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Quality in Sport

The Effects of Hormonal Contraception on Physical Performance and Health of Female Athletes: A Systematic Review
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  4. Medical Sciences

The Effects of Hormonal Contraception on Physical Performance and Health of Female Athletes: A Systematic Review

Authors

  • Julia Szwech https://orcid.org/0009-0006-3792-0101
  • Gabriela Blecharz 5 Military Clinical Hospital SPZOZ in Cracow https://orcid.org/0009-0007-9275-3913
  • Natalia Jańczyk Stefan Zeromski Specialised Hospital (SP ZOZ) in Cracow https://orcid.org/0009-0000-1862-9681
  • Marlena Jankowska Stefan Zeromski Specialised Hospital (SP ZOZ) in Cracow https://orcid.org/0009-0005-2240-8853
  • Karolina Mędrysa Voivodeship Hospital in Bielsko-Biała https://orcid.org/0009-0002-1557-0244
  • Michał Presak 5 Military Clinical Hospital SPZOZ in Cracow https://orcid.org/0009-0006-0335-5917
  • Jakub Jan Pokrzepa 5th Military Hospital with Polyclinic in Cracow https://orcid.org/0009-0000-7907-1511
  • Karolina Baran Independent Public Health Care Facility of the Ministry of Internal Affairs and Administration in Krakow https://orcid.org/0009-0004-1627-5065
  • Alicja Winkowska Independent Public Health Care Facility of the Ministry of Internal Affairs and Administration in Krakow https://orcid.org/0009-0005-2050-0031
  • Katarzyna Bartnik 5th Military Hospital with Polyclinic in Cracow https://orcid.org/0009-0005-9095-5875

DOI:

https://doi.org/10.12775/QS.2025.40.59410

Keywords

hormonal contraception, sex hormones, athletes, menstrual cycle, physical performance

Abstract

Introduction 

Physical performance and health of female athletes are influenced by physiological changes from the menstrual cycle and hormonal contraception (HC). Hormonal fluctuations can affect muscle strength, endurance, regeneration, and psychological well-being, impacting sports results. HC prevents pregnancy, regulates menstrual cycles and alleviates premenstrual syndrome symptoms. However, it can also cause side effects such as nausea, headaches, weight gain, and mood swings.

 

Aim of the study

The aim of the study was to analyze the effects of hormonal contraception on the physical performance and health of female athletes.

 

Materials and methods
The article was created based on the PubMed and Cochrane databases. The literature was analyzed using following keywords: hormonal contraception, menstrual cycle, athletes, sex hormones, physical performance

 

Results

HC stabilizes hormone levels, potentially reducing performance fluctuations associated with the menstrual cycle. Some studies indicate a slight reduction in aerobic capacity and muscle strength in women using HC, compared to those with a natural cycle. In addition, HC has a positive effect on regeneration after intense training and reducing the risk of overtraining. Athletes reported better sleep quality and fewer cycle-related symptoms, allowing them to train more regularly. What is more, some research highlights estrogen’s anti-inflammatory effect, which supports muscle repair.

 

Conclusion 

The use of HC use appears to have a minor impact on physical performance, especially among team athletes. However, subjective benefits may improve training comfort. Further research is needed to explore HC’s effects across various sports disciplines.

References

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[2] L. Ekenros et al., “Perceived impact of the menstrual cycle and hormonal contraceptives on physical exercise and performance in 1,086 athletes from 57 sports,” Front Physiol, vol. 13, Aug. 2022, doi: 10.3389/fphys.2022.954760.

[3] O. Heyward et al., “Oral contraceptive use in Premiership and Championship women’s rugby union: perceived symptomology, management strategies, and performance and wellness effects,” Science and Medicine in Football, vol. 8, no. 2, pp. 95–102, 2024, doi: 10.1080/24733938.2022.2156588.

[4] S. Ryall, H. Ohrling, T. Stellingwerff, S. Black, K. Reilly, and J. S. Thornton, “Contraception Choice for Female Endurance Athletes: What’s Sport Got to Do With It? A Cross-Sectional Survey,” Sports Medicine, Dec. 2024, doi: 10.1007/s40279-024-02078-1.

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[8] K. SantaBarbara, E. Helms, M. Armour, and N. Harris, “Menstrual cycle characteristics, hormonal contraceptive use and perceptions of related effects in resistance-trained athletes,” Int J Sports Sci Coach, vol. 19, no. 4, pp. 1570–1577, Aug. 2024, doi: 10.1177/17479541241228986.

[9] A. Reif, B. Wessner, P. Haider, H. Tschan, and C. Triska, “Strength Performance Across the Oral Contraceptive Cycle of Team Sport Athletes: A Cross-Sectional Study,” Front Physiol, vol. 12, Jul. 2021, doi: 10.3389/fphys.2021.658994.

[10] A. Dole, M. Beaven, and S. T. Sims, “Menstrual Cycle Tracking in Sports Research: Challenges, Progress, and Future Directions,” Physiologia, vol. 3, no. 4, pp. 598–610, Nov. 2023, doi: 10.3390/physiologia3040044.

[11] B. Kayser, “Where sports performance meets reproductive rights: hormonal contraception,” Drugs: Education, Prevention and Policy, vol. 31, no. 4, pp. 396–402, 2024, doi: 10.1080/09687637.2023.2261614.

[12] K. J. Elliott-Sale et al., “The Effects of Oral Contraceptives on Exercise Performance in Women: A Systematic Review and Meta-analysis,” Oct. 01, 2020, Springer. doi: 10.1007/s40279-020-01317-5.

[13] N. Brown, C. J. Knight, and L. J. Forrest, “Elite female athletes’ experiences and perceptions of the menstrual cycle on training and sport performance,” Scand J Med Sci Sports, vol. 31, no. 1, pp. 52–69, Jan. 2021, doi: 10.1111/sms.13818.

[14] H. E. Cabre, L. M. Gould, L. M. Redman, and A. E. Smith-Ryan, “Effects of the Menstrual Cycle and Hormonal Contraceptive Use on Metabolic Outcomes, Strength Performance, and Recovery: A Narrative Review,” Jul. 01, 2024, Multidisciplinary Digital Publishing Institute (MDPI). doi: 10.3390/metabo14070347.

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[21] M. A. Carmichael et al., “A pilot study on the impact of menstrual cycle phase on elite australian football athletes,” Int J Environ Res Public Health, vol. 18, no. 18, 2021, doi: 10.3390/ijerph18189591.

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Published

2025-04-03

How to Cite

1.
SZWECH , Julia, BLECHARZ, Gabriela, JAŃCZYK, Natalia, JANKOWSKA, Marlena, MĘDRYSA, Karolina, PRESAK, Michał, POKRZEPA, Jakub Jan, BARAN, Karolina, WINKOWSKA, Alicja and BARTNIK, Katarzyna. The Effects of Hormonal Contraception on Physical Performance and Health of Female Athletes: A Systematic Review. Quality in Sport. Online. 3 April 2025. Vol. 40, p. 59410. [Accessed 28 June 2025]. DOI 10.12775/QS.2025.40.59410.
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Vol. 40 (2025)

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Medical Sciences

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Copyright (c) 2025 Julia Szwech , Gabriela Blecharz, Natalia Jańczyk, Marlena Jankowska, Karolina Mędrysa, Michał Presak, Jakub Jan Pokrzepa, Karolina Baran, Alicja Winkowska, Katarzyna Bartnik

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