Purpose: Menstruation and menstrual symptoms are commonly cited barriers to physical activity in women. The delay or avoidance of menstruation through extended oral-contraceptive (OC) regimens may mitigate these barriers, yet information on menstrual-manipulation practices in young physically active women is sparse. The objective of this study was to investigate prevalence of, and reasons for, menstrual manipulation with OCs in recreationally and competitively active women. Methods: One hundred ninety-one recreationally active (self-reported moderate to vigorous physical activity 150–300 min/wk) women (age 23 ± 5 y), 160 subelite recreationally active (self-reported moderate to vigorous physical activity >300 min/wk) women (age 23 ± 5 y), and 108 competitive (state-, national- or international-level) female athletes (age 23 ± 4 y) completed a self-administered questionnaire assessing OC-regimen habits and reasons for manipulation of menstruation. Results: The majority (74%) of OC users reported having deliberately manipulated menstruation at least once during the previous year, with 29% reporting having done so at least 4 times. Prevalence of menstrual manipulation (at least once in the previous year) was not different between competitive athletes, subelite recreationally active women, and recreationally active women (77% vs 74% vs 72%; P > .05). The most cited reasons for manipulating menstruation were special events or holidays (rated by 75% as important/very important), convenience (54%), and sport competition (54%). Conclusions: Menstrual manipulation through extended OC regimens is common practice in recreationally and competitively active young women, for a range of reasons relating to convenience that are not limited to physical activity. This strategy may help reduce hormone-related barriers to exercise participation, thereby positively affecting participation and performance.
Schaumberg is with the School of Health and Sports Sciences, University of the Sunshine Coast, Sippy Downs, QLD, Australia. Emmerton is with the School of Pharmacy, Curtin University, Perth, WA, Australia. Jenkins and Skinner are with the School of Human Movement and Nutrition Sciences, University of Queensland, St Lucia, QLD, Australia. Burton is with the School of Applied Psychology, Griffith University, Mount Gravatt, QLD, Australia. Janse de Jonge is with the School of Environmental and Life Sciences, University of Newcastle, Ourimbah, NSW, Australia.
Greig AJ, Palmer MA, Chepulis LM. Hormonal contraceptive practises in young Australian women (≤25 years) and their possible impact on menstrual frequency and iron requirements. Sex Reprod Healthc. 2010;1(3):99–103. PubMed doi:10.1016/j.srhc.2010.06.001
GreigAJ, PalmerMA, ChepulisLM. Hormonal contraceptive practises in young Australian women (≤25 years) and their possible impact on menstrual frequency and iron requirements. . 2010;1(3):99–103. PubMed doi:10.1016/j.srhc.2010.06.00110.1016/j.srhc.2010.06.001)| false
Edelman A, Micks E, Gallo MF, Jensen JT, Grimes DA. Continuous or extended cycle vs. cyclic use of combined hormonal contraceptives for contraception. Cochrane Database Syst Rev. 2014;(7):CD004695. PubMed doi:10.1002/14651858.CD004695.pub3
EdelmanA, MicksE, GalloMF, JensenJT, GrimesDA. Continuous or extended cycle vs. cyclic use of combined hormonal contraceptives for contraception. . 2014;(7):CD004695. PubMed doi:10.1002/14651858.CD004695.pub325072731)| false
Sulak PJ, Cressman BE, Waldrop E, Holleman S, Kuehl TJ. Extending the duration of active oral contraceptive pills to manage hormone withdrawal symptoms. Obstet Gynecol. 1997;89(2):179–183. PubMed doi:10.1016/S0029-7844(96)00488-7
Schneider MB, Fisher M, Friedman SB, Bijur PE, Toffler AP. Menstrual and premenstrual issues in female military cadets: a unique population with significant concerns. J Pediatr Adolesc Gynecol. 1999;12(4):195–201. PubMed doi:10.1016/S1083-3188(99)00025-X
SchneiderMB, FisherM, FriedmanSB, BijurPE, TofflerAP. Menstrual and premenstrual issues in female military cadets: a unique population with significant concerns. . 1999;12(4):195–201. PubMed doi:10.1016/S1083-3188(99)00025-X10.1016/S1083-3188(99)00025-X10584223)| false
Powell-Dunford N, Cuda AS, Moore JL, Crago MS, Deuster PA. Menstrual suppression using oral contraceptives: survey of deployed female aviation personnel. Aviat Space Environ Med. 2009;80(11):971–975. PubMed doi:10.3357/ASEM.2566.2009
Powell-Dunford NC, Cuda AS, Moore JL, Crago MS, Kelly AM, Deuster PA. Menstrual suppression for combat operations: advantages of oral contraceptive pills. Womens Health Issues. 2011;21(1):86–91. PubMed doi:10.1016/j.whi.2010.08.006
Rosenberg MJ, Meyers A, Roy V. Efficacy, cycle control, and side effects of low- and lower-dose oral contraceptives: a randomized trial of 20 μg and 35 μg estrogen preparations. Contraception. 1999;60(6):321–329. PubMed doi:10.1016/S0010-7824(99)00109-2
RosenbergMJ, MeyersA, RoyV. Efficacy, cycle control, and side effects of low- and lower-dose oral contraceptives: a randomized trial of 20 μg and 35 μg estrogen preparations. . 1999;60(6):321–329. PubMed doi:10.1016/S0010-7824(99)00109-210.1016/S0010-7824(99)00109-2)| false
ArcherDF. Menstrual-cycle-related symptoms: a review of the rationale for continuous use of oral contraceptives. Contraception. 2006;74:359–366. PubMed doi:10.1016/j.contraception.2006.06.00310.1016/j.contraception.2006.06.00317046376)| false