Prevalence and Self-Perceived Experiences With the Use of Hormonal Contraceptives Among Competitive Female Cross-Country Skiers and Biathletes in Norway: The FENDURA Project

Tina P Engseth; Erik P Andersson; Guro S Solli; Bente Morseth; Tor Oskar Thomassen; Dionne A Noordhof; Øyvind Sandbakk; Boye Welde

doi:10.3389/fspor.2022.873222

Prevalence and Self-Perceived Experiences With the Use of Hormonal Contraceptives Among Competitive Female Cross-Country Skiers and Biathletes in Norway: The FENDURA Project

Front Sports Act Living. 2022 Apr 14:4:873222. doi: 10.3389/fspor.2022.873222. eCollection 2022.

Authors

Tina P Engseth¹, Erik P Andersson¹, Guro S Solli^{1

2}, Bente Morseth¹, Tor Oskar Thomassen¹, Dionne A Noordhof³, Øyvind Sandbakk^{1

3}, Boye Welde¹

Affiliations

¹ School of Sport Sciences, UiT, The Arctic University of Norway, Tromsø, Norway.
² Department of Sports Science and Physical Education, Nord University, Bodø, Norway.
³ Department of Neuromedicine and Movement Science, Centre for Elite Sports Research, Norwegian University of Science and Technology, Trondheim, Norway.

Abstract

Purpose: To investigate the prevalence of hormonal contraceptive (HC) use by female cross-country (XC) skiers and biathletes competing at a national and/or international level, their reasons for HC use, and to compare negative symptoms related to the HC-/menstrual cycle in HC users and non-HC users. Additionally, to characterize the self-perceived influence of HC use on training and performance.

Methods: A total of 113 Norwegian competitive XC skiers and biathletes completed an online questionnaire including both closed and open-ended questions. The questions were designed to assess the type of HC, reasons for use, self-reported negative symptoms related to HC-/menstrual cycle, as well as athletes' experiences regarding how HC use affects training and performance.

Results: In total, 68% of all the athletes used HC, with 64 and 36% of them using a progestin-only and combined type HC, respectively. Non-contraceptive reasons for HC use were reported by 51% of the progestin-only HC users vs. 75% of the combined HC users (P = 0.039), with reduction of negative menstrual-related symptoms as the most common reason. Of the athletes reporting regular withdrawal bleedings in connection to HC use, 80% of the progestin-only and 86% of combined HC users experienced negative menstrual-related symptoms, which was comparable to the non-HC group (86%). The majority (81%) of HC users experienced solely positive, or no effect, of HC use on training and performance, with no differences between progestin-only and combined HC users (P = 0.942).

Conclusions: In total, 68% of the XC skiers and biathletes used HC, with the highest proportion (64%) using a progestin-only HC. Many athletes used HC to manipulate their menstrual cycle due to perceived negative menstrual-related symptoms that interfered with their training sessions and/or competitions.

Keywords: combined hormonal contraceptives; endurance; female athletes; hormonal contraceptives; progestin-only hormonal contraceptives.