Hormone Hesitancy and What It Costs Telehealth Brands

Most telehealth categories are share fights. A GLP-1 brand wins a customer another GLP-1 brand would have had. Birth control has a different problem. A meaningful part of the market is not choosing between prescribers at all. It is deciding whether to stay on hormonal contraception, and a brand that treats that decision as a misunderstanding to be fixed tends to lose the customer entirely.

That shift changes what a birth control brand should be saying in paid social, and it is the reason our birth control ad creative is built around agreement rather than correction. This piece is written for the marketers running those brands. It is not a view on which method anyone should use, and it makes no claims about any contraceptive.

What Hormone Hesitancy Means for a Brand

Hormone hesitancy is a useful name for a buying behavior, not a medical position. It describes a customer who is uneasy about hormonal contraception, often because of her own experience with side effects, sometimes because of what she has seen other people describe, and usually a mix of both. She may still be using a hormonal method. She may have stopped. She may be looking at options that do not involve a prescription at all.

For a telehealth brand, the important part is not why she feels that way. It is what she does next. Some of these customers switch to a different prescription. Some leave the category and do not come back to a prescriber. The brand's marketing has a lot of influence over which of those two paths she takes.

What the Data Shows

The clearest national picture comes from KFF's 2024 Women's Health Survey, which surveyed 3,901 women ages 18 to 49 and was published in November 2024. In it, 23% of contraceptive users said they would use a different method if they could choose any method available, and among women not using their preferred method, 25% cited concern about side effects, or side effects they had already experienced, as the reason.

Social media is a large part of where that concern is discussed. KFF reported in January 2025 that 39% of women of reproductive age in its 2024 survey had encountered content about birth control on social media in the past year.

Research on that content points in one direction. A November 2024 summary from Penn's Leonard Davis Institute reported that a 2023 study led by Emily Pfender found 74% of the YouTube influencers sampled who spoke about birth control encouraged discontinuation, and that a later TikTok study by the same team found nearly half of the posts analyzed promoted the same idea. A separate 2025 analysis of 307 TikTok videos about the oral contraceptive pill, published in Frontiers in Reproductive Health by Ilori and colleagues, found side effects mentioned in 79% of the videos and discontinuation discussed in 24%.

Where the Customer Goes

When she leaves a hormonal method, she does not necessarily go to a competitor. In the same KFF 2024 survey, condoms and withdrawal were among the most widely used methods across age groups, and 22% of women ages 18 to 25 reported using fertility awareness-based methods. KFF noted that this could reflect growing interest in non-hormonal methods discussed on social media outlets that reach young people.

Those are methods a person can start and stop without a prescription. From a telehealth brand's point of view, a customer who moves to one of them has not switched providers. She has left the funnel. There is no competing ad to outbid and no comparison page to win. The loss happens in her own decision, often well before she would ever see a retargeting ad.

That is what makes this category unusual. The brand is competing less with other prescribers than with the idea that a prescriber is not needed at all, and it cannot win that contest by arguing, because arguing is part of what drove her away.

Why Correcting Her Loses the Customer

The instinct in health marketing is to answer concern with facts. A customer raises side effects, and the brand explains why she should not worry. In most categories that is reasonable. In this one it lands as dismissal, and dismissal is a large part of the story she has already heard.

The content analysis research reflects that. Pfender and colleagues, reporting in Health Promotion Practice on a sample of 100 TikTok videos, found the videos often framed hormonal contraceptives and interactions with health care providers negatively, and frequently discussed stopping hormonal contraception without a plan for another method. A brand that responds by correcting her is casting itself as the dismissive provider in that narrative.

The frustrating part for brands is that clinicians remain the source she would rather hear from. KFF's January 2025 report noted that in its 2022 survey, health care providers were both the primary source, at 57%, and the preferred source, at 74%, of contraception information for reproductive-age women using contraception. Yet among women who had seen birth control content on social media, only 10% had discussed it with a doctor or health care provider. The conversation she wants is available. She is not having it.

What It Costs a Telehealth Brand

The cost does not show up as a lost auction. It shows up later and less visibly. A customer acquired at full price who stops at her first bad experience never reaches the months of refills that made her worth acquiring. A customer who leaves feeling dismissed can say so in a review or a comment, which becomes part of the content the next prospect reads.

It also distorts the numbers a brand manages by. Acquisition metrics can look healthy while retention quietly erodes, and because the loss is to the category rather than to a competitor, it is easy to misread as a pricing or channel problem. The tempting response is to spend more on acquisition, which buys more customers into the same leak. Our guide to telehealth ad performance metrics that actually matter covers which numbers to watch beyond the cost of acquiring a customer.

None of that needs a precise figure to be actionable. Any brand can check its own data for where in the customer journey cancellations cluster, and what the cancellation reasons say, before deciding how much of its problem is really this one.

The Creative Response

The response is to start by agreeing. Creative that reflects her experience back to her, in her words, without a counterargument, earns the right to say what comes next. What comes next is not a claim about any method. It is an offer of the conversation she says she wants: a clinician who asks questions, listens, and can change the prescription if something is not working for her.

Three rules keep that honest. Never claim what a method will or will not do, including that it has no side effects. Never disparage the alternatives she is weighing, including stopping. And never manufacture the experience with invented comments or scripted testimonials presented as real. Patient stories are powerful here precisely because they are real, and our guide to using patient stories in telehealth UGC without FTC violations covers how to use them properly.

The most credible messenger is usually a clinician. A clinician who opens by acknowledging side effects as a real reason people reconsider their method is saying something the audience rarely hears from that role.

Beyond the Ad

The same principle belongs in the rest of the customer experience. A check-in message after a new prescription starts that invites her to raise anything that does not feel right. A cancellation flow that offers a conversation with a clinician before the account closes, without pressure and without an argument. A support team trained to listen first. Each of these catches the moment a customer would otherwise decide alone.

How much this matters depends on the business model. A subscription brand feels the loss in every month a customer does not stay, while a consultation model feels it at the refill. Our guide to marketing female Rx telehealth brands places birth control within the wider category.

The Short Version

Birth control brands lose people to the category, not just to competitors. Survey data from KFF shows side effect concern is a leading reason women are not on their preferred method, and research on social media content shows the discussion leans toward stopping. Correcting that customer confirms the story that providers do not listen. Agreeing with her, and offering a clinician who will, keeps the conversation and the customer inside the category.