Women are being bombarded with false claims that hormone replacement therapy (HRT) will keep them slim, energetic, glowing and brain-sharp into old age by doctors and health experts on social media who have money to gain, two major studies warn.
The study has led for calls for drug regulators to work with tech companies to ensure women are given reliable and independent health advice.
In a hard-hitting paper published in BMJ Open, Dr Margaret McCartney and colleagues pulled apart the online hype surrounding HRT and testosterone. They examined 180 separate claims or recommendations made across six different social media platforms.
More than half (53%) of the claims came from professionals – including doctors, professors, psychologists, dieticians, nurses, sports scientists and physiotherapists. The rest came from lay people, which included, nutritionists patients, media outlets and professional organisations. Yet in 77% of cases, the person or organisation stood to financially benefit – either through selling products connected to the menopause or private practice consultations. Many were also being paid consultancy fees by the drug companies manufacturing the drugs.
The claims catalogued by McCartney’s team went far beyond the cautious green light given by national guidelines. In the UK, HRT is officially recommended only to treat menopausal hot flushes, night sweats, vaginal dryness and – in some cases – low mood. Testosterone is reserved solely for women with persistently low libido after other HRT treatment.
But online, it’s often being touted as a “youth elixir”. Among the promises identified:
glowing skin and fewer wrinkles,
relief of depression,
renewed vitality,
improved bone and muscle conditions,
sharper brain function and motivation,
avoidance of weight gain or even guaranteed weight loss,
protection against heart problems and dementia,
and improved sleep.
Dr McCartney warned these claims are not evidence-based. “Social media commonly contains claims for HRT outside official drug regulator guidance. Conflicts of interest by commentators are also common,” she wrote. Most of the commentators stood to gain financially from the claims, the study found. Dr McCartney said: “Over three quarters of the social media posts had a commercial conflict.”
The concern comes amid a dramatic rise in uptake. The use of HRT soared by 35% between 2021 and 2022 alone, fuelled in part by celebrity endorsements, private clinics and an explosion of online menopause “coaches” and influencers.
Social media, Dr McCartney said, is a major driver of this boom. The study highlights how doctors, psychologists, dieticians, sports scientists, fitness gurus, nutritionists and “menopause coaches” are using Instagram, TikTok, Facebook, YouTube and other platforms to promote HRT as a lifestyle upgrade.
She warned: “It is critical women can base decision making on high quality evidence as they may do more harm than good by taking the drugs.”
And she added: “This underlines how important it is for women to get really good, high quality but also independent advice. The way that social media delivers information to us seems to make this hard. I hope that social media companies work with the NHS and NICE to boost the rankings of evidence based, conflict free, information.”
Dr James Larkin Co-author of the study said: “People need to be aware that online personalities recommending health products often have a financial interest related to those products. A financial interest that they are not declaring. This is potentially a reason we are seeing so many HRT recommendations that aren’t in line with best practice.”
The research is born out by a separate study published in the JAMA Network Open journal, which scanned 982 social media posts on Instagram and TikTok covering five hot-button health tests – from “egg-timer” fertility tests to gut microbiome kits and testosterone checks.
Together, those posts reached 194 million followers. Almost nine in ten (87.1%) espoused benefits. Just 14.7% mentioned the potential harms, and only and only 6.4% cited any scientific evidence at all. It found 68% of account holders had a clear financial interest, and 83.8% of posts were promotional in tone.
The authors concluded: “Most posts were misleading or failed to mention important harms, including overdiagnosis or overuse.”
Many of the claims came from professionals working in private practice, selling HRT consultations, or those with a direct financial relationship with the companies that make the drugs.