Hannah E. Cabre, Sam R. Moore, Abbie E. Smith-Ryan, FACSM. The University of North Carolina, Chapel Hill, NC.

BACKGROUND: Hormonal contraceptive (HC) use is often associated with positive and negative side effects, which may impact exercise performance. The purpose of this study was to characterize HC use, and the associated perceived side effects in active adult females. METHODS: 304 healthy, active adult females using HC between the ages 18-52 years living in the United States (Age=29.3±7.6 yrs; Ht=166.5±7.2 cm; Wt=67.7±13.4 kg; BMI=24.4±4.7 kg/m2; age of menarche=13.0±1.7 yrs) completed an online questionnaire based on previously validated assessments to characterize menstrual cycle, prevalence of HC use, perceived side effects, and physical activity. Physical activity was reported in minutes over seven days and was converted into METminutes/week (METmin/wk). Total METmin/wk was classified using the International Physical Activity Questionnaire categorical scores as high (HIGH; ≥3,000 METmin/wk; n=60) and moderate (MOD; ≥600 METmin/wk; n=244). Data are reported as descriptive statistics and proportions; Pearson’s chi-squared analyses were used to examine the relationships between categorical variables. RESULTS: Combined oral contraceptives were the most used (50.7%) followed by progestin-only contraceptives (hormonal intrauterine devices=39.1%; implants=5.9%; vaginal rings=4.1%). There were no significant differences between HIGH and MOD for incidences of premenstrual syndrome (56.7% vs. 51.2%, p=0.450), reports of painful periods (50.0% vs. 41.8%, p=0.450), perceived positive side effects (68% vs. 65.6%, p=0.686), or perceived negative side effects (53.3% vs. 56.1%, p=0.694). In the total sample, reduced bleeding (36.8%), cessation/less frequent periods (33.9%), and reduced cramps (30.3%) were the most common perceived positive side effects for HC use, while mood changes/swings (19.4%), weight gain (16.4%), and tiredness/fatigue/lethargy (12.8%) were the most reported perceived negative side effects. The highest reported positive side effects did not change when stratified for activity level. For negative side effects, MOD reported a higher incidence of weight gain (16.8%) and bloating (14.3%), while HIGH reported greater incidence of irregular periods (16.7%). CONCLUSION: HC use may have more benefits for exercise performance by reducing negative menstrual side effects, particularly in MOD active females. Practitioners and coaches should be aware of HC use as perceived symptoms may vary across activity level.

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