Contraception in female athletes

Background Girls and young women are frequently active in sports but only some of them have a special physical strain as top athletes due to performance-oriented training and competitions. Question Which relevant aspects of contraception regarding the balance of performance and the influence of sexual steroids must be taken into account for counselling top female athletes? Material and methods There is a broad spectrum of contraceptive methods. Studies and publications about contraceptive methods focus on advantages and disadvantages but not on possible interactions of sexual steroids and physiological functions. This article presents publications on the topic of contraception in elite female athletes from recent years, systematic reviews and international guidelines which also considered these aspects. Results The productive cooperation between sport science and medicine has produced many studies on the interaction between athletic performance and the menstrual cycle as well as contraceptive methods in recent decades; however, there is still a lack of prospective randomized controlled trials on specific research questions. Conclusion Female top athletes use hormonal contraceptives to a similar extent as girls and women of the same age. For top female athletes in different sports, various aspects must be taken into account choosing the optimal contraceptive method with possible additional benefits but also considering negative effects and complications.