The Fit Girl’s Guide to Birth Control

Women are such amazing creatures that it’s downright mind boggling at times. I know what you’re thinking – you and I are both women, so such self-praise sounds a bit excessive.

But really, think about it for a minute. Our physical makeup is dramatically different from that of our male counterparts. We have to train nearly twice as hard to make any substantial gains in the gym, and we’re genetically preprogrammed to store more fat than men, all because of the differences in our hormonal makeup.

Let’s face it, ladies, our bodies are built for child rearing, not heavy lifting or figure competitions. Regardless of whether those babies are a goal of yours or not, your system will always do its best to ensure a soft & comfortable atmosphere for that baby’s development during the first nine months of its existence.

Nature’s plan.

What’s even more interesting is the fact that if you’re actively working on preventing pregnancy, you’ll likely have an increased hormonal imbalance and even more pronounced effects of the estrogen hormone doing its job.

Not sure what I’m talking about? There is a phrase that will conjure up memories of bloat, fat gain, nausea, spotting or breakthrough bleeding, mood swings, and even severe headaches. It’s a short phrase with a lot of power. Ready?

“The Pill.”

Most of those who’ve tried birth control pills are well aware of their possible side effects. These are to be expected; anytime hormone levels are changed in any way, the body is bound to let you know of the changes.

Birth control pills are comprised of synthetic estrogen and progesterone (or in some cases, just one of those two). Since the menstrual cycle and ovulation are regulated by these hormones, this increase results in a variety of changes within the reproductive system, which results in pregnancy prevention.

Now, as any woman in the fitness industry knows, we try our very best to decrease the female hormones in our bodies. We all know that increased levels of testosterone, along with decreased estrogen hormones, are essential to the sense of well-being and overall health.

It’s testosterone that helps us gain lean mass, reduce fat storage, increase sexual desire, ward off that “I’m PMS’ing-leave-me-alone” mood, keep our skin healthy, and our minds sharp. Excessive levels of its opposing hormone, estrogen, produce the exact opposite effect on our bodies.

Clearly, increasing your very own estrogen levels by going on the pill sounds more than just a little crazy. It is, however, seen as an absolute necessity by most women. Many of us just accept the unfortunate side effects and learn to deal with the consequences of a less than perfect hormonal balance.

After all, what else is there?

That’s the question we’ll answer in this article. I’ve done some extensive research on the topic, including interviewing numerous fitness and figure competitors regarding their personal experiences with birth control pills. Each of these girls has discovered what works for her; whether it’s a lower dose estrogen pill or a viable alternative that does the job while keeping those hormone levels at least somewhat conducive to her hardcore fitness lifestyle and ultra-lean body goals.

The Pill

Types of Birth Control Pills

There are two basic categories: those containing progestin only, and combination pills containing both progestin and estrogen.

Progestin-only pills contain no estrogen. These are sometimes referred to as the “mini-pill,” and are considered ideal for breastfeeding women since the presence of estrogen reduces milk production.

The mini-pill works by thickening the cervical mucus, thereby preventing sperm from entering the uterus. They must be taken at the same time every day.

While these pills don’t contain any estrogen, they’re not considered figure-friendly by any means. You see, the pill’s progesterone component has been shown to increase appetite – which of course makes it very difficult to diet, resulting in weight gain.

Some of the other side effects of the mini-pill include irregular or heavy bleeding, spotting, and severe headaches. Additionally, progestin-only pills have been shown to be slightly less effective than their combination counterparts – so that the chance of becoming a mommy is actually increased when choosing these over estrogen containing birth control pills.

Combination pills are ones containing both estrogen and progestin. This category can be broken down into three different types, which are as follows:

Monophasic pill. This is the original birth control pill. Each pack of these pills consists of 21 active pills containing the same amount of estrogen and progestin in each pill, and 7 placebos, which contain no hormones.

The second type of the combination pill is called multiphasic.Also referred to as biphasic and triphasic, multiphasic oral contraceptives contain varied amounts of hormones and are designed to be taken at specific times over the pill-taking period.

Each of the pills in this pack contains different levels of estrogen and progestin so that the hormones are varied throughout the month. They were developed for the specific purpose of reducing side effects of oral contraceptives. Women taking multiphasic pills report having fewer episodes of breakthrough bleeding and spotting, but as of now, those are the only sides that have been shown reduced.

The last type of the combination pill is the continuous use pill. This is the brand new one of the bunch, being approved in the spring of ’07. The best known brand of the continuous use pill is Lybrel, which also happens to be a multiphasic pill. It comes in a 28-day pack and is meant to be taken without any breaks in between pill packets, which basically means not having a period at all.

Some of the side effects associated with all combination oral contraceptives include most of the ones you’d normally hear about, including nausea, severe headaches, possible vomiting, irregular bleeding, and weight gain resulting from the changes in the body’s hormonal makeup.


Birth Control Options for Fit Girls

Now that we’ve gone over the basic differences among the pills, let’s take some time discussing ones that seem to be popular with women who are in the fitness industry.

Those ladies who are on the pill and training hard almost always opt for low dose pills. Low dose birth control pills are mostly monophasic pills that have an estrogen component of less than 35 micrograms. Some examples of this type of pill include LoOvral, Nordette, and Ortho-Cept.

There are also two newer formulas of low dose pills on the market, both of which have become a quick favorite among many figure competitors. Cyclessa is a brand new low dose oral contraceptive that’s also multiphasic. The low estrogen in its varying-hormone package has actually been shown to result in weight loss for many women who begin taking it… and those who didn’t lose any noticeable weight, didn’t gain any fat, according to the studies.

Yasmin is another newer low dose pill with many fit ladies in its fan club. Because of a more natural progestin in its formula, it’s been associated with improved skin texture for those who are naturally oily or acne-prone, an improved sense of well-being, and even weight control help due to reduced water retention.

Ultra low dose pills exist as well, and these are ones that have the lowest amount of estrogen in a birth control pill, which is 20 micrograms. This dose of estrogen is sufficient for contraception, however these pills oftentimes result in more spotting and breakthrough bleeding than pills containing 30-35 micrograms of estrogen, which is why most women who’ve tried them end up opting for the low dose pills instead.

If you’re interested in trying an ultra-low oral contraceptive, two of the most popular ones are Alesse and Mircette, with the prior being a favorite of three figure competitors I’d interviewed.

One other factor that’s interesting when it comes to all oral contraceptives (even low dose ones) is that they’ve been shown to decrease total and free testosterone by almost half, while increasing total cortisol levels. This, of course, is quite a negative effect for all of us trying to build muscle – it’s just bad news from the anabolic perspective.

Tired of taking pills? Read on!

Pill Alternatives

Now if none of the aforementioned sides scare you, and the only thing you dislike about the oral contraceptives is the oral part, there are a couple of alternatives that work in ways very similar to that of the low dose pills, without having to take the actual pill!

These are the NuvaRing and the Patch. Both work by supplying the same amount of hormones as low dose pills, so side effects along with benefits are very similar. Ladies who dislike taking pills may find it easier to go with either of these two, though each of the two has its own inconveniences.

NuvaRing is a small, flexible ring inserted into the vagina once monthly. It’s left in place for three weeks, and then taken out for a week. Once that week’s passed, a new ring is inserted for the following three-week period.

A few of the fitness ladies I spoke with find the NuvaRing to be very practical. One of them mentioned that it’s helped her get rid of the terrible migraine headaches she used to get with the low dose pill while also helping her lose some water weight she’d been carrying.

The Patch operates by delivering the hormones directly into the bloodstream through the skin via a thin patch. It must be replaced once weekly for three weeks straight, taking a break on the fourth week. The Patch may be applied just about anywhere on the body, and needs to stay in place at all times – regardless of the activity (yes, even training, cardio, or bathing).

As you’d suspect, this wasn’t a favorite of any of the girls’ I’d spoken with. Two of them had experimented with it as it seemed like a convenient, easy birth control method; both were quickly disappointed as the Patch began irritating their skin after just a couple of cardio sessions. My guess is it just wasn’t created with fitness-oriented ladies in mind.

The Patch

There’s just one other thing I’d like to mention about the NuvaRing and the Patch. Both have caused quite a bit of controversy since their FDA approval. Over the past several months, there’ve been a number of lawsuits filed against both companies, claiming that the birth control devices are responsible for blood clots, resulting in stroke, heart attacks, and even death.

Neither of the devices has been taken off the market, and both companies are maintaining innocence, stating that their products have proven to be safe in most cases.

My personal advice? Do your own research and be sure that your decision is an informed one.

Non-Hormonal Alternatives

For those of you hoping to stay away from anything that will alter your natural hormone levels, there are alternatives. The majority of fitness and figure girls I’ve spoken with, have opted for hormone-free birth control methods – everything ranging from male and female condoms, diaphragms, cervical caps, and lea’s shields (all of which work by creating a physical block), to longer lasting methods, such as the IUD… to permanent ones, like tubal ligation.

Since the IUD seemed to be the most obvious choice for most of the competing ladies, I’d like to discuss that in depth. An IUD is a tiny, T-shaped device that gets inserted directly into the uterus by your OB/GYN. It’s made of soft plastic and contains either copper or hormones.

The non-hormonal ones are the ones I’d like to focus on, as these are the ones most popular in the fitness world. These are known as the ParaGard Copper T 380A IUD, contain copper, and can be worn for up to 12 years. They are effective as soon as they’re inserted and can be removed at any time.

Mirena IUD

Keep in mind that ovulation still occurs when you use an IUD, so you’ll still have your period. Many women complain of more intense cramps and heavier or irregular periods, but most of the fitness-oriented girls find these sides to be a small price to pay for stable hormone levels and the ability to maintain a higher level of testosterone.

Another detail to keep in mind is the IUD installation process itself. It isn’t a pleasant experience by any means – many of the ladies I spoke with said it was one of the most painful experiences they’d endured. But really, just put things into perspective for a second: the insertion lasts for about five minutes, and you’ll most likely be worry-free for a period of over 10 years!

If you don’t already have kids, the IUD may not be suitable for you. The company states that women who have never been pregnant before have an increased risk of expulsion (expelled by the body, usually within the first year) due to a smaller uterus and difficulty with insertion. Check with your doc and follow his or her recommendations when it comes to your particular case.

I’d also like to note that many women are concerned about the safety of copper IUD’s. This concern is mostly grounded in a few events that took place in the 70’s when the very first IUD to hit the market (known as the Dalkon Shield) had to be recalled after 12 of its 2.8 million users died.

The Dalkon Shield was pulled out of doctor’s offices immediately, and although no other IUD since that period has ever been found unsafe, their reputation remains somewhat tarnished. If you begin to seriously consider this device, be sure to do your research just as you would with anything else – plenty of information is available upon an Internet search.


And that, ladies, pretty much sums up your birth control options. My only hope is that this article gave you a starting point for your own research and made you a more informed patient, one who’ll enter the OB/GYN’s office armed with knowledge.

Keep in mind that the effects any birth control pill will have on anyone will depend on not only the combination and the dose you’re taking, but also on your individual hormonal makeup and response. Because of this, the final decision is best left to you and a doc you trust.