Birth control is a complicated topic for many women, runner or not. If choosing a hormonal birth control pill, there’s a myriad of options, and among those options there’s a myriad of ways your body might react to the new hormones you’re putting in your body.
When it comes to runners choosing a hormonal birth control method (or any athlete for that matter), there’s a lot to consider. Runners seek medical attention and crowdsource with running friends as to what they’re on and how it has worked for them–but unfortunately, you won’t know how your body does on the Pill until you try it.
Phoebe Wright is a five-time NCAA champion and former professional runner who’s also a pharmacist. She tweeted on the topic on Monday, outlining a lot of the pitfalls that athletes can run into.
*Potential* pros of oral birth control:
1. Consistent hormones
2. Less menstrual irregularities
3. Control over when you have your period
4. Less iron (blood) loss
1. Weight gain
2. Increased fat mass
3. Mood swings
4. It's hard to find the right one
— Phoebe Wright (@Phe800) November 4, 2019
How birth control works
Hormonal birth control prevents the hormone surge required for ovulation. The progestin (the hormone in the birth control pill) makes the uterus less suitable for implantation. Some experts believe these hormonal fluctuations can cause a performance bump. Some also believe women experience a performance decline at certain points in the cycle. Birth control prevents these hormonal fluctuations and may result in more consistency in performance.
What athletes should watch for
When choosing a birth control method, Wright explains that there are two main hormones involved: estrogen and progestin. The main difference between pill brands is the dose of ethinyl estradiol (or estrogen.) If your estrogen is too low, you may have spotting between periods. If it’s too high, you may experience nausea, weight gain and breast tenderness. In general, Wright recommends that runners stay low when it comes to estrogen levels.
Wright says the most important thing is finding a method that works with your body. “You’ll know within two months if it is a good fit. Your mood should be stable, there should be minimal weight gain and spotting and your training shouldn’t be affected. If it is not right, switch.”
Wright says the most common concern with birth control and running is that it will hinder training. “This is a valid concern. When running is a part of your life, running well makes you happy, and being happy makes you run well. It’s hard to be happy or run well if your hormones are controlling all your actions. The biggest hindrance birth control can have on your training is weight gain. The ethinyl estradiol can cause you to gain fat, and the progestin can cause water retention. It’s not much, maybe two to three pounds on average. Weight gain does not happen with every athlete or every birth control type. I never experienced weight gain while on birth control. There is conflicting evidence if weight gain is even seen in athletes taking birth control. If this side effect happens, it is usually in the first couple of months, and it comes off within a month.”
- Take it [the pill] at the same time every day to prevent spotting.
- Stomach upset or nausea? Try taking your birth control with food.
- Never make life changes during the season (as long as you can help it.) That’s the number one rule. Start birth control in the off-season so you have time to monitor how it affects your body. If it doesn’t feel right, stop or switch.