(123) Menopause Goes Viral: The Quality and Credibility of TikTok’s Health Content

Abstract Introduction TikTok has emerged as a popular platform for sharing medical information, including discourse on menopause, and has gained increased visibility. Despite increased visibility, no systematic analysis has evaluated the quality or reliability of menopause-related content on TikTok. We aimed to assess the extent to which misinformation regarding menopause is spread across the internet, contributing to mistrust in healthcare. Objective The goal of this study was to assess the presence or absence of misinformation about menopause on TikTok. Methods TikTok videos featuring the hashtags #menopause and #menopausehealth were web-scraped using the Apify platform, which retrieved publicly available data from the top 100 results for each hashtag. Forty-five videos were excluded because they were non-English or were unavailable at the time of review. Following a training session wherein all five reviewers jointly coded 10 videos to standardize reviews, four reviewers independently coded 73 videos each, and scored them with the Patient Education Materials Assessment Tool A/V (PEMAT-AV), which assesses understandability and accessibility of audio/visual media. A fifth reviewer served as the tie-breaker for inconsistencies in scoring. The four reviewers also coded the same list of videos to generate a DISCERN Score, which assessed the reliability and quality of each video. Each DISCERN score was averaged and analyzed for agreement between reviewers. Results A total of 155 videos were included, collectively amassing 9.42 million plays, 3.18 million likes, 838 523 shares, and 186 310 comments. Most creators were female (73.5%). Fifty videos (32.2%) were created by healthcare professionals, including 30 physicians. Educational content was the most common theme, present in 95 of the videos (61.3%). Promotional content appeared in 38 (24.5%) videos. Nearly one-third (n = 46, 29.7%) highlighted “natural” remedies like castor oil and Moringa supplements, whereas only 13 videos (8.4%) discussed hormone replacement therapy. Eleven (7.1%) included citations, and 14 (9%) of videos were suspected to be AI-generated, using physicians’ likenesses. The average DISCERN Score for all included videos was 11.50 out of a total possible score of 25. In a preliminary analysis for a subset of videos, the average PEMAT-AV understandability score was 0.58 and average actionability score was 0.48. Conclusions Nearly 40% of young people search on TikTok before Google, and up to 20% of videos contain misinformation (Brewster et. al 2022). Menopause information on TikTok has garnered public attention but is often dominated by non-physicians and promotional content, with limited discussion of evidence-based therapies, as indicated by the low DISCERN score. The promotion of “natural” remedies, low citation use, and the emergence of AI-generated videos raise concerns about misinformation. Greater engagement from healthcare professionals is needed to ensure accurate menopause information online. Disclosure No.