Hormone Hesitancy: Young Adults' Experiences with Long-Acting Reversible Contraceptives

This study aims to evaluate young adults' values and preferences regarding hormones throughout their decision-making process in using long-acting reversible contraception (LARC).

From January to June 2025, we conducted 40 semi-structured in-depth interviews with young adults currently or previously using hormonal or non-hormonal LARC. The interview topics included decisions and experiences starting, using, and discontinuing their LARC method. We utilized both deductive and inductive coding and conducted thematic analysis around hormonal hesitancy and how it impacts LARC use.

Most participants expressed hesitancy around hormones in contraception. Their apprehension centered on three main themes. First, participants expressed how contraception can be a divergence from "natural" lifestyles and noted anti-hormonal social media messaging they had encountered. Next, participants attributed undesired changes in their menstruation or libido to hormones. Lastly, participants described how non-hormonal methods (including copper IUD, fertility awareness methods, and condoms) were better aligned with their desired contraceptive features.

These results demonstrate current contraceptive decision-making among young LARC users and reflect broader trends toward non-hormonal methods and "holistic" lifestyles. This work highlights the importance of engaging young adults with medically-accurate information about hormones so they can consider evidence in aligning their preferences with decisions about contraception.