A perspective on current research investigating the effects of hormonal contraceptives on determinants of female athlete performance

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 decades.  ere are numerous review articles on the e€ ect of oral contraceptives (OC) on athletic performance, however we feel that these reviews are insu cient as they do not include all categories of hormonal contraceptives. In addition to OCs, there are many other delivery systems for hormonal contraceptives including Intrauterine Devices (IUDs), injections, transdermal patches, implants and vaginal rings. TABLE 1 shows the characteristics of each type of hormonal contraceptive. Most hormonal contraceptives contain the synthetic oestrogen Ethinyl Estradiol (EE), however there are four generations of progestins, each with varying androgenicity and potency; for a comprehensive review see Benagiano et al.. Each type of hormonal contraceptive has multiple formulations and brands that supply oestrogens and/or progestins in various concentrations for di€ erent durations. As such, the term “hormonal contraceptives” is an umbrella phrase that refers to any type of exogenous hormones that alters endogenous endocrine function and prevents pregnancy.  is is the ˆ 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. In athletes, the prevalence of OC use is estimated to be 40-50%, however the most recent large-scale data was published in 2005 and the use of other methods of hormonal contraceptives, beyond OCs, has not been reported. Abstract