis. J Pediatr Adolesc Gynecol. 2024 Apr;37(2):142-148.

2.     Teede HJ, Tay CT, Laven JJE, Dokras A, Moran LJ, Piltonen TT, Costello MF, Boivin J, Redman LM, Boyle JA, Norman RJ, Mousa A, Joham AE. Recommendations From the 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome. J Clin Endocrinol Metab. 2023 Sep 18;108(10):2447-2469.

3.     De Moel-Mandel C, Donnelly A, Bugden M. "Do You Know What Birth Control Actually Does to Your Body?": Assessing Contraceptive Information on TikTok. Perspect Sex Reprod Health. 2025 Sep;57(3):358-367.