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Mia A. Schaumberg, Lynne M. Emmerton, David G. Jenkins, Nicola W. Burton, Xanne A.K. Janse de Jonge and Tina L. Skinner

Extended oral-contraceptive (OC) regimens (ie, avoiding menstruation by continually taking hormone [active] pills) are anecdotally reported among physically active women to reduce the effect of menstruation and/or menstrual symptoms on physical activity, exercise, or sport. 1 Greig et al 2

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Beatriz Rael, Nuria Romero-Parra, Víctor M. Alfaro-Magallanes, Laura Barba-Moreno, Rocío Cupeiro, Xanne Janse de Jonge, Ana B. Peinado and on Behalf of the IronFEMME Study Group

phase at the time of testing through the measurement of female sex hormones. 3 In women taking oral contraceptive (OC) pills, natural endogenous secretion (estradiol and progesterone) is downregulated due to the intake of the exogenous ones (ethinyl estradiol and progestin); thus, they present a

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Claire Rechichi, Brian Dawson and Carmel Goodman

Some reports suggest variation in physiological responses and athletic performance, for female athletes at specific phases of the menstrual cycle. However, inconsistent findings are common due to the inappropriate verification of menstrual cycle phase, small subject numbers, high intra- and interindividual variability in estrogen and progesterone concentration, and the pulsatile secretion of these hormones. Therefore, the oral contraceptive (OC) cycle may provide a more stable environment in which to evaluate the acute effect of reproductive hormones on physiological variables and exercise performance. To date, most of the OC research has compared differences between OC use and nonuse, and few researchers have examined within-cycle effects of the OC. It is also apparent that OC use is becoming far more prevalent in athletes; hence the effect of the different exogenous and endogenous hormonal profiles on athletic performance should be investigated. Research to date identifies potential for variation in aerobic performance, anaerobic capacity, anaerobic power and reactive strength throughout an OC cycle. The purpose of this review is to present and evaluate the current literature on the physiology of exercise and athletic performance during the OC cycle.

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Mikkel Oxfeldt, Line B. Dalgaard, Astrid A. Jørgensen and Mette Hansen

Reports on HC use in athletes vary. A recent survey among elite athletes in the United Kingdom reported that 50% to use HC, 14 whereas 57% of U.S. athletes used oral contraceptives (OCs). 15 In both studies, athletes reported their athletic performance to be influenced by their cycle. 14 , 15 Female

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Daniel Martin, Craig Sale, Simon B. Cooper and Kirsty J. Elliott-Sale

dysmenorrhea. 9 , 10 There are different delivery methods for HCs, including oral contraceptives (OCs), implants, injections, transdermal patches, vaginal rings, and intrauterine systems (IUSs). In the United Kingdom, a hormone-releasing coil is typically referred to as an IUS, whereas a copper-based, non

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Marc Sim, Brian Dawson, Grant Landers, Debbie Trinder and Peter Peeling

The trace element iron plays a number of crucial physiological roles within the body. Despite its importance, iron deficiency remains a common problem among athletes. As an individual’s iron stores become depleted, it can affect their well-being and athletic capacity. Recently, altered iron metabolism in athletes has been attributed to postexercise increases in the iron regulatory hormone hepcidin, which has been reported to be upregulated by exercise-induced increases in the inflammatory cytokine interleukin-6. As such, when hepcidin levels are elevated, iron absorption and recycling may be compromised. To date, however, most studies have explored the acute postexercise hepcidin response, with limited research seeking to minimize/attenuate these increases. This review summarizes the current knowledge regarding the postexercise hepcidin response under a variety of exercise scenarios and highlights potential areas for future research—such as: a) the use of hormones though the female oral contraceptive pill to manipulate the postexercise hepcidin response, b) comparing the use of different exercise modes (e.g., cycling vs. running) on hepcidin regulation.

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Katherine A. Beals and Melinda M. Manore

This study examined the prevalence of and relationship between the disorders of the female athlete triad in collegiate athletes participating in aesthetic, endurance, or team/anaerobic sports. Participants were 425 female collegiate athletes from 7 universities across the United States. Disordered eating, menstrual dysfunction, and musculoskeletal injuries were assessed by a health/medical, dieting and menstrual history questionnaire, the Eating Attitudes Test (EAT-26), and the Eating Disorder Inventory Body Dissatisfaction Subscale (EDI-BD). The percentage of athletes reporting a clinical diagnosis of anorexia and bulimia nervosa was 3.3% and 2.3%, respectively; mean (±SD) EAT and EDI-BD scores were 10.6 ± 9.6 and 9.8 ± 7.6, respectively. The percentage of athletes with scores indicating “at-risk” behavior for an eating disorder were 15.2% using the EAT-26 and 32.4% using the EDI-BD. A similar percentage of athletes in aesthetic, endurance, and team/anaerobic sports reported a clinical diagnosis of anorexia or bulimia. However, athletes in aesthetic sports scored higher on the EAT-26 (13.5 ± 10.9) than athletes in endurance (10.0 ± 9.3) or team/anaerobic sports (9.9 ± 9.0, p < .02); and more athletes in aesthetic versus endurance or team/anaerobic sports scored above the EAT-26 cut-off score of 20 (p < .01). Menstrual irregularity was reported by 31% of the athletes not using oral contraceptives, and there were no group differences in the prevalence of self-reported menstrual irregularity. Muscle and bone injuries sustained during the collegiate career were reported by 65.9% and 34.3% of athletes, respectively, and more athletes in aesthetic versus endurance and team/anaerobic sports reported muscle (p = .005) and/or bone injuries (p < .001). Athletes “at risk” for eating disorders more frequently reported menstrual irregularity (p = .004) and sustained more bone injuries (p = .003) during their collegiate career. These data indicate that while the prevalence of clinical eating disorders is low in female collegiate athletes, many are “at risk” for an eating disorder, which places them at increased risk for menstrual irregularity and bone injuries.

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Editorial Finding Research Funds for Sports Physiology Projects David Pyne 6 2009 4 2 149 150 10.1123/ijspp.4.2.149 Brief Review Athletic Performance and the Oral Contraceptive Claire Rechichi * Brian Dawson * Carmel Goodman * 6 2009 4 2 151 162 10.1123/ijspp.4.2.151 Original Investigations

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Guro S. Solli, Silvana B. Sandbakk, Dionne A. Noordhof, Johanna K. Ihalainen and Øyvind Sandbakk

Women using combined oral contraceptives (OCs) have exhibited higher cortisol levels, 21 lower maximal aerobic capacity, 22 and less adaptation to sprint interval training 23 than nonusers, whereas endurance performance seems unaffected. 14 , 24 , 25 It is currently unknown whether the varying doses

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Claire-Marie Roberts and Jacky Forsyth

training advice for the female athlete or exerciser. For example, we learned that females oxidize more lipids than do men during submaximal exercise ( Stevenson, 2018 ), which will clearly demand a different nutritional intake for effective performance. Likewise, females using oral contraceptives may be at