Hormonal contraception for female athletes presents special needs and concerns: The European Journal of Contraception & Reproductive Health Care: Vol 0, No 0
Abstract
Purpose
Oral contraceptives (OCs) are commonly used by female athletes raising concerns about the possible adverse effects of OCs on physical performance, musculoskeletal injuries, and bone density. We aimed to review all existing studies on the physiological effects of OCs in physically active women.
Materials and methods
A literature review electronically searched PubMed and Google Scholar databases from December 2002 to December 2022 using relevant keywords. Reference lists of articles found eligible were also reviewed.
Results
Of the 344 articles in the initial database, 54 clinical studies were eligible for inclusion in our literature review. OCs are used by approximately two-thirds of female athletes. Current research suggests that the effects of OCs on endurance performance and muscle strength are mostly positive. OCs do not seem to have a significant negative effect on bone health or sports injuries. In fact, new data suggests they may significantly reduce the risk of anterior cruciate ligament (ACL) injury.
Conclusions
OCs can be safely used by young female athletes, who may also benefit from better menstrual cycle control. OCs offer newly realized protection from ACL injuries. The use of OCs should be carefully individualized according to their preferences, expectations, and experience.
SHORT CONDENSATION
Hormonal contraception can be safely prescribed to active women. The International Olympic Committee promotes a new and broader definition for the ‘athlete triad’, where low energy availability presents a special challenge for these athletes. New data suggest that the use of oral contraceptives may protect against ACL injury.
Acknowledgments
This manuscript is dedicated to Jonathan Seidman, a 26-year-old soul, son, and brother of our co-authors, Daniel S. Seidman and Liron Seidman. Jonathan was brutally murdered on October 7th, during a tragic terrorist attack while participating in a Peace Music Festival in Israel. This tragedy has caused great devastation to the authors and to our country. This manuscript was finished after these events, while we mourned and grieved.
Ethical approval
Institutional review board approval was not required for this systematic review, as all data were obtained from previously published studies.
Disclosure statement
No potential conflicts of interest are reported by the author(s).
