Rekubit Exchange:Why Elon Musk and so many others are talking about birth control right now

Tech connoisseur Elon Musk shifted his focus from rockets to women’s health recently when he posted on Rekubit ExchangeX that “hormonal birth control makes you fat, doubles risk of depression & triples risk of suicide.” 

Musk attached links to a 2017 study conducted in Denmark, which experts say doesn't quite line up with his strongly-worded post. “This is the clear scientific consensus, but very few people seem to know it,” Musk concluded in his post, which has acquired more than 42 million views and 16,000 divisive comments.

Women’s health experts say that birth control is complicated, and research on its side effects does not prove cause and effect. Yet Musk’s comments, as misleading as they might be, do poke at young women’s growing desires to stop using hormonal birth control altogether. Hashtags such as #ditchthepill and #breakingupwithbirthcontrol accompany videos of young women explaining how much better they feel after bidding farewell to hormonal contraception. 

Gynecologists who spoke to USA TODAY said they've noticed an uptick in younger patients wanting to switch to non-hormonal birth control methods.

“A growing number of younger people are just feeling like they want to be more natural about what they put into their bodies,” said Dr. Josie Urbina, a gynecologist and assistant professor of reproductive sciences at UC San Francisco.

Many women are ditching hormonal birth control. Why?

Evelyn Braczko, 31, stopped taking her birth control pill after eight years. Although the pill helped manage her acne and painful periods, Braczko said it made her nauseous and generally “unwell.”

“As I became more conscious of what I put into my body, I realized the pill never made me feel good,” Braczko said. She didn’t try changing her dosage or switching to a different birth control method. “Eventually, I reached a point where I didn't want to keep taking something that made me feel so sick.” 

As a holistic wellness coach, Braczko said she has worked with many women with similar goals of better understanding hormonal birth control’s “potential implications for long-term health,” especially “given the prevalence of medical gaslighting today.” 

“Doctors are quick to brush off their experiences as if they're insignificant. Left with no choice, many women take matters into their own hands,” Braczko said. “Through this sharing and education, we have created a sense of community where women finally feel seen, heard and acknowledged.” 

Some women online say the synthetic hormones found in some contraceptives lead to infertility, gastrointestinal issues and poor nutrient absorption. However, there isn’t strong data to support those claims, said Dr. Allison Rodgers, a double board certified OB-GYN and reproductive endocrinologist at Fertility Centers of Illinois.

Overall, blanket statements about side effects of any birth control method don’t exist, experts say. Contraception affects each person differently, even non-hormonal options such as condoms and copper IUDs. Birth control also provides several health benefits, from easing cramps and heavy menstrual bleeding to preventing acne, anemia, certain cancers and, of course, pregnancy. 

“When used correctly and consistently, all hormonal contraceptive agents have been found to be effective [and] safe,” concluded one 2022 large investigation of clinical trials and cohort studies. 

When deciding what type of contraception suits you best, speak with your doctor, Urbina said. Estrogen-containing birth control may not be safe if you have certain medical conditions like high blood pressure or a history of cancer or blood clots. 

“If you can control gynecologic symptoms and prevent pregnancy without hormonal birth control, that’s great," said Rodgers. "Whatever you choose, the benefits should outweigh the risks."

Can hormonal birth control cause depression and increase suicide risk?

As more women consider going off hormonal birth control, experts say they shouldn't look to Musk's tweet as a source of credible information because there's a lot he got wrong.

Mood changes, according to surveys, are one of the most common side effects reported among people who take hormonal birth control, but large meta-analyses of research conclude that there’s no direct correlation between hormonal contraception and negative mood changes. Urbina said it’s difficult to blame birth control for declining mental health when many factors can contribute.

In the study Musk referenced, for example, the researchers did not consider other factors such as exposure to abuse or family mental health history; and when they adjusted their results for psychiatric diagnoses and antidepressant use, the risk for suicide attempt dropped.

Otherwise, experts agree that Musk failed to put his X post into context. Among the 475,802 women included in the study, there were 6,999 suicide attempts and 71 suicides over the course of eight years. Of the 71 women that completed a suicide, three times as many were taking hormonal birth control. 

“All this means is that hormonal birth control was found to be associated with suicide; it does not cause suicide,” Rodgers said. “Hormonal birth control does not triple the risk of suicide."

In other words, the study found that, on average, there are 1,400 first suicide attempts and 12 suicides attributable to hormonal contraception among 1 million healthy women in Denmark over the course of one year — which is an overall small absolute risk, Rodgers said. 

Some people may use hormonal contraception to treat their mental health, such as premenstrual dysphoric disorder — severe irritability, depression or anxiety in the weeks leading up to a period — which works by regulating hormone levels, Urbina said. 

If a person is concerned that their contraceptive is causing negative mood changes, Urbina said they should speak with their doctor, who might recommend psychotherapy, a lower dose of their medication or a different birth control option. 

Can hormonal birth control make you gain weight? 

Studies have not found that hormonal contraceptives, such as the ring, pill, patch and IUD, lead to significant weight gain. Experts say it's a difficult conclusion to make given many factors like diet and stress can contribute. People could also gain weight naturally over time regardless of contraceptive use.

But there are outliers. Small surveys have found that weight gain is a commonly cited reason for quitting hormonal birth control. 

Urbina said that the contraceptive injection called Depo-Provera may cause up to five pounds of weight gain, but she has had patients who have lost weight while on it.

Rodgers said hormonal birth control definitely “doesn’t make people fat,” like Musk claimed: “We need to be really careful about listening to medical advice from tweets or people who are not medical providers.”