Birth Control Concerns

Q: I've been taking birth control pills since I was 17 and lately I've been worrying about whether or not this could be hindering my performance on the track.

Do birth control pills affect athletic performance? What is the best form of birth control for a runner?

K.H.
Seattle, Washington

A: The effect of birth control pills on athletic performance is an area in which very little research has been done. Of the few studies performed on small numbers of exercising women using oral contraceptives, some have shown a slight reduction in muscle endurance measured by grip strength, and V02 max (aerobic capacity) measured on a treadmill exercise test.

The significance of these laboratory findings upon actual performance is difficult to ascertain. It is not even known if these findings can be accurately reproduced. On the positive side, one study of Swedish soccer players who used oral contraceptives showed they had fewer injuries than non-users. Oral contraceptives do protect a woman from bone loss associated with amenorrhea.

Oral contraceptives are the most popular and reliable method of birth control. They actually decrease the risk of developing ovarian and uterine cancer. Recent research on their relationship to breast cancer has not convinced the FDA to change the labeling or add any warnings to the packaging. The current low dosage formulations cause very little bloating and weight gain. They are neither banned nor tested for at any athletic event.

Two studies in the early '80s, however, found that runners preferred using barrier forms of contraception (diaphragm and spermicidal jelly). The best form of birth control for any woman is the form that she and her partner will use. While scientists continue to do research, I feel that contraception for the athlete should be influenced, more by personal preference than by the fact that she exercises.

While we are on the subject of birth control, we would like to point out that infection prevention should be a major consideration when making these decisions. The rates of infection of sexually transmitted diseases are staggeringly high.

The consequences of these diseases are very serious, including pelvic inflammatory disease, cervical cancer, sterility and even death from AIDS. Using condoms along with a spermicidal jelly or foam containing Nonoxynol 9, a substance that has been shown to kill the AIDS virus, can substantially reduce your chances of infection and also provide contraception.

About the authors: Carol L. Otis, M.D., is Chief Medical Advisor to the Sanex WTA and a UCLA student health physician. Roger Goldingay is a former professional soccer player. They are married and the co-authors of The Athletic Woman's Survival Guide.

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