The Pill and the Female Athlete

At one point, the Pill was regarded as a major breakthrough for female athletes; being “in control” of their cycle and avoiding pregnancy was not only empowering for women athletes, but it allowed them to be more involved in sports and other athletic endeavors. In fact, many women athletes that experienced the ‘female athlete triad’ (in short, females experiencing energy deficits, bone loss or stress fractures, and irregular or no menstrual cycles) were – and still are – put on hormonal birth control as a way of ‘fixing’ the issue. However, this may be masking a deeper issue, leading to a decrease in athletic performance and potentially dangerous consequences (1).


Unfortunately, research on birth control’s impact on athletic performance isn’t great; it often yields conflicting results mainly because enough studies haven’t been done. There are many variables such as the type of birth control, the Pill’s hormonal profile (specific amount and type of hormones in the particular brand), and how certain hormones can affect women differently (2, 3, 4). However, I’ll explore some of the information out there so you can make the best choice for you when it comes to birth control and your #gainz.


The Pill and the Female Athlete


Normally, testosterone peaks around ovulation, which helps improve our mood and overall energy level and increase our sex drive; it’s nature’s beautiful built-in system to make sure we are ready for sex when our body can get pregnant. However, hormonal birth control suppresses ovulation, causing our bodies to lack that bump in testosterone. Many more well-known side effects like mood swings, yeast infections, reduced libido, vaginal dryness, and fatigue are also related to that lack of testosterone. A more subtle side effect from this decrease in testosterone may be difficulty in building lean muscle mass, and possibly muscle strength. In fact, one study showed 40% less muscle gain from a group on the Pill versus not. In addition, the group on the Pill had much higher levels of cortisol, which is associated with muscle breakdown (5). Other studies have shown that oral contraceptives cause weight (fat) gain, but no muscle gain (6). Another research review indicated that the Pill may affect muscle force production, but noted that due to the lack of proper research (or conflicting research) a definitive statement couldn’t be made (7).


Furthermore, the Pill may also cause deficiencies in nutrients, especially B vitamins and the minerals magnesium, selenium, and zinc (8, 9, 10). Depletion of these nutrients cause women to feel more fatigued and may limit athletic recovery. Some women also experience side effects like bloating, nausea, and mood swings on the Pill. All of these things may make it much harder to get in the gym, let alone perform optimally.  


Having said all of that, you’ll have to weigh your options after doing your own research. Just like with anything you put in or on your body, you need to check in with yourself and see how you feel. Nobody knows your body like you, so trust your womanly intuition when it comes to your cycle and birth control options. If you choose to take the Pill but are concerned about building muscle, try to look for one with low-androgenicity progestins, which has been found to have less of an impact on muscle gain (11). Keep a journal to see how you feel before, during, and after workouts, as gathering this data can help you determine if things are truly working for your body or not.


Also know you have options that don’t have the side effects of hormonal birth control. The book Taking Charge of Your Fertility has a whole chapter on tracking your cycle to prevent pregnancy. We at BIRTHFIT highly recommend tracking your cycle to get in touch and work with your feminine rhythm. For a kickass discussion on all things related to a woman’s cycle, listen to BIRTHFIT Podcast #127 Featuring Nicole Jardim; Nicole talks about working with your cycle and planning intentional workouts during certain times of the month. There’s plenty of technology to help you do this, such as Wink and the Kindara app, Daysy or Ava. Also, non-hormonal methods of birth control such as condoms, Copper IUD or Spermicide gel are also effective options.


For an awesome discussion about birth control, check out BIRTHFIT Podcast #86 “What do you know about The Pill?”


Do you have more questions on the Pill and your athletic performance? Find a BIRTHFIT RD near to you get support!


Molly Powell

BIRTHFIT Milwaukee      @birthfitmke



  8. Webb, JL. “Nutritional effects of oral contraceptive use: a review. J Reprod Med. 25(4) 1980: 150-6. PubMed
  9. Lussana, F., et. al. “Blood levels of homocysteine, folate, vitamin B6 and B12 in women using oral contraceptives compared to non-users.” J. Thromb Res. 112, 1-2 (2003): 37-41. PubMed
  10. Anderson, KE, et. al. “Effects of oral contraceptives on vitamin metabolism.” J. Adv Clin Chem. 1976. PubMed
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