Hormonal contraceptive use, menstrual cycle characteristics and training/nutrition related profiles of elite, sub-elite and amateur athletes and exercisers: One size is unlikely to fit all

Abstract

The aim of the present study was to simultaneously audit hormonal contraceptive (HC) use, menstrual cycle characteristics and training/nutrition related profiles in pre-menopausal women from varying athletic and exercise backgrounds. Elite ( n = 51), sub-elite ( n = 118) and amateur ( n = 392) female athletes and exercisers were examined via an anonymous quantitative/qualitative survey tool. All analyses for ratio data were conducted utilising one- and two-way ANOVA/ANCOVA and odds ratio models, with ordinal data analysed via Pearson's Chi-squared tests. HC use was similar across elite, sub-elite and amateurs (34–44%). Menstrual cycle length was not different ( P = 0.08) between competitive levels (28 ± 13 days), but 66% of respondents reported cycle variability (10 ± 11 days). Training profiles were not different based on contraceptive status ( P > 0.05) yet were across competitive groups ( P < 0.05). Daily meal/snack intakes were not different between contraceptive status ( P > 0.05), though elite and sub-elite groups reported a higher daily meal consumption compared to amateurs ( P < 0.01). Forty percent of all respondents skipped meals, attributed to lack of time, schedule and alterations in appetite, with reported changes in taste preferences during pre-menses (14–35%) and menses (15–25%) towards sweet foods (60%), with cravings for chocolate and other confectionary (25%). Prevalence of dietary supplement use was not influenced by contraceptive status ( P = 0.31), though elites (76%) reported higher use ( P = 0.04) than amateurs (63%). Data demonstrates that in female athletes and exercisers, competitive level appears to affect simple markers of training and nutrition practice, yet contraceptive status does not.

Fatigue Resistance Is Altered during the High-Hormone Phase of Eumenorrheic Females but Not Oral Contraceptive Users

“…To add to the complexity of understanding hormonal fluctuations, menstrual manipulation through hormonal contraceptives is widely practiced by many female athletes (14,15) to alleviate menstrual discomfort and reduce inconveniences that may impact their quality of training and competition (16). Monophasic oral contraceptives (OC) are the most common form of menstrual manipulation and include 7 d of no pill ingestion or placebo followed by 21 d of a constant exogenous hormone dosage (17). The exogenous synthetic hormone analogues delivered (i.e., ethinyl estradiol and progestin) by OC exert additional metabolic effects when compared with the endogenous ovarian hormones released through a normal MC (18), such as decreasing glucose tolerance (19), augmenting insulin resistance, and reducing muscle glycogen utilization (20).…”