The Birth Control Band-Aid

Is Birth Control The Answer For Female Athletes With RED-S?

If you recently caught my posts “No Flo, No Go” and “Let’s Keep Talkin’ Period” you know how I feel about a woman’s menstrual cycle…. it’s what gives us our superpowers!

If you didn’t get to check them out, you can do so here.

Since their publishing, I’ve gotten quite a few questions, and many of them addressing the topic of… Birth Control (oral contraceptive pills (OCP), injections, etc.). I’ve received messages stating, ” When I lost my period, I got put on birth control and things got better.” 

Well, ladies…. we need to chat about this a little bit more.

If you are an athlete who has lost their period and received birth control to regulate your period, listen up.

If you are a provider who has been prescribing birth control to female athletes with irregular or missing cycles, this is also for you.

Just an FYI….

Oral (or injectable) birth control is not recommended for female athletes experiencing amenorrhea or menstrual irregularities secondary to Relative Energy Deficiency in Sport (RED-S) & The Female Athlete Triad.

Yes, I said it.. it is NOT recommended.

The common theory that OCP’s and other forms of hormonal birth control help improve bone health and decrease fracture risk is a farce. Research shows that birth control can help maintain bone health, but it does not increase bone deposition or bone mineral density. So what does that mean for a female athlete with RED-S on OCP? 

Bone health impairments such as stress fractures, osteopenia, and osteoporosis are still a possibility. Especially if the primary causes of secondary amenorrhea and irregular cycles are masked by hormonal birth control. 

We can’t forget the reasons behind amenorrhea in the female athlete. It is often a result of low energy availability (energy output>energy intake) and under-recovery. A female’s body enters a hypoestrogenic state due to energy insufficiency. Not only will they lose their menstrual cycle, but can also experience things such as chronic fatigue, decreased endurance, depression & anxiety, poor bone health & poor sports performance. 

If we want to help improve the health and wellness of the female athlete experiencing RED-S, hormonal birth control may not be the best option. We need to examine the athlete with a wider lens. Please note, there are medical diagnoses (PCOS, PID, endometriosis) that will benefit from OCP/injectable birth control to address menstrual dysfunction. However, in the absence of such a diagnosis, the cause}  for menses loss needs closer examination before administering oral/injectable contraception.

If you are a female athlete (outside of menopause age) or have a young female athlete who has experienced menstrual irregularity, don’t just jump for the quick fix. Make sure you ask the questions! 

Let’s stop using band-aids for females experiencing RED-S! 

If you have any questions regarding the topic above, please feel free to use the contact form below!

Here’s to creating resilient & strong female athletes!

Cheers, 

Ashley