We often post about the menstrual cycle to help people figure out how it might affect their training.

However, how does this information change with hormonal contraception?

Research on the menstrual cycle is variable in quality and results.

Research on contraceptive use and athletic performance? Even more limited and variable!

So what do we know?

Hormone disruption

We can use our menstrual cycle as a ‘marker of health’; a regular cycle is one indicator of adequate energy intake (i.e. we’re consuming enough food to support exercise and bodily processes).

However, some hormonal contraceptives can disrupt our endogenous hormones (those that we make in our bodies) and, as a result, we may not experience natural menstrual cycles.

In these situations, we cannot use our natural menstrual cycle as a marker of health to help monitor if we have adequate energy availability (see last week’s post on RED-S). 

Hormonal Contraceptive Pill

On some hormonal contraceptive pills, some bleeding may be experienced. However, this is not a period but rather a ‘withdrawal bleed’.

In this case, the presence of bleeding isn’t an indicator of adequate energy availability.

Alternatively, some hormonal contraceptives pills can prevent bleeding altogether.

In the absence of periods or only having ‘withdrawal bleeds’, athletes don’t know whether they would be having periods if they weren’t using hormonal contraception and, therefore, are unable to use it as a marker of health.

What can you do if you take hormonal contraceptives?

Athletes who menstruate and who take hormonal contraceptives should consider monitoring other indicators of low energy availability and RED-S, such as decreased training response, decreased strength, decreased coordination, low mood…

Tracking

Athletes using hormonal contraception do report still experiencing symptoms that could be linked to hormonal fluctuation or withdrawal bleeds.

Tracking may still be useful but this needs to be done with your hormonal contraceptive in mind. Using an app like Clue, that has good information about different forms of contraceptives, would be a good approach.

Is a natural cycle better?

Some people experience negative symptoms when using certain forms of hormonal contraceptives.

Others find they help with their symptoms and have an overall positive impact on their climbing/life.

Based on current research into athletic performance and contraceptives the answer is: we don’t know.

Research has been on small groups with variable results.

However, it is worthwhile being informed and making a choice which is right for you, taking everything into account.

If you’re starting or stopping contraceptives, monitoring how you feel may provide you with useful information on what works best for you. 

If you haven’t already check out this Q&A Ella did on the subject!

If you’re concerned about your menstrual health, speak to a medical professional.

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