Abstract
Abstract Hormonal contraceptives are used by approximately half of female athletes and may affect athletic performance as a result of their action on the endogenous hormonal milieu. In athletes, hormonal contraceptive use appears to have little effect on body composition, however further studies are needed assessing progestin-only contraceptives as they may have a negative effect in the general population. The type of progestin contained within the contraceptive may influence the anabolic response of muscle to loading although this relationship is complex as it may be due to either direct or indirect effects of exogenous hormones on protein synthesis and satellite cell proliferation. The altered hormonal milieu in hormonal contraceptive users has predominately been shown to have no effect on muscle strength and whilst maximal oxygen uptake is sometimes reduced, this does not translate into measures of performance. The majority of previous research has used cross-sectional designs and/or grouped together different types and brands of hormonal contraceptives and little research has been conducted on progestin-only contraceptives in athletes. Future research should use prospective, randomised-controlled designs to assess the effects of all types of hormonal contraceptives on athletic performance in females.
Highlights
The possible interaction between exogenous reproductive hormones and athletic performance in females is an important issue that has been the topic of debate for at least four decades1. ere are numerous review articles on the e ect of oral contraceptives (OC) on athletic performance[2,3,4,5,6], we feel that these reviews are insu cient as they do not include all categories of hormonal contraceptives
The use of long-acting contraceptive methods, such as the Intrauterine Devices (IUDs) and implant, has been increasing[12] and we suggest that it is important to understand how OCs in uence performance, and how other methods of hormonal contraceptives may affect female athletes. is article will present a brief overview of the effects of different types of hormonal contraceptives on a number of factors that in uence athletic performance
Androgenic contraceptives may interfere with appetite regulation by suppressing the secretion of the satiating hormone cholecystokinin[25]. It is unclear whether the addition of oestrogens in combined contraceptives in uences the e ects of the progestins[26]. In both combined and progestin-only contraceptives there is a down-regulation of reproductive hormones which has been demonstrated to reduce basal metabolic rate[27,28], increase visceral fat deposition[29], increase concentrations of appetite-stimulating hormones[30] and reduce the concentrations of satiating hormones30. e combination of these factors suggests that contraceptive use may result in weight gain but this has not been demonstrated in athletes[16, 24]
Summary
The possible interaction between exogenous reproductive hormones and athletic performance in females is an important issue that has been the topic of debate for at least four decades1. ere are numerous review articles on the e ect of oral contraceptives (OC) on athletic performance[2,3,4,5,6], we feel that these reviews are insu cient as they do not include all categories of hormonal contraceptives. Is is the rst paper to consider the e ects of a large variety of hormonal contraceptives on athletic performance, as opposed to focussing on OCs as previous reviews have. Recent data suggest that ~22% of the general population uses OCs, with ~9% using other forms of hormonal contraceptives[9]. Since this time, the use of long-acting contraceptive methods, such as the IUD and implant, has been increasing[12] and we suggest that it is important to understand how OCs in uence performance, and how other methods of hormonal contraceptives may affect female athletes. Is article will present a brief overview of the effects of different types of hormonal contraceptives on a number of factors that in uence athletic performance The use of long-acting contraceptive methods, such as the IUD and implant, has been increasing[12] and we suggest that it is important to understand how OCs in uence performance, and how other methods of hormonal contraceptives may affect female athletes. is article will present a brief overview of the effects of different types of hormonal contraceptives on a number of factors that in uence athletic performance
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