Throughout their reproductive years, some women and girls might choose to use hormonal contraception.
Hormonal contraceptives are medications or devices containing synthetic oestrogen and/or progesterone that have the primary purpose of preventing an unplanned pregnancy. Today, many female athletes also use hormonal contraception for additional reasons[1], such as:
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To modify bleeding (e.g., to avoid bleeding during competitions and events etc.)
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Manage menstrual cycle-related symptoms (e.g., abdominal cramps, breast pain, headaches, bloating etc.) as well as other medical conditions (e.g., endometriosis)
How do hormonal contraceptives work?
Generally, hormonal contraceptives can prevent pregnancy in three different ways:
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Preventing ovulation: Throughout the menstrual cycle, the ovaries release an egg each cycle, which is known as ovulation. Hormonal contraceptive use alters our reproductive hormone function which prevents the release of eggs from the ovaries. With no egg released, there’s nothing for sperm to fertilise, and as such, prevents pregnancy.
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By thinning the uterine lining: This creates an unfriendly environment for a fertilised egg to implant and develop.
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Thickening cervical fluid or mucus: This makes it difficult for sperm to pass through the cervix and reach an egg (if one is released).
Hormonal contraceptives change your natural menstrual cycle depending on the type. For example, you might not experience the typical rise and fall of natural oestrogen and progesterone observed in a menstrual cycle. There are various types of hormonal contraceptives such as the combined pill, intrauterine system, and the implant (and much more), which all work to deliver hormones in different ways (e.g., orally, through the skin or muscle, etc.).
Reminder: The bleed you might experience on hormonal contraceptives is not your period, it is known as a withdrawal bleed or breakthrough bleed.
Where to get advice on hormonal contraceptives?
It’s essential to consult with a healthcare professional regarding hormonal contraceptive options to help you make informed decisions that prioritise your health and safety. If you experience any unwanted side effects, don't hesitate to contact your healthcare professional to explore alternative options. These might include your GP and gynaecologist.
References
[1]Elliott-Sale, K. J., & Hicks, K. M. (2018). Hormonal-based contraception and the exercising female. In The Exercising Female (pp. 30-43). Routledge.