Over the previous year, many female athletes have talked regarding the influence of menstruation on their athletic performance and the usage of oral contraceptives to control the menstrual cycle. However, limited knowledge is present about oral contraceptives (OC), especially hormonal OC related side effects on athletes’ health. The study enlightens the OC related side effects and period prevalence among elite athletes.

The study aimed to determine the period prevalence of hormonal contraceptive (HC) use and characterisation the noticed side effects related to HC use and the menstrual cycle.

A questionnaire developed to evaluate the causes behind HCs initiation and discontinuation, period prevalence of HC use, and 430 elite female athletes filled side effects perceived by non-HC and HC users. The measurement of between-groups comparisons, associations between categorical variables and descriptive statistics were done.

A total of 69.8% of athletes went for HCs at some point, and 49.5% were those who currently use HCs. Most commonly used HCs were the combined oral contraceptives (68.1%), including 30.0% using progestin-only contraceptives (intrauterine system = 2.8%, injection = 3.7%, and implant = 13.1% ).  Progestin-only HC (39.1%) users exhibited more adverse effects (high in implant users) than combined-HC users (17.8%; P = .004). Athletes used HCs showed positive perceived side effects associated with their ability to manipulate or predict the frequency, amount and timing of menstrual bleeding. On the other hand,  77.4% Non-HC users informed adverse side effects while their menstruation, principally during days 1–2 of menses with  29 (5) days menstrual cycle length.

The HCs used by almost half of the elite athletes. Progestin-only contraceptive users showed higher incidences of adverse effects. Practitioners and athletes should sustain an open dialogue to proceed the athlete best interest due to the high interindividual variability in recorded side effects.