guest Post: Birth control and athletic performance

In this country, 62% of American women are using some form of contraceptive. Of those, almost 50% are using some form of hormonal method including the pill, patch, or injectable. The most popular form being the pill. While many women choose the pill to prevent pregnancy, it is also frequently prescribed for irregular cycles, acne, severe PMS or other hormonal imbalances. Many women prescribed these oral contraceptives are warned of potential side effects like blood clots, weight gain or breakthrough bleeding, but are woefully ignorant of some of the other detrimental effects that can be brought about by prolonged pill usage.  


As a former college athlete and a current elite CrossFit competitor, I never considered that my hormonal birth control could have potentially detrimental side effects on my athletic performance. It wasn’t something that was ever discussed by any physician that I ever saw with regards to gynecological health.  When my performance, sleep, mood and energy levels started to suffer a few years ago, I never thought that my birth control might be to blame.


Like many young women, I was on hormonal birth control for a number of years. In my late teens and early/mid twenties it seemed like everything was running just as it should be. I excelled in collegiate volleyball, achieved two bachelor’s degrees, worked for and even started some great companies. I also began competing in CrossFit at a very high level. My passion for CrossFit led to a passion for nutrition that then led me to my two current jobs,  an online nutrition coach for Power Athlete HQ and a functional nutritionist at Specialty Healthcare and Wellness in Houston, TX.  While I have always thrived on a busy schedule with high training demands, as I neared my 30’s things began to change. I found myself struggling to keep up with my demanding schedule and it seemed like no matter how much I WANTED to keep training CrossFit at a high level, I was feeling more and more fatigued. At this point in my life, my training and my athletic performance were (and still are) extremely high on my priority list.  Not being able to consistently train was really distressing. My sleep was also getting worse.  I would lie in bed feeling exhausted but struggle to turn my brain off in order to actually fall asleep.


As a practicing functional nutritionist, I chose many methods to try to diagnose and fix my mounting fatigue including nutritional support, supplementation, cutting back on work and training, and making sleep a bigger priority, but nothing seemed to truly solve my problems. After suggestions from colleagues and other health professionals, I decided to delve a little further into the research and found many ways in which that tiny little pill was killing my performance.


Oral contraceptives cause vitamin, mineral and antioxidant deficiencies including B6, Folate, B12, Zinc, Selenium, Magnesium, Phosporous and multiple antioxidants. B vitamins are utilized in the body to convert carbohydrates to energy, for red blood cell production, DNA synthesis and tissue and cellular repair. B12 deficiencies, in particular, are highly significant fatigue causers. Magnesium is utilized in over 300 reactions in the body, including the energy production pathway that allows mitochondria to generate ATP.  Antioxidant depletion affects the body in multiple ways. Antioxidant’s jobs are to neutralize free-radicals within the body. These free radicals actually damage the mitochondria within the cells and make them run less efficiently. In this way, oral contraceptives increase oxidative stress in the body. As an athlete, adequate energy production is essential to keeping a high level of performance and, as far as antioxidants go, exercise does create oxidative stress in the body. If the body is unable to handle the oxidative stress associated with daily living due to low antioxidant levels, there is no way that it can effectively handle the additional oxidative stress created through training. It’s a double whammy to those cells! Now, it can be assumed that perhaps aggressive supplementation of these nutrients could neutralize the negative effects, but there’s one major influence that the pill has on the body that cannot be fixed with supplementation.  I truly believe this is the most detrimental to athletic performance, the increased production of sex hormone binding globulin or SHBG. SHBG is a special kind of protein that binds testosterone and renders it inactive. This is one of the reasons the pill is prescribed for acne.  It is believed that excess testosterone can result in increased acne. The problem for female athletes is that we naturally have lower levels of testosterone than our male counterparts.  Testosterone is linked to increased muscle mass, bone mass, competitive drive and sex drive. You can see how an increased binding of the small amount of testosterone that we have could cause serious problems for female athletes, especially those (like CrossFitters) whose sport has a very large strength and weightlifting bias.


To me, the research is clear. Extended use of oral contraceptives decreases athletic performance and increases fatigue.  For those of us who still wish to avoid pregnancy, finding a reliable form of non-hormonal birth control is paramount. That’s why I’m grateful to have been introduced to The Creighton Model FertilityCare System. The CrMS uses a standardized, scientific approach to fertility and when used appropriately has a 99.5% effectiveness at avoiding pregnancy, which is comparable to many forms of hormonal methods and higher than condom usage. Since discontinuing oral contraceptives, my sleep has been better, my fatigue has lessened exponentially and even my digestive health has improved! If you have found yourself struggling with fatigue and have slowly watched your performance slip, I encourage you to find a Certified FertilityCareTM Practitioner  and watch these small changes pay off big in the gym and in life!




Guttmacher Institiute (2015, October) Contraceptive Use in the United States. Retrieved August 22, 2016, from


Panzer C., et al.  Impact of oral contraceptives on sex hormone-binding globulin and androgen levels: a retrospective study in women with sexual dysfunction. J Sex Med 2006 Jan; 3(1): 104-13.


Zal F, et al. Effect of vitamin E and C supplements on lipid peroxidation and GSH-dependent antioxidant enzyme status in the blood of women consuming oral contraceptives. Contraception. 2012 Jul;86(1):62-6.



Akinloye O, et al. Effects of contraceptives on serum trace elements, calcium and phosphorous levels. West Indian Med J. 2011 Jun;60(3):308-15. 

Leah Kay, RN, BSN

Leah is married to Neal Kay and together they co-own CrossFit Katy in Katy, TX. She holds a Bachelor’s Degree from Trinity University where she also played four years of Division III Volleyball, helping her team finish 5th in the NCAA DIII National Championships her Senior year. She also holds a bachelor’s of science in Nursing from University of Texas Health Science Center-Houston and is currently studying to become a Nutritional Therapy Practitioner Certified through the Nutritional Therapy Association.  She is passionate about helping athletes of all levels improve their athletic performance through proper nutrition and supplementation and does this through her work as a functional nutritionist at Specialty Healthcare and Wellness and as an online Nutrition Coach for Power Athlete HQ. 

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