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Is birth control affecting your race day performance?


Struggling with the negative effects of your menstrual cycle on your training, performance and recovery? You may find that certain hormonal contraceptives could help. A new study published in the Journal of Sports Sciences suggests that using a hormonal intrauterine device (IUD) or implant may be more likely to support success in endurance sports, while progestin-only oral contraceptives (POC) and no birth control (non-HC) at all might leave you feeling tired and less ready to train.

stomach ache

The study investigated 58 female endurance athletes around age 21 using various methods of contraception:  IUD, implant, POC, COC and non-HC. Over 12 months, the participants completed three questionnaires and logged their perceived cycle-related symptom severity, sleep quality, and physical and mental readiness to train, using a scale from one (no symptoms/low sleep quality/not ready) to 10 (severe symptoms/high sleep quality/very ready). Resting heart rate was also reported daily. Data was sorted into pre-bleeding, bleeding and non-bleeding phases of the menstrual cycle.

Contraceptives study results
Results logged by study participants, broken into three phases of the menstrual cycle. Photo: Journal of Sports Sciences

Implant users reported significantly less severe symptoms on bleeding days (where symptoms are intensified for all participants), and logged the highest overall sleep quality. IUD users logged the second-highest overall sleep quality and the highest physical readiness to train, but the more severe overall symptoms. IUD and non-HC appeared to support a relatively consistent resting heart rate.

Reports from POC users, on the other hand, indicated lower physical readiness to train and the worst sleep quality across all menstrual cycle phases. Non-HC users logged severe cycle-related symptoms and felt the least ready to train.

Choosing the best method

Since the severity of symptoms was inversely correlated with sleep quality and feeling physically ready for training, it’s essential to limit exposure to factors that could worsen symptoms or slow recovery. Contraception methods with minimal effects on heart rate are ideal for sports where training zones and heart rate monitoring play a key role in fitness tracking.

woman running

The study highlights the importance of tailoring contraceptive choices to an athlete’s needs, emphasizing that the right method can make a significant difference in training and performance. Results suggest the implant is the best option to manage symptoms or sleep-related concerns, while the IUD can aid with sleep and heartbeat regulation. Consulting with your doctor to explore these options can be a key step toward achieving your running goals.



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