There is evidence to suggest that the oral contraceptive pill (OCP) can have an effect on skeletal health, soft tissue injury, and performance in female athletes (Bennell, White & Crossley, 1999). Female athletes primarily use the OCP for contraceptive purposes, but cycle manipulation and control of premenstrual symptoms are secondary advantages of its use (Bennell, White & Crossley, 1999). The effect of the OCP on bone density in normally menstruating women is unclear, with some studies reporting no effect, others a positive effect, and some even a negative effect (Bennell, White & Crossley, 1999). A recent study, on the long term use of OCP and fractures in later life has shown no significant association (Memon, Iverson, & Hannaford, 2011). However, Memon, Iverson & Hannaford (2011) note that the results of this study are contrary to earlier research, and thus, whether the OCP influences the risk of stress fracture and soft tissue injuries continues to remain unclear.
Moreover, the effects of the OCP on performance are particularly relevant for elite sportswomen (Bennell, White & Crossley, 1999). Although a reduction in VO2MAX (measure of how much oxygen a person can use during maximum exertion) has been reported (Lebrun, Petit, McKenzie, Taunton & Prior, 2003), yet, it is not clear as to whether decreased maximal aerobic performance (VO2MAX) will necessarily compromise competitive performance. In contrast, some studies claim that the OCP may enhance performance by reducing premenstrual symptoms and menstrual blood loss (Lebrun, 1993).
There is anecdotal evidence to suggest that the OCP contributes to weight gain, however, this is currently unfounded in the scholarly literature (Rosenberg, 1998). Nevertheless, its ability to increase extracellular fluid is a contributing factor to total body weight (Rosenberg, 1998). Bennell, White & Crossley (1999) argue that the advantages of the pill, for sportswomen, outweigh any potential disadvantage. However, Fallah, Sani & Firoozrai (2009), report that the oral contraceptive pill contributes to selenium and zinc deficiency, important elements in maintain optimal performance.
This being so, individual variation in response to the OCP should be taken into account and monitored. Sportswomen should be counselled about the potential benefits and disadvantages of using the OCP in order to make an informed decision.
Bennell, K., White, S & Crossley, K. 1999. The oral contraceptive pill: a revolution for sportswomen? British Journal of Sports Medicine, 33, 4, 231-238.
Fallah, S., Sani, F.J & Firoozrai. 2009. Effect of the oral contraceptive pill on the selenium and zinc status of healthy subjects. Contraception, 80, 40-43.
Lebrum, C.M. 1993. Effect of different phases of the menstrual cycle and oral contraceptives on athletic performance. Sports Medicine, 16, 6, 400-430.
Lebrum, C.M., Petit, M.A., McKenzie, D.C., Taunton, J.E & Prior, J.C. 2003. Decreased maximal aerobic capacity with use of atriphasic oral contraceptive in highly active women: a randomised controlled trial. British Journal of Sports Medicine, 37, 315-320.
Memon, S., Iversen, L & Hannaford, P.C. 2011. Is the oral contraceptive pill associated with fracture in later life?: new evidence from the royal college of general practitioners oral contraceptive study. Contraception, 84, 1, 40-47.
Rosenberg, M. 1998. Weight change with oral contraceptive use during the menstrual cycle. Contraception, 58, 6, 345-349.