Could Your Birth Control Method Be Affecting Your Performance In The Gym? Here's What Experts Say
Thanks to TikToks, sketchy health blogs, and Thanksgiving soapboxes courtesy of your toxic aunt, the rumor that birth control affects your ability to perform athletically has been spread far and wide for way too long.
We get why it's confusing. Hormonal birth control methods such as contraceptive pills alter your hormones, which can affect…well, everything else, like your workouts.
But, science hasn't exactly found that to be true. Plus, there are several kinds of birth control methods; some are more studied than others. We have some limited information on how oral contraceptive pills (OCPs) affect athletic performance in females. Other forms, including intrauterine devices (IUDs) with and without hormones, as well as implants, work differently and are even less studied. We consulted the experts to find out what we know, and what we don't, about how your birth control may affect your workouts.
Meet the Experts: Jessica Shepherd, MD, is a board-certified ob-gyn, author of Generation M: Living Well in Perimenopause and Menopause, and Women's Health advisory board member. Bailey McLagan is a PhD candidate in exercise physiology at the University of Southern California, who specializes in women's performance research, including how birth control affects workouts.
It's difficult to generalize these medications' effects since there are a bunch of different types, and they affect women differently.
The most commonly used is oral contraceptives. These medications include synthetic hormones and generally work by "sending a signal to our brain to tell our body not to release an egg,' says Bailey McLagan, MS, a PhD candidate in exercise physiology at the University of Southern California, who studies the role of female hormones in exercise and recovery. 'The goal is to prevent ovulation, thus preventing the possibility of getting pregnant.'
They can cause a handful of side effects that may indirectly affect performance, such as mood changes, spotting, cramping, nausea, or headaches. Even though these side effects are possible, it's important to note that not everyone will experience them, McLagan notes.
Beyond side effects, 'it's not clear what, if any, effect OCPs have on training,' McLagan says. 'This is because there are so many kinds that are often not recorded in research and because studies don't often differentiate between OCP users and non-users.'
One 2022 study, for example, looked at hormonal oral birth control effects on strength training outcomes, including muscle thickness, muscle fiber size, and composition over a 12-week period. They found that factors were similar between women who did and did not use oral contraceptives, says Jessica Shepherd, MD, board-certified ob-gyn and Women's Health advisory board member.
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Another study looked at exercise performance factors such as workload, exhaustion, time to completion, mean peak outputs, rate of production, and maximal oxygen intake between oral contraception users and non-users. The study found a trivial reduction in performance factors in those using oral contraception. 'It's important to remember that performance is impacted by a lot of things, so a trivial reduction doesn't signify an advantage in one over the other,' McLagan says.
Some studies have looked at the impact of hormonal birth control on VO2 max—a measure of how much oxygen you use during training, Dr. Shepherd says. When VO2 max is high, it means that your body is more efficient at delivering oxygen to the muscles, Dr. Shepherd says. One study found the use of oral contraceptives might lower VO2 max.
As mentioned, oral contraceptives aren't the only form of birth control. Dr. Shepherd says hormonal IUDs have shown some positive results. In one study, it was found to be the best-tolerated contraceptive for female endurance athletes. It also had the highest percentage of users who perceived positive training and competition impacts.
'Overall, there should be better research that looks at a prospective, randomized design to assess the effects of all types of hormonal contraceptives on athletic performance in females,' Dr. Shepherd says.
What we do know: Much more research needs to be done to determine the effects of different birth control methods on training performance.
Ultimately, how your experience on how birth control affects your workouts will differ from others. Therefore, you might have to go through some level of trial and error to determine what works for you. If you're on a new form of birth control, your doctor might tell you to stay on it for more than a month to see if potential symptoms subside or not.
Ultimately, you shouldn't have to choose between being on birth control and getting the workout results you want.
There are a ton of reasons to stay on birth control beyond pregnancy prevention—and there are tons of options to choose from. So don't be afraid to advocate for yourself to find the one that gives you the best results in all aspects of your life.
'If a certain form of OCP is making you feel uncomfortable, it may be that you need a different formulation of hormones, a lower dose, or switch to a different birth control method altogether,' McLagan says. Keep an open line of communication with your doctor, and adjust as necessary until you find a path that works for you.
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