Prevalence of hormonal contraceptive use and reported side effects of the menstrual cycle and hormonal contraceptive use in powerlifting and rugby

Abstract

The prevalence of hormonal contraceptive (HC) use and the associated symptomology of use or non-use are under-studied in athletic populations, and in particular, in strength and collision sports. This study aimed to investigate the prevalence of hormonal contraceptive use and reported side effects of the menstrual cycle and hormonal contraceptive use in powerlifters and rugby players. METHODS:Competitive female powerlifters and rugby players (aged 18 y), representing a strength and a collision sport respectively, completed an anonymous online questionnaire for the purpose of assessing self-reported prevalence of HC use, and symptoms of the menstrual cycle and HC use. Athletes were categorized by sport (powerlifters, n=149; rugby players, n=135) in order to conduct a stratified analysis. For open-ended questions, a content analysis was conducted to categorize responses, and frequency analyses were performed. RESULTS:Current HC use was reported by 51.1% of athletes, with similar prevalence for the two sports (powerlifting, 48.3% vs. rugby, 54.1%, P=0.34). Side effects of the menstrual cycle were reported in 83.5% of non-HC users, with the most common being unspecified cramping (42.4%), headache/migraine (24.5%), and fatigue (24.5%). Side effects were reported in 40.0% of HC users, with the most common being mood changes (17.9%), stomach pain (8.3%) and headaches/migraines (6.9%). 2 CONCLUSION:A large proportion of HC users and non-users in this study experience negative side effects of HC use and the menstrual cycle, respectively. The symptoms experienced by both groups are wide-ranging, with a high degree of variation between individuals. The negative side-effects experienced by HC users and non-users may have an influence on athletic performance, and this requires future investigation.

Prevalence and Self-Perceived Experiences With the Use of Hormonal Contraceptives Among Competitive Female Cross-Country Skiers and Biathletes in Norway: The FENDURA Project

“…The 68% prevalence of HC use in this study is higher than the ~50% prevalence reported in earlier studies on athletes from various sports (Martin et al, 2018 ; Oxfeldt et al, 2020 ; Solli et al, 2020 ; Clarke et al, 2021 ; Nolan et al, 2022 ). Furthermore, over 60% of HC users in the current study employed a progestin-only type of HC, which differs from previous studies where most (61–74%) athletes used a combined type (Martin et al, 2018 ; Oxfeldt et al, 2020 ; Solli et al, 2020 ).…”

“…However, recent data from the Norwegian Prescription Database shows a rapid increase in the use of long-acting progestin-only HCs (i.e., implants and IUS) during the past 3 years (Furu et al, 2021 ). In the athlete population, approximately half of the respondents from various sports in the United Kingdom, Ireland, Denmark, and Norway reported hormonal contraceptive (HC) use (Martin et al, 2018 ; Oxfeldt et al, 2020 ; Solli et al, 2020 ; Nolan et al, 2022 ), with athletes in technical sports (e.g., golf, table tennis etc.) showing a higher proportion of HC use (80%) compared to athletes competing in endurance sports (50%) (Oxfeldt et al, 2020 ).…”

Perceived impact of the menstrual cycle and hormonal contraceptives on physical exercise and performance in 1,086 athletes from 57 sports

“…The majority of the athletes (63%) in this study were using HCs, which is a higher proportion than among the general population ( Lindh et al, 2017 ), as well as among other groups of elite athletes ( Martin et al, 2018 ; Oxfeldt et al, 2020 ; Solli et al, 2020 ; Nolan, Elliott-Sale and Egan, 2022 ). However, Engseth et al (2022) showed a similar proportion, 68%, in cross-country skiers and biathletes.…”

“…The use of HCs in the general population of Scandinavian women of reproductive age is approximately 40% (Lindh et al, 2017). A higher proportion, 50%-57%, of HC use has been reported for different athlete populations in various European countries (Martin et al, 2018;Oxfeldt et al, 2020;Solli et al, 2020;Nolan, Elliott-Sale and Egan, 2022), and Engseth et al (Engseth et al, 2022) showed a proportion of 68% in Norwegian cross-country skiers and biathletes. In general, combined oral contraceptives (OCs) containing estrogen and progestin are reported as more commonly used (60%-74% of athletes) in athletes compared to progestin-only HCs (Martin et al, 2018;Oxfeldt et al, 2020;Solli et al, 2020).…”

Relationship between history of hormonal contraceptive use and anaemia status among women in sub-Saharan Africa: A large population-based study

“…One of such SRH priorities is the use of hormonal contraceptives. Hormonal contraceptive is a type of contraceptive that administers “exogenous hormones that affect the endocrine regulation of the female reproductive system and may inhibit ovulation” [ 2 ]. The commonest form of hormonal contraceptives is oral contraceptives [ 2 ].…”